Epidemiology of Gestational diabetes in Rural Wardha

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Presentation transcript:

Epidemiology of Gestational diabetes in Rural Wardha Dr Manish Prabhakar Guide: Dr P R Deshmukh

Introduction: Gestational diabetes mellitus (GDM) is a severe and neglected threat to maternal and child health. India is one of the diabetes capitals of the world, and has among the highest rates of women with GDM, with more than 5 million women affected in the country each year. Prevalence of GDM varies considerably among urban and rural population in India. This study will be undertaken to determine the prevalence of GDM and risk factors associated with it in rural women of Wardha in central India.

Objective: To Study the epidemiology of Gestational Diabetes Mellitus in rural area of central India

Material and Methods: Study Design: Cross-sectional Study Study area The study will be carried out in all of the 67 villages under the three Primary Health Centres namely Anji, Kharangana Gode and Talegaon having a total population of 120,000. Study population Study population will be all the married women who become pregnant during the study period . Study period : Oct 2016- Sept 2017

. Inclusion and Exclusion criteria Inclusion criteria: All the newly diagnosed pregnant women who give written informed consent will be included in the study. Exclusion criteria: Pregnant Mothers suffering from chronic and severe diseases will be excluded from the study. Pregnant mothers who are going to move out from the study area for a period of more than 6 months and females below 15 years will be excluded from the study.

. Sample size : Considering 15.6 % minimal expected prevalence, with 5 % alpha error with 20% relative allowable error, Sample size by Open Epi is , 562 + 10 % non responders = 618 Guideline : for this Study using DIPSI Criteria, Fasting venous blood sample will be collected from the pregnant women, 2 hours after intake of 75gm of oral glucose for estimating plasma glucose. This one step procedure for diagnosing GDM is simple, economical and feasible. Screening will be done in 20th weeks of gestation. Followed by Sample collection If found negative at this time, the screening test is to be performed again around 24th – 28th week and finally around 32nd – 34th week.

Sampling procedure : 3 PHCs of Wardha Wardha Dist Anji, Kharangana, Talegaon Population around 1,20,000 Baseline Survey for 15-45 year Women Completed Follow up of Women to find out newly diagnosed pregnancy Enrollment of all Pregnant Women, Written Consent taken First Venous Blood Sample Collected blood glucose estimation DATA Entry and Result Analysis

Time line .

Data Entry and Analysis: Data Entry will be done in Excel Sheet. And Analysis will be done in SPSS 20.0 software

References: 1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2009;32:S62–7. 2. Kalyani KR, Jajoo S, Hariharan C, Samal S. Prevalence of gestational diabetes mellitus, its associated risk factors and pregnancy outcomes at a rural setup in Central India. Int J Reprod Contracept Obstet Gynecol. 2014; 3(1): 219-224. 3. Gestational diabetes mellitus--guidelines. V. Seshiah, A. K. Das, V. Balaji, Shashank R. Joshi, M. N. Parikh, Sunil Gupta, Diabetes in Pregnancy Study Group J Assoc Physicians India. 2006 August; 54: 622–628.

4. Yogev Y, Chen R, Langer O, Hod M 4. Yogev Y, Chen R, Langer O, Hod M. Diurnal Glycemic profile characterization in non- diabetic non obese subjects during the first trimester. The 37th Annual Meeting of The Diabetes And Pregnancy Study Group, Myconos – Hellas: September, 2005. 5. Seshiah V, Balaji V, Madhuri S Balaji, Sanjeevi CB, Green A. Gestational Diabetes Mellitus in India. JAssoc Physic of India 2004; 52:707–11. 6. Nahum GG, Wilson SB, Stanislaw H. Early-pregnancy glucose screening for gestational diabetes mellitus. J Reprod Med 2002; 47:656-62. 7. Seshiah V, et al. One Step procedure for screening and diagnosis of gestational diabetes mellitus. J Obstet Gynecol India 2005; 55:525–29. 8. Nahum GG, Wilson SB, Stanislaw H. Early-pregnancy glucose screening for gestational diabetes mellitus. J Reprod Med 2002; 47:656-62. .

9. American Diabetes Association. Gestational diabetes mellitus 9. American Diabetes Association. Gestational diabetes mellitus. Diabetes Care 2003;26 (suppl): S103-5. 10. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes Res Clin Pract. 2014;103(3):341–363 11. Buchanan A, Xiang AH. Gestational diabetes mellitus. J Clin Invest. 2005; 115:485–91 12. Association of Physicians of India. Diagnosis and management of GDM: Indian guidelines, chap. 55. Medicine update, vol. 13. 2013. 13. Vandorsten JP, Dodson WC, Espeland MA, et al. NIH consensus development conference: diagnosing gestational diabetes mellitus. NIH Consens State Sci Statements. 2013; 29:1–31 14. Rani PR, Begum J. Screening and Diagnosis of Gestational Diabetes Mellitus, Where Do We Stand. Journal of Clinical and Diagnostic Research: JCDR. 2016;10(4):QE01-QE04. 15. Seshiah V, Balaji V, Balaji MS, Pannerselvam A, Arthi T, Thamilarasi M, et al. Prevalence of GDM in South India (Tamilnadu). A Community Based Study. J Assoc Physicians India. 2008; 56:329–33. .