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Gestational Diabetes

Study various aspects of Gestational Diabetes Mellitus (GDM) & comorbidities using ANC records from BKLWH

(ANC clinic data from March 2018-2020 Onwards)

Introduction

Gestational diabetes mellitus (GDM) is defined as glucose intolerance that is first recognized in pregnancy includes

  1. Gestational diabetes arising de novo in pregnancy develops in 2nd trimester and is induced by maternal insulin resistance.
  2. Also previously undiagnosed diabetes or IGT

Institutional Ethics Committee approval for the DEVRAN Cohort study

Main objectives

  1. Estimate the prevalence of GDM
  2. Generate control group (non diabetic pregnancies) and do comparison of maternal characteristics (family history, weight gain, blood pressure etc) as well as neonatal outcomes ( placental weight,
    anthropometry)
  3. Compare foetal growth using USG data (Do GDM foetuses grow faster?)

Metabolism in non-diabetic pregnancy

  1. Normal pregnancy includes insulin resistance through the diabetogenic effects of placental hormones and progesterone.
  2. The maximum effect is seen in late second and third trimesters.
  3. Maternal insulin sensitivity is reduced in pregnancy by about 50% by the end of second trimester
  4. Post prandial blood glucose levels rise with compensatory hyperinsulenemia and enhanced lipolysis
  5. These conditions favour nutrient transfer of the fetus.

Methodology

Study Design

Longitudinal

Anthropometry

Weight by electronic weighing scale, height by stadiometer, circumference using seca tape.

Body Composition

Body composition is assessed using bioelectrical impedance using MC-780 analyser (TANITA,
Japan).

Dietary Assessment

Dietary diversity and nutritional intake estimated using 24 hour recall.

Health Education

About nutrition, physical fitness and normal ergonomics

Gestational Diabetes in Undernourished Women of Konkan Region

By DIPSI guidelines

Study Overview

Total 506 pregnant women have completed Oral Glucose Tolerance Test

Basic Characteristics of Subjects

26.7
Age (years)

23.1
Gestation (weeks)

48.3
Weight (Kg)

20.5
BMI (Kg/Sq.m)

Prevalence

20.3%
Prevalence of Gestational Diabetes Mellitus
Despite absence of overweight

24%
Diagnosed in Early Gestation

Gestational Diabetes Data by Gestation Period

Gestation at GTT Subjects with 2 hour plasma glucose ≥140mg/dl Weight (kg) at diagnosis
All 103 (20.3%) 48.4 ±10.1
0-16 weeks 25 (24.3%) 46.0 ±9.9
16-20 weeks 14 (13.6%) 47.2 ±8.3
20-24 weeks 13 (12.6%) 48.7 ±10.0
24-28 weeks 16 (15.5%) 49.6 ±9.4
>28 weeks 35 (34.0%) 50.0 ±11.1

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