Prevalence and predictors of gestational diabetes mellitus in rural Assam: a cross-sectional study using mobile medical units

Abstract

ObjectiveTo determine the prevalence and predictors of gestational diabetes mellitus (GDM) in rural Assam, India using a network of Mobile Medical Units.Study designA field-based cross-sectional study.SettingsRural areas of Assam state, India.ParticipantsA total of 1410 pregnant women in gestational age of 24–28 weeksInterventionIdentification of pregnant women in 24–28 weeks of pregnancy from villages and administering them Government of India recommended oral glucose tolerance test for GDM confirmation.Primary and secondary outcome measuresPresence of gestational diabetes among pregnant women, risk factors and predictors of GDM.ResultsA total of 1212 pregnant women underwent the oral glucose tolerance test. One hundred and ninety-eight women were ineligible due to existing chronic diseases or very high blood glucose level before the test. The overall GDM prevalence in Assam was 16.67% (95% CI 14.61% to 18.89%). Women aged 26–30 years (adjusted odds ratio, aOR 1.70; CI 1.14 to 2.52), who passed 10th class (aOR 1.58; CI 1.05 to 2.37), belonging to Muslim religion (aOR 1.52; 95% CI 1.05 to 2.21) and above poverty line (aOR 1.38; 95% CI 1.00 to 1.91) had significantly increased likelihood of developing GDM compared with respective baseline groups (p<0.05). Body mass index, gravida and being non-anaemic were non-significant risk factors for GDM. Family history of diabetes (aOR 1.82; 95% CI 1.08 to 3.06) and smoking (aOR 1.61; 95% CI 1.10 to 2.35) were significant and independent predictors of GDM.ConclusionThe prevalence of GDM in rural Assam is high. The mobile medical units may play a significant role in the implementation of GDM screening, diagnosis, treatment to ensure better maternal and foetal health outcomes in rural Assam.

Screening for gestational diabetes, Ahmedabad, India

“…This prevalence is higher than that found in studies in rural central India (1.9%; 11/575), 22 New Delhi (5.7%; 170/2970) 23 and Haryana (7.1%; 43/607) 24 but lower than the prevalence in Assam (16.7%; 202/1212). 25 This higher prevalence indicates the need for implementation of this project on a wider scale during the second trimester, 24–28 weeks. The women who had gestational diabetes were referred and followed up for management and treatment.…”

Measurement and Mapping of Maternal Health Service Coverage Through a Novel Composite Index: A Sub-National Level Analysis in India

“…However, national mean percentage coverage of some of the indicators of maternal health service coverage is quite perturbing, such as; screening for diabetes (ANC indicator), SBA attended home deliveries, c-section delivery and treatment for obstetric complications (all INC indicators) as they recorded relatively low mean percentage (around 30%) coverage across the country. Some state speci c studies recorded prevalence of gestational diabetes ranged between 9.89-35% [31][32][33][34][35], which is quite alarming. In this regard, in compliance with the recommendations of WHO and International Association of Diabetes and Pregnancy Study Group (IADPSG), India requires region speci c efforts to expand its coverage of screening for diabetes among pregnant women [34].…”

Diabetic retinopathy in pregnancy - A review

“…[ 73 ] Urbanization along with its other disadvantages has shown an increased prevalence of diabetes in pregnancy too. [ 14 15 16 17 18 ]…”

“…[ 13 ] Prevalence of GD in rural and urban populations across various regions in India is given in Table 5 . [ 14 15 16 17 18 ]…”