When they give us those alarming figures about diabetes
in the country, they are not even counting the three million women who
are pregnant and diabetic every year.
It is
estimated that about 10 per cent of women who get pregnant every year
develop diabetes during their gestation period, usually in the last
trimester. Even with 10 per cent, the numbers in this country are
damning: it works out to about three million women every year, counting
the total number of annual deliveries at 27 million.
Of
these three million women, in 5-10 years after pregnancy, 30 per cent
go on to develop Type 2 Diabetes, according to Hema Divakar, president,
Federation of Obstetricians and Gynaecological Societies of India
(FOGSI). Samar Banerjee, diabetologist, Vivekananda Institute of Medical
Science, Kolkata, adds that in women followed up for 20 years, it was
clear that up to 70 per cent of them who had gestational diabetes
mellitus (GDM) went on to develop diabetes.
And
there are clear factors that facilitate this: enormous weight gain after
pregnancy, following a sedentary lifestyle and not eating healthy, he
adds. “When women are pregnant, they listen to everything the doctor
says, but once the baby is born, they don’t even return for follow-up
checks,” Dr. Divakar adds.
In a sense, we are
entering an environment where the family is most willing to do something
about the mother’s condition during her pregnancy. This is an
opportunity to enable the whole family alter its lifestyle,” said Anil
Kapur, board member, World Diabetes Foundation.
No
wonder then that the federation has been agitated enough to reach out to
these people, by organising training programmes on gestational diabetes
for members. Dr. Divakar, explains, “This is an effort to address the
tsunami of diabetes in this country. The woman who develops diabetes in
pregnancy has an increased risk of developing Type 2 Diabetes later in
life. In addition, there is a high risk for the baby born to such
mothers too.”
While that sounds scary, it is
possible, with simple techniques, to ensure that both the mother and
foetus remain diabetes free. “Focus on the foetus for the future,” says
V.Seshaiah, chairman, Diabetes in Pregnancy Study Group India (DIPSI),
the agency that is partnering FOGSI in the venture.
“The
intra-uterine environment is very precious, how a baby shapes out is
decided here. It is important to not let the baby in the womb know that
the mother has diabetes. It is possible, even with following a
recommended meal plan, he says.
Dr. Divakar
indicates the accepted protocol to test pregnant women: One dose, 75mg
of glucose solution is used to check the post-prandial sugar levels.
Anything in excess of 120 means a need to investigate further. “If we
assume that a doctor can do this test just once, then let it be done at
20 weeks.
However, with the more awareness we manage
to get out, it will be ideal to test at 12 weeks of pregnancy.” FOGSI
and DIPSI together will train 100 master trainers to then train 1000
others in 25 regions across the country.
“We hope to
map and tap every single case of GDM in the country. Intervention with
follow-up over several years is the only way to prevent mothers moving
into diabetes,” Dr. Divakar says.
Source: http://www.thehindu.com/news/national/tamil-nadu/tackling-gestational-diabetes-in-the-womb/article4728101.ece
