Union government is now working towards capacity building following its release of the national guidelines for diagnosis and management of gestational diabetes management (GDM).
“We are keen to implement the recommended guidelines for universal screening and management of GDM in India. We have integrated it with ante-natal care package and linked it with NCD clinics for a continued care”, said Dr. Dinesh Baswal, Deputy Commissioner, Maternal Health (In-Charge), Ministry of Health & Family Welfare, Government of India.
“Taking a cue, Asian Research & Training Institute for Skill Transfer launched the Pehla Kadam’ project last year. Its focus is on sensitizing and raising awareness on the fact that it is major health concern, but preventable. This year with the ‘Sweet Heart’ project ARTIST is on a mission to ensure the ‘Single Step Test’ using 75 -75gm glucose offered to all pregnant women so that even a single case of diabetes in pregnancy is not missed,” said Dr. Hema Divakar, CEO and Chairperson of ARTIST, Vice Chair, Diabetes in Pregnancy Working Group of FIGO and the FOGSI Ambassador to FIGO.
India is home to 40.9 million people with diabetes nearly 15% of the global diabetes burden; projections show that this will increase to 70 million by 2025. Focusing attention on GDM is the most sustainable and cost effective way of addressing the double disease burden of high maternal and newborn morbidity and mortality and rising rates of obesity, diabetes, and cardiovascular diseases, she added.
The project will focus on building awareness for women even before pregnancy and train the health workers to test and manage those with high blood sugars, through a framework of standard guidelines, issued by the government. These women will need care beyond pregnancy to prevent type-2 diabetes and heart ailments.
Explaining the significance of the Sweet Heart project, Dr. Divakar said that there are 5 million pregnancies with high blood sugar every year in India and the children born to these women are prone to childhood obesity, and tragically likely to have diabetes at a much younger age. To save the next generation from the ‘sweet disease’, we have to act now.
“Training healthcare providers and doctors for understanding the framework and administering the right test at the right time for 30 million pregnant women every year is no easy task. We have launched capacity and skill enhancement online training courses, which are comprehensive and ensure that the guidelines are followed strictly,” he said.
There is a need to eradicate the long-term clinical effects, which adversely impact maternal and neonatal health, and contribute to the burden of non-communicable diseases, especially type 2 diabetes, cardiovascular disease, and obesity. During pregnancy, GDM has been associated with polyhydramnios, preeclampsia, prolonged labour, caesarean section, uterine atony, postpartum haemorrhage, infection, and progression of retinopathy, as well as spontaneous abortion, intrauterine death, stillbirth, congenital malformation, shoulder dystocia, birth injuries, neonatal hypoglycaemia, and infant respiratory distress syndrome, he added.