Diagnosis and principles of management of gestational diabetes mellitus in the prevailing COVID-19 pandemic
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ORIGINAL ARTICLE
Diagnosis and principles of management of gestational diabetes mellitus in the prevailing COVID-19 pandemic Veeraswamy Seshiah 1 & Vijayam Balaji 1 & Samar Banerjee 2 & Rakesh Sahay 3 & Hema Divakar 4 & Rajesh Jain 5 & Rajeev Chawla 6 & Ashok Kumar Das 7 & Sunil Gupta 8 & Dharani Krishnan 9
# Research Society for Study of Diabetes in India 2020
Abstract Background Limited medical facilities are available due to Covid-19 pandemic. Nevertheless, all efforts should be made in planning judicial and possible methods of delivering health care, particularly to pregnant woman with GDM. GDM may play a crucial role in the increasing prevalence of diabetes and obesity and also may be the origin of cardiometabolic diseases. Methods It is mandatary to diagnose and care pregnant woman with GDM. The test suggested to diagnose GDM has to be evidence based and in this regard “a single test procedure” evaluated meets this requirement. This doable test has been accepted by the Diabetes in Pregnancy Study Group India (DIPSI) and approved by MHFW-GOI, WHO, International Diabetes Federation, and International Federation of Obstetricians and Gynecologists. MHFW-GOI also recommends testing at first antenatal visit and then at 24–28 weeks of gestation. This opportunity can also be utilized for performing ultrasonography for assessing fetal development. Result The first-line management is MNT and life style modifications. Non-responders may require insulin or OHA. The target glycemic control is FPG ~ 5.0 mmol/dl (90 mg/dl) and 2 h PPPG ~ 6.7 mmol/dl (120 mg/dl). The goal is to obtain newborns birth weight appropriate for gestational age between 2.5 and 3.5 kg, a step to prevent offspring developing diabetes. Conclusion The essential precaution required during COVID pandemic is to wear face mask, avoid crowded places, and maintain social distancing. Finally, the economical and evidence based “single test procedure” of DIPSI is most appropriate for screening during the COVID pandemic. Keywords Gestational diabetes mellitus (GDM) . Medical nutrition therapy (MNT) . Oral hypoglycemic agent (OHA) . Postprandial plasma glucose(PPPG) . Fasting plasma glucose (FPG) . Ministry of Health and Family Welfare . Government of India (MHFW-GOI)
Introduction * Veeraswamy Seshiah [email protected] 1
Dr. Balaji Diabetes Care Center and Dr. Seshiah Diabetes Research Institute, Chennai 600029, India
2
Vivekananda Institute of Medical Sciences, Calcuta, India
3
Department of Endocrinology, Osmania Medical College & Osmania General Hospital, Hyderabad, India
4
Divakar’s Specialty Hospital, Bengaluru, India
5
Jain Hospital, Kanpur, Uttar Pradesh, India
6
Diabetes in Pregnancy Study Group India, Delhi, India
7
Pondicherry Institute of Medical Sciences, Pondicherry, India
8
Diabetes in Pregnancy Study Group India, Nagpur, India
9
Chennai, India
The world has turned topsy-turvy with the COVID-19 pandemic. This will adversely affect the medical profession, particularly in the diagnosis and care of people with diabetes. This is g
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