Imperative to test all pregnant women for gestational diabetes

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  1. A recent paper published in the Journal of the Association of Physicians of India has highlighted the need to screen every pregnant woman for gestational diabetes even if no symptoms are exhibited.
  2. Gestational Diabetes Mellitus (GDM) is defined as Impaired Glucose Tolerance (IGT) with onset or first recognition during pregnancy.
  3. Undiagnosed or inadequately treated GDM can lead to significant maternal & fetal complications. Maternal risks of GDM include polyhydramnios, prolonged labour, obstructed labour, caesarean section, uterine atony, postpartum haemorrhage, infection and progression of retinopathy. These are the leading global causes of maternal morbidity and mortality.
  4. Fetal risks include spontaneous abortion, intra-uterine death, stillbirth, congenital malformation, shoulder dystocia, birth injuries, and infant respiratory distress syndrome.
  5. Further, women with GDM and their off springs are at increased risk of developing type 2 diabetes and other non-communicable diseases later in life. Type 2 diabetes is characterised by high blood sugar, insulin resistance, and relative lack of insulin.
  6. To prevent and minimize maternal and fetal morbidity associated with GDM, Ministry of Health and Family Welfare in India had released a national guideline for provision of universal screening and management of GDM as part of the essential antenatal package.
  7. The guidelines recommend early testing during the first trimester i.e. Week 1 to 12. If the test is negative, the guidelines recommend to repeat the test between 24-28 weeks.

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