PREVALENCE OF GLUCOSE INTOLERANCE IN POST-PARTUM WOMEN WITH HISTORY OF GESTATIONAL DM
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Keywords
gestational diabetes mellites, pregnant women’s, glucose tolerance test
Abstract
with onset or first recognition during pregnancy. This definition helps for diagnosis of unrecognized pre-existing Diabetes also. The definition applies whether insulin or only diet modification is used for treatment.
Aims- prevalence of glucose intolerance in post-partum women with history of gestational DM.
Materials and methods- this is prospective observational study done in Department of obstetrics and Gynaecology, MGM Medical college and MY hospital, Indore from January 2020 to January 2022 in 100 patients. All pregnant women with GDM who are attending antenatal outdoor and admitted for delivery at obstetrics and gynecology, Department studied. A total 100 pregnant women had been selected as study population on the basis of inclusion and exclusion criteria. Informed consent had been taken from every patient for their voluntary participation. Necessary information had been collected as per Performa which had include Basic information, chief complain, obstetric history, menstrual history, past medical and surgical history, dietary habit, family history, gestational age at which GDM detected, treatment received during antenatal period for GDM.
Results- mean age (Mean ± S.D.) of patients being 25.4400±3.6991 years. Proportion of patients was significantly higher in age group 26-30 years. The prevalence of GDM was found to be higher in women belonging to upper middle class (49.0%). It was found that 30(30.0%) patients had BMI <25 kg/m2, 51(51.0%) patients had BMI 25-30 kg/m2, 19 (19.0%) patients had BMI 30.0 -35.0 kg/m2 and no patient had BMI >35.0 kg/m2. GDM was more prevalent among patients with positive family history of DM. Maximum number of GDM patients were diagnosed between 24 -28 weeks of gestation with a mean (± S.D) of 26.42+3.4994. 34% Patients treated with insulin therapy,30% were on oral hypoglycemic drug and 36 %were controlled with diet modifications. The mean gestation age of delivery (Mean± S.D.) was37.6120±1.5270weeks.In postpartum period, 6 weeks following delivery 14 % cases persistently developed impaired fasting glucose and 15% cases developed impaired glucose tolerance. Following 12 weeks of post-partum period 9% cases had impaired fasting glucose and 6% cases had impaired glucose tolerance. On the basis of PPBS 5% Patients convert to diabetes at 6 weeks and 1% patients at 12 weeks follow up.
Conclusion- In present study, increasing maternal age, increased BMI, upper socioeconomic status, family history of DM was significantly associated with GDM. If blood sugar level was not controlled with diet and exercise, then oral hypoglycaemic (metformin) and insulin therapy (human insulin, insulin analogs) were used.GDM women have high risk of developing diabetes in the future and need to be followed postpartum to reduce the risks for complications of diabetes and to avoid conception of future pregnancies in the setting of uncontrolled hyperglycaemia. In conclusion, as rates of type 2 diabetes continue to increase, women with GDM should be educated that glucose intolerance may not be temporary, that it can be modified by behaviour changes and that is why postpartum testing is important.
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Dr Richa Sharma
SR OBGY, Gajra Raja Medical College, Gwalior.
Dr Rini Bachotiya
Assistant Professor, RD Gardi Medical College, Ujjain.