Volume 4, Issue 3, September 2019, Page: 73-82
Review of FIGO & ADA, WHO, IADPSG Guidelines for GDM for Low Resource Setting and Integration of DIPSI with MOHFW Govt of India, Guidelines
Rajesh Jain, Gestational Diabetes Prevention Control Project, Maternal Health, National Health Mission, Lucknow, India
Susanne Olejas, World Diabetes Foundation, Copenhagen, Denmark
Lee Sam Goo, 239 Bio Inc, Jangsu-eup, South Korea
N. Bhavatharinin, S. R. C. Diabetes Care Centre, Erode, India
Ashish S. Dengra, Department of Medicine, Mahi Diabetes Thyroid Care & Research Centre, Jabalpur, India
Reza Shoghli, Department of Cardiology, Tehran Heart Center, Azad University of Tehran, Central Branch, Iran
Sanjeev Davey, Department of Community Medicine, Muzaffarnagar Medical College, Muzaffarnagar, India
Rachna Jain, Department of Obstetrics & Gynecology, Jain Hospital, Kanpur, India
Received: May 21, 2019;       Accepted: Jul. 19, 2019;       Published: Sep. 4, 2019
DOI: 10.11648/j.ijde.20190403.12      View  670      Downloads  93
OGTT is performed in pregnant women by measuring the plasma glucose in fasting or non-fasting after 2-hour ingesting 75 grams of glucose (Monohydrate Dextrose Anhydrous). For diagnosing gestational diabetes (GDM) Indian Guidelines (DIPSI Test) are simple and can be done easily in low resource setting where large number of pregnant women visit for ANC check-up. The severity of GDM increases because of the action of insulin is diminished (insulin resistance) due to raised hormone secretion by the placenta. Other risk factors for GDM are being elderly, increased BMI, or obesity, weight gain in pregnancy, history of diabetes in family, stillbirth or a congenital abnormality in previous deliveries. GDM has previously been considered to be transient during pregnancy and resolve after pregnancy but, pregnant women with hyperglycaemia are at higher risk of developing GDM in subsequent pregnancies and about half of the women with a history of GDM will develop type II Diabetes within five to ten years after delivery. DIPSI simple testing protocol is endorsed by the National Health Mission (GOI) Guideline on GDM, and also endorsed by the FIGO guideline on HIP for use in South Asia. This testing protocol has been followed by Sri Lanka, Pakistan and Bangladesh in the region. Tamil-Nadu state and Uttar Pradesh states in India launched a Universal GDM Program in 2007 and 2016 respectively, covering all pregnancies by testing and managing GDM with MNT, Metformin and Insulin in most of health care facilities. Around 28,000 ANM have been given glucometers, strips, glucose 75 gm packets for implementation of the largest GDM program in Uttar Pradesh, India to date.
To cite this article
Rajesh Jain, Susanne Olejas, Lee Sam Goo, N. Bhavatharinin, Ashish S. Dengra, Reza Shoghli, Sanjeev Davey, Rachna Jain, Review of FIGO & ADA, WHO, IADPSG Guidelines for GDM for Low Resource Setting and Integration of DIPSI with MOHFW Govt of India, Guidelines, International Journal of Diabetes and Endocrinology. Vol. 4, No. 3, 2019, pp. 73-82. doi: 10.11648/j.ijde.20190403.12
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hod M, Kapur A, Sacks DA, et al. The International Federation of Gynaecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care.
Guariguata L, Linnenkamp U, Beagley J, et al. Global estimates of the prevalence of hyperglycaemia in pregnancy. Diabetes Res Clin Pract 2014; 103: 176–85.
American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2003; 25: s5–s20.
World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. World Health Organization, 2013; WHO/NMH/MND/13.2.
Fetita LS, Sobngwi E, Serradas P, et al. Consequences of fetal exposure to maternal diabetes in offspring. J Clin Endocrinol Metab 2006; 91: 3718–24.
IDF 2017 International Diabetes Federation IDF Diabetes Atlas 8th ed. http://www.idfatlas.org
Magee, MS., Walden, CE. (1993) 'Influence of diagnostic criteria on the incidence of gestational diabetes and perinatal morbidity', JAMA, 269 (5), pp. 609-15.
Mohan, V., Sandeep S, (2007) 'Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res', 125, pp. 217-30.
Haeusler, M., Weiss, PA. (2000). 'Can glucose tolerance test predict fetalhyperinsulinism?' BJOG, 107 (12), pp. 1480-5.
Behera, MK., Das, S, and Misra, S. (2010)'B-cell function and insulin resistance in pregnancy and their relation to fetal development', Metab Syndr Relat Disord, 8 (1), pp. 25-32.
Anjalakshi, C., Balaji V and Balaji M. (2011) 'Inadequacy of fasting plasma glucose to diagnose gestational diabetes mellitus in Asian Indian Women', Diabetes Res Clin Pract, 94 (1), pp. 21-3.
Maternal health Division (2018) ‘Diagnosis & Management of Gestational Diabetes Mellitus Technical and Operational Guidelines’, Ministry of health & family Welfare, GOI.
American Diabetes Association ‘Management of diabetes in pregnancy: Standards of Medical Care in Diabetes 2018’. Diabetes Care 2018; 41 (Suppl. 1): S137–S143.
AAO 2014 ‘Screening for Diabetic retinopathy, American Association of Ophthalmology, www.aao.org/clinical statement.
Bullo M, Tschumi S, Bucher BS, Bianchetti MG, Simonetti GD. Pregnancy outcome following expo- sure to angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists: a systematic review. Hypertension 2012; 60: 444–45.
Kazmin A, Garcia-Bournissen F, Koren G. Risks of statin use during pregnancy: a systematic review. J Obstet Gynaecol Can 2007; 29:906– 908.
Charron-Prochownik D, Downs J. Diabetes and Reproductive Health for Girls. Alexandria, VA, American Diabetes Association, 2016.
Dabelea D, Hanson RL, Lindsay RS, et al. Intra- uterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant siblings. Diabetes 2000; 49: 2208–2211.
Duckitt K, Harrington D. Risk factors for pre- eclampsia at antenatal booking: systematic re- view of controlled studies. BMJ 2005; 330: 565.
Henderson JT, Whitlock EP, O’Conner E, Senger CA, Thompson JH, Rowland MG. Low- dose aspirin for the prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force [article online], 2014. Rockville, MD: Agency for Healthcare Research and Quality. Available from http://www.ncbi.nlm.nih.gov/books/NBK196392/.
Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy out- comes: a population-based study. Lancet 2006; 368: 1164–1170.
Stuebe AM, Rich-Edwards JW, Willett WC, Manson JE, Michels KB. Duration of lactation and incidence of type 2 diabetes. JAMA 2005; 294: 2601–2610.
Pereira PF, Alfenas R de CG, Arau´jo RMA. Does breastfeeding influence the risk of developing di- abetes mellitus in children? A review of current evidence. J Pediatr (Rio J) 2014; 90: 7–15.
Han S, Crowther CA, Middleton P, Heatley E. Different types of dietary advice for women with gestational diabetes mellitus. Cochrane Database Syst Rev 2013; 3: CD009275.
Rowan JA, Hague WM, Gao W, Battin MR, Moore MP; MiG Trial Investigators. Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med 2008; b358: 2003–2015.
Gui J, Liu Q, Feng L. Metformin vs insulin in the management of gestational diabetes: a meta- analysis. PLoS One 2013; 8: e64585.
Nachum Z, Zafran N, Salim R, et al. Glyburide versus metformin and their combination for the treatment of gestational diabetes mellitus: a randomized controlled study. Diabetes Care 2017; 40: 332–337.
Balsells M, Garc´ıa-Patterson A, Sola` I, Roque´ M, Gich I, Corcoy R. Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: a systematic review and meta-analysis. BMJ 2015; 350: h102.
Browse journals by subject