South - East Asia is the home of one fifth (19%) diabetic people of the world. Bangladesh has the 2nd largest diabetic population in this region. One in four live births are affected by hyperglycaemia during pregnancy. Gestational diabetes mellitus (GDM) is one of the main contributor to this. GDM is defined as development of glucose intolerance/hyperglycaemia during 2nd & 3rd trimester of pregnancy who were previously known to be normoglycaemic. The aim of this study was to compare the Incidence of GDM between 13 to 28 weeks of gestational period (group 1) & after 28 weeks of gestational period (group 2), management & outcome of these 2 groups as well as the evaluation of the risk factors.
250 newly diagnosed GDM cases were randomly selected. Patients underwent for Oral Glucose Tolerance Test (OGTT) (75 gm glucose) irrespective of the presence of the risk factors of GDM during 2nd & 3rd trimester of pregnancy while antenatal visit & were diagnosed according to International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Thorough histories were taken & examinations were done for evaluating the risk factors. All data were compiled & statistically analyzed in SPSS version 23.
The incidence of GDM from 13 to 28 weeks of gestational period (group 1) were 60% of the study population & the rest, 40% were diagnosed after 28 weeks of gestational period (group 2).70% of group 1 & 77% of group 2 population required only life style modification (diet chart + exercise) for the management of GDM. Only 30% & 23% of group 1 & 2 population respectively required insulin. It is seen that almost 74.6% of the total participants had overweight or obesity as their risk factors along with 40% others having risk factors as family history of diabetes.
As we can see that most of the participants in this study had overweight or obesity as their risk factors, that is reflected in the treatment and management of them also. Most of the patients were taken into normal range of blood glucose by giving specific diet chart and daily exercise only. Again we can see from the study that participants are getting diagnosed as GDM patients after 28 weeks also at a large number.
Although the ideal protocol is to check for GDM before 28 weeks of pregnancy, but it should be considered that patients can develop GDM even after this period of time, specially those who are with risk factors. So specific action as doing OGTT has to be implemented in place so that no patient gets left behind and everybody gets proper treatment which will improve the ultimate fate of the pregnancy scenario.
Dhaka, Dhaka, Bangladesh
ASSISTANT PROFESSOR OF DEPARTMENT OF ENDOCRINOLOGY AT AD-DIN WOMEN'S MEDICAL COLLEGE, MOGBAZAR ,DHAKA,BANGLADESH.
POST GRADUATION STUDENT
Epidemiology, Dhaka, Bangladesh
I am a medical graduate. I completed my MBBS from Ibrahim Medical College and BIRDEM General Hospital under University of Dhaka. After that I completed my one year clinical internship training. Following that I worked as a Lecturer in Department of Community Medicine at Ad-Din Women's Medical College & Hospital for two years. Now i am enrolled in Master's in Public Health ( MPH) in Epidemiology at Bangabandhu Sheikh Mujib Medical University (BSMMU).