1. A Study on Gestational Diabetes in Eastern India
Poster No: P-1538
Dr Anirban Sinha, Dr Raiz Ahmed, Dr Vivek Mathew, Dr Subhankar Chowdhury, Dr Satinath Mukherjee
Institute of Post Graduate Medical Education And Research, Kolkata , India
Poster Title
INTRODUCTION
METHODS
RESULTS
Gestational diabetes mellitus, defined as “carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy,” is associated with an increased risk of complications for mother and child during pregnancy and birth. Reported rates of gestational diabetes range from 2 to 10 percent of pregnancies.
Immediately after pregnancy, 5 to 10 percent of women with gestational diabetes are found to have diabetes, usually type 2.
In a study from Jammu region of India, prevalence of GDM was found to be 6.94%., family history of diabetes was 24.19% and caesarean section was 22.58% among untreated group.
In the Indian context, screening is essential in all pregnant women as the Indian women have eleven-fold increased risk of developing glucose intolerance during pregnancy compared to Caucasian women.
The main options for diagnosis are a one step oral glucose tolerance test (taking measurements at fasting, one and/or two hours after 75 g glucose, or at fasting, one, two, and three hours after 100 g) or a two step strategy.
We collected data from 200 consecutive patients attending antenatal clinic of our hospital who consented for the study. Pregestational diabetes (patients with IGT, IFG, or an A1C of 5.7–6.4%) cases were excluded from current study.
We have screened the patients with 1 hr glucose challenge test .
The positive patients (>130mg/dl) were confirmed with 2 hr 75 gm glucose challenge test using diagnostic cut points of greater than 92 mg/dl for the fasting glucose test; greater than 180 mg/dl one hour after drinking the 75-gram glucose solution; and greater than 153 mg/dl two hours after drinking the glucose solution. 
We performed the test in 24 – 28 wks and again in 32 – 34 wks to detect the patients who were missed on the first screening.
All GDM patients were treated following standard guidelines throughout pregnancy.
Birth weight at delivery is statistically significant between GDM and Non GDM Groups.(P 0.001). BMI is statistically significant between GDM and Non GDM Groups. ( P 0.005).
Mode of Delivery (Cesarean section Vs Normal delivery) is not statistically significant between GDM and Non GDM Groups. ( P 0.790)
Although 75.9% patients were diagnosed GDM in 24 – 28 wks screening, remaining 24.1 % patients were diagnosed when retested in 32 – 34 wks time.
There is a poor correlation between birth weight at delivery and 75 gm OGTT values.
There is a significant correlation between Birth weight and BMI in non GDM group but no significant correlation in GDM group.
RESULTS
Prevalence of GDM in current study is 15 % among pregnant women attending our tertiary care hospital.
Normal Population
Gestational Diabetes
+ve Family History*
14.1 %
40 %
Age (Yrs)
23.58 ± 4.05
26.13 ± 4.31
BMI*
22.21 ± 2.36
25.42 ± 4.02
Primipara *
56.5 %
42.9 %
Past Spontaneous Abortion*
6.5 %
10 %
Normal Delivery
8.3 %
Birth weight (Kg)*
2.6 ± 0.44
3.08 ± 0.54
OBJECTIVES
CONCLUSION
A significant proportion of pregnant women attending the antenatal clinic are found to have GDM (15%) which is higher than normally reported.
Mean BMI is more in GDM population compared to non GDM group which may be used as clinical indicator even in high risk population.
In a high risk population like ours a second screening at wks can detect 24.1% missed cases screened at 24 – 28 wks.
Determine the prevalence of gestational diabetes in pregnant women attending tertiary care hospital
Incidence of newly detected cases of gestational diabetes when screened in wks who were normal on 24 wks.