Negotiating Gestational Diabetes Mellitus in India: A National Approach

Thanawala, Uday; Divakar, Hema; Jain, Rajesh; Agarwal, Mukesh

doi:10.3390/medicina57090942

Cited by 12 publications

(6 citation statements)

References 41 publications

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“…The latest guidelines for diagnosis and management of GDM by the Maternal health division of the Ministry of Health and Family welfare by the government of India recommends the use of oral metformin after 20 weeks of gestation in contrast to tedious parental administration which makes insulin therapy costly and causes adherence issue especially in low resource country such as India leading to a better and more sustainable patient-centric care. [ 46 47 48 ]…”

Section: Discussionmentioning

confidence: 99%

Comparison of neonatal and maternal outcomes of anti-diabetic drugs in the treatment of gestational diabetes mellitus

Shah

et al. 2022

Journal of Family Medicine and Primary Care

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The safety and efficacy of different anti-diabetic drugs are not clear because of the lack of sufficiently powered clinical trials. This network meta-analysis was conducted to compare the efficacy and safety of three anti-diabetic drugs (insulin, glyburide, and metformin), and rank them as per their efficiency to control glucose levels, pregnancy, and neonatal outcomes. The study design is a systematic review, meta-analysis, and network meta-analysis. After a systematic search of existing databases, 34 randomized controlled trials were selected for inclusion in the analysis. We did pairwise network meta-analysis to calculate standardized mean difference and odds ratio (OR) as the summary measures for numerical and dichotomous variables, respectively, by using random-effects model. Our key outcomes were incidence of neonatal hypoglycemia, respiratory distress syndrome, macrosomia, C-section, admission to neonatal intensive care unit (NICU) and mean differences in the birth weight of neonates, gestational age at birth, HbA1C levels, fasting blood sugar, large at gestational age, and post-prandial glucose. It was found that metformin significantly lowered the post-prandial levels of glucose as compared with both glyburide and insulin in pairwise analysis (SMD = 14.11 [23–4.8]; SMD = 22.45 [30–14]), respectively. There was a significant reduction in birth weights of babies whose mothers were administered metformin as compared with either glyburide or insulin. The proportion of neonates admission to NICU was significantly lower for metformin when compared with insulin [Log OR = 0.334 (0.0184, 0.6814))]. Large at gestational age was significantly lower for metformin as compared with both glyburide and insulin [log OR = 0.6882 (0.171, 1.329), log OR = 0.393 (0.00179, 0.8218)], respectively. Oral anti-diabetic drugs especially metformin performed better than both glyburide and insulin for all neonatal and maternal outcomes except that it significantly lowered the neonatal birth weight.

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Section: Discussionmentioning

confidence: 99%

Comparison of neonatal and maternal outcomes of anti-diabetic drugs in the treatment of gestational diabetes mellitus

Shah

et al. 2022

Journal of Family Medicine and Primary Care

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“…The scientific literature defines GDM as a state of hyperglycemia developing in pregnancy as a result of IR or reduced insulin production, which resolves following delivery [ 32 , 33 , 34 , 35 , 36 ]. GDM is the most common metabolic disease during pregnancy and it can affect 3–31% of women.…”

Section: Pregnancy As a Window For The Development Of Metabolic Diseasesmentioning

confidence: 99%

Effects of Probiotic Supplementation during Pregnancy on the Future Maternal Risk of Metabolic Syndrome

Obuchowska

GORCZYCA

Standyło

et al. 2022

IJMS

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Probiotics are live microorganisms that induce health benefits in the host. Taking probiotics is generally safe and well tolerated by pregnant women and their children. Consumption of probiotics can result in both prophylactic and therapeutic effects. In healthy adult humans, the gut microbiome is stable at the level of the dominant taxa: Bacteroidetes, Firmicutes and Actinobacteria, and has a higher presence of Verrucomicrobia. During pregnancy, an increase in the number of Proteobacteria and Actinobacteria phyla and a decrease in the beneficial species Roseburia intestinalis and Faecalibacterium prausnitzii are observed. Pregnancy is a “window” to the mother’s future health. The aim of this paper is to review studies assessing the potentially beneficial effects of probiotics in preventing the development of diseases that appear during pregnancy, which are currently considered as risk factors for the development of metabolic syndrome, and consequently, reducing the risk of developing maternal metabolic syndrome in the future. The use of probiotics in gestational diabetes mellitus, preeclampsia and excessive gestational weight gain is reviewed. Probiotics are a relatively new intervention that can prevent the development of these disorders during pregnancy, and thus, would reduce the risk of metabolic syndrome resulting from these disorders in the mother’s future.

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“…1 It does not rule out the likelihood that undiagnosed glucose intolerance developed before or at the same time as the pregnancy. 2 Gestational diabetes is a transient condition that resolves once the baby is born. India has the second-highest prevalence of patients with type 2 diabetes mellitus worldwide.…”

Section: Introductionmentioning

confidence: 99%

Physical activity levels of pregnant women at the time of diagnosis with gestational diabetes attending a tertiary care hospital in Lucknow City, Uttar Pradesh

Gupta,

Singh,

Pandey

et al. 2024

IJOGR

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: Gestational Diabetes Mellitus (GDM) is one of the pregnancy complications characterized by carbohydrate intolerance that develops or is discovered during pregnancy. Physical inactivity and excessive gestational weight gain have been identified as independent risk factors for maternal obesity and pregnancy-related disorders, such as gestational diabetes. Awareness of the significance of physical activity for bodily and psychological health is vitally essential. The woman and her family members need to be swayed to change with time and let go of their myths and false cultural perceptions that exercise can harm the baby. : To determine the physical activity pattern of pregnant women at the time of diagnosis with GDM. : 188 pregnant women diagnosed with gestational diabetes mellitus was selected for the study. Pregnancy Physical Activity Questionnaire was used to calculate the duration; frequency, intensity, and type of physical activity during current gestational period. An average weekly energy expenditure in Metabolic Equivalent of Task (MET-h-week) was calculated. Demographic data including age, socioeconomic status, parity, literacy and working status were collected. Data was analysed on 188 pregnant women diagnosed with GDM. The physical activity of moderate intensity was less performed by the pregnant women. None of the pregnant women were involved in vigorous type of physical activity. Only light intensity activities were performed by the study participants. The study concluded light intensity activity was commonly carried by pregnant women thus a low level of physical activity was observed during the pregnancy.

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Negotiating Gestational Diabetes Mellitus in India: A National Approach

Cited by 12 publications

References 41 publications

Comparison of neonatal and maternal outcomes of anti-diabetic drugs in the treatment of gestational diabetes mellitus

Comparison of neonatal and maternal outcomes of anti-diabetic drugs in the treatment of gestational diabetes mellitus

Effects of Probiotic Supplementation during Pregnancy on the Future Maternal Risk of Metabolic Syndrome

Physical activity levels of pregnant women at the time of diagnosis with gestational diabetes attending a tertiary care hospital in Lucknow City, Uttar Pradesh

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