Published in The Hindu on March 8, 2012
For the first time in the country, 14,000 pregnant women will be screened for gestational diabetes (GDM), and equal number of women with and without gestational diabetes and children born to such mothers would be followed up for 15 years.
The screening programme was started two months ago by Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabtetes Care Centre in Chennai, together with the Tamil Nadu government. It is being done at three centres representing rural, semi-urban and urban populations. The three centres are at Thiruvallur, Siadapet and at Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre. The World Diabetes Foundation is funding the programme.
“Screening of 14,000 women will be at random and those with gestational diabetes and equal number of women without GDM will be included in the programme,” said Dr. V. Balaji, Senior Diabetologist and Director of Dr. Balaji Diabetes Care Centre and Dr. V. Seshiah Diabetes Research Institute.
During the first year 7,000 women will be screened and another 7,000 women will be screened next year, bringing the total number of women who would be screened to 14,000.
The programme will follow-up GDM mothers and children born to them for a period of 15 years (study group). During the same period, equal number of non-GDM mothers and their children will be followed up as controls. For instance, if 2,000 women with GDM are found during the screening, 2,000 non-GDM women will be enrolled as controls.
Gestational diabetes hovers at around 16 per cent in India. Studies have shown that children born to women with uncontrolled gestational diabetes are more prone to suffer from childhood obesity and have a higher risk of developing a metabolic syndrome like diabetes during their adulthood. Similarly, women with uncontrolled gestational diabetes also stand to suffer from diabetes at a later point in their life.
In this programme, the glucose level of all women with gestational diabetes will be controlled either through diet manipulation or insulin. Though some studies show that children born to mothers with gestational diabetes are more prone to developing diabetes, there is no hard data to support this. According to Dr. Balaji, this study will be the first to provide long term data of factors that cause diabetes in children even when they are born to women whose gestational diabetes has been controlled.
“Screening of pregnant women for gestational diabetes will be done immaterial of the gestation period,” said Dr. Balaji.
This becomes essential as gestational diabetes can be detected as early as at 16 weeks of gestation and even in those who have normal glucose level in the first and second trimester can turn up positive for gestational diabetes during the third trimester.
The pilot study conducted by Dr. Balaji, Dr. Seshiah and Dr. Madhuri Balaji together with the State government has been rolled out throughout the Tamil Nadu. Controlling gestational diabetes has now become a national programme and has been implemented in four States, including Bihar.