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A Prospective Study to Determine if Management of Cases of Gestational Diabetes Mellitus (GDM) can be Modified

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Abstract

Background

To study maternal–fetal outcomes in patients of GDM diagnosed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria but subsequently using a twenty-four-hour seven-value sugar profile to evaluate patients before instituting management.

Methods

This prospective observational study was conducted at a tertiary hospital in New Delhi, India, over a period of one year. During this period, women diagnosed as GDM between 24 and 28 weeks of gestation using IADPSG criteria underwent seven-value sugar profile in twenty-four hours before initiating any therapy. Those with normal profile were kept on observation only, whereas others were managed by Medical Nutrition Therapy (MNT) with or without pharmacotherapy as required to maintain euglycemia. Maternal and fetal outcomes were documented and analysed to detect differences between the groups.

Results

Out of 2279 pregnant women, 201 (8.8%) were diagnosed as GDM. The twenty-four-hour seven-value sugar profile was normal in 78 (38.8%) patients, who were managed only by close observation. Treatment was given to other patients; 93 (46.2%) patients were managed with MNT only, whereas pharmacotherapy by way of metformin was added to 22 (10.9%) patients and 8 (3.9%) patients required insulin. Differences in maternal–fetal outcomes between the treated and untreated groups were not found to be statistically significant.

Conclusions

The policy of evaluating patients with twenty-four-hour seven-value sugar profile after an abnormal Oral Glucose Tolerance Test eliminated over one-third women from receiving treatment and interventions for GDM without compromising maternal–fetal outcomes.

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Acknowledgments

The help of Dr. Varun Kashyap, Assistant Professor, Biostatistics, HIMSR, New Delhi in statistical analysis is gratefully acknowledged.

Funding

This study did not receive funds from any source.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, Hamdard Nagar, New Delhi, Delhi, 110062, India

    Reva Tripathi, Nidhi Gupta, Farhat Mazhari & Tanya Gupta

  2. Bokaro Steel City, India

    Farhat Mazhari

Authors
  1. Reva Tripathi
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  2. Nidhi Gupta
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  3. Farhat Mazhari
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  4. Tanya Gupta
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Correspondence to Farhat Mazhari.

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The authors have no conflicts of interests to declare.

Ethical Approval

The study has been approved by the Institutional Ethical Committee.

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Informed consent was obtained from the individuals.

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Farhat Mazhari is a Senior Resident, Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research‚ Jamia Hamdard University, Hamdard Nagar, New Delhi – 110062, Delhi, India.

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Tripathi, R., Gupta, N., Mazhari, F. et al. A Prospective Study to Determine if Management of Cases of Gestational Diabetes Mellitus (GDM) can be Modified. J Obstet Gynecol India 72, 147–153 (2022). https://doi.org/10.1007/s13224-021-01507-9

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  • DOI: https://doi.org/10.1007/s13224-021-01507-9

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