Screening pregnant women for diabetes

SCREENING PREGNANT women for gestational diabetes has become all the more compelling with the results of such an exercise done at an antenatal clinic in Chennai this year. Nearly 25 per cent of the 1018 pregnant women screened were diagnosed as diabetic with either fasting plasma glucose and/or post glucose level above 90 mgs and 120 mgs respectively.

(However, the number of the screened women already being diabetic but were never diagnostic earlier is not known). The fallout of gestational diabetes in pregnant women is the possibility of offspring becoming diabetic at a later stage, said Dr. V. Seshaiah, Medical Director (Diabetes Unit) at Apollo Hospital, Chennai who did the screening.

"Foetal Beta cells are programmed to produce more insulin to handle the increased levels of glucose made available to the foetus by the mother. Once programmed, the possibility of developing diabetics at a later stage becomes real," said Dr. Seshaiah.

The good news is that simple screening of pregnant women for fasting blood sugar level and post glucose level during the 28-32 week and necessary modification of the mother's diet and/or insulin injection to control the sugar level can help prevent the offspring from becoming diabetic at a later stage. However, gestational control of sugar in the mother cannot guarantee a disease free state in the offspring if other triggers like genetic factors exists.

"Gestational diabetes in the mother is one of the factors which can cause diabetes in the offspring and is a easily preventable one if screening and necessary steps are taken," Dr. Seshaiah stressed. The number of diabetics in India is very huge and such a simple step will go a long way in bringing down the number.

Controlling gestational diabetes has other advantages too. Outcome of pregnancy is one of it. But the most important benefit is preventing the mother from continuing to be a diabetic even after delivery. According to Dr. A. Ramachandran, Managing Director of M.V. Hospital for Diabetes, Chennai, the percentage of Indian women who continue to remain diabetic after delivery is fairly high compared to the US. This drives home the importance of a simple yet effective step in preventing more Indians from becoming diabetic.

R. Prasad

in Chennai

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