Life-cycle approach for prevention of gestational diabetes mellitus

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Clinical Epidemiology and Global Health


Problem considered: Despite enough evidence available supporting temporal relation between gestational diabetes mellitus (GDM) and overt DM, former has earned less attention while managing current diabetes epidemic. This calls for a community-based ‘Life-cycle approach’ that could employ mutually-linked interventions specific to GDM prevention at various stages of life cycle by utilizing involving already existing Indian health system. Methods: Freely accessible, full-text articles published between 1990 and 2018, available in PubMed and Google Scholar in English language, pertaining to GDM risk factors and its preventive strategies were reviewed using combination of medical subject headings (MeSH) and keywords. Results: GDM prevention begins right from pre-pregnancy phase. Adoption of a healthy lifestyle, mass awareness of risk factors, early identification and prompt referral are key to avert pre-GDM development. During pregnancy, government of India (GoI) mandates universal GDM screening for all Indian pregnant women, avoiding any undiagnosed/untreated GDM woman, thus preventing occurrence of complications including overt DM. Those screened GDM positive are more likely to develop overt DM throughout postpartum. During postpartum, American Diabetes Association (ADA) recommends postpartum diabetes screening for all women with GDM, by employing two h 75 g oral glucose tolerance test (OGTT) and HbA C prior to and beyond three months postpartum, respectively. Conclusions: Promotion and practice of life-cycle approach would be key to curb overall diabetes incidence. 1

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