Sheikh, Aisha

Sheikh, Lumaan

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eCommons@AKU

eCommons@AKU Section of Diabetes, Endocrinology and Metabolism Department of Medicine 8-2020 Changing prevalence of gestational diabetes mellitus during pregnancy over more than a decade Aisha Sheikh Lumaan Sheikh Follow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_med_diabet_endocrinol_metab  Part of the Endocrine System Diseases Commons, Endocrinology, Diabetes, and Metabolism Commons, Maternal and Child Health Commons, and the Obstetrics and Gynecology Commons 1477Dear Madam, Gestational Diabetes Mellitus (GDM)adversely affects the maternal and neonatal outcomes ofpregnancy. Poorly controlled GDM is associated withmacrosomia, polyhydramnios, operative deliveries,shoulder dystocia, neonatal hypoglycaemia, neonatali n t e n s i v e  c a r e  u n i t  a d m i s s i o n ,  n e o n a t a lhyperbilirubinaemia but the worst is the unexplained stillbirths.1We studied the prevalence of GDM at The Aga KhanUniversity Hospital (AKUH), Pakistan over the period of2005 till 2018. AKUH is a tertiary care center and on theaverage hosts more than 5000 deliveries per year.We observed a progressive increase in the prevalence ofGDM from the year 2005 till the year 2018 (figure). In 2005it was 6.3% and remained stable at around 8% from 2006till 2010. Over the ensuing years a progressive rise wasseen. In 2011, it was 9.86%. Now in 2017 and 2018, it'saround 19%. The average prevalence in initial 5 years ofthis study period was 8.09% (from 2005 till 2009) and inthe last 5 years (2014 till 2018) 17.8%. It has clearly morethan doubled during this study duration.This rise in prevalence of GDM is partly contributed by achange in GDM screening and diagnosis in our institute.Most of the OB/GYN consultants shifted to universal GDMscreening practices and adopted the InternationalAssociation of Diabetes in Pregnancy Study Group(IADPSG) criteria in the year 2012.2 However this increasein prevalence is a reflection of increasing back groundprevalence of Type 2 Diabetes Mellitus (T2DM) and obesityas well. Two recent surveys have shown the prevalenceof Type 2 Diabetes in Pakistan at 26% and 17.8%.3,4We need more data on GDM prevalence based upon theIADPSG criteria from different parts of Pakistan to knowthe exact burden of the disease.Over more than a decade the prevalence of GDM isincreasing, necessitating the need to improve thescreening and management of GDM to improve thematernal, foetal and neonatal outcomes. There is a needof more prospective studies on GDM from Pakistan.Centralized national GDM registry, post-partum Diabetesrisk reduction strategies, public awareness and health careprofessional's (HCPs) GDM training workshops are all theneed of the hour. There is a dire need of public and privatepartnership, involvement of HCPs at primary, secondaryand tertiary care for concerted efforts to manage GDMand to implement strategies to reduce the risk of DM inthe mother and the baby in the Coming years.Acknowledgement:  We are grateful to Ms Javeriah Khan,Associate at HIMS for helping us with the medical recordsof pregnancies affected by GDM.Disclaimer: None.Conflict of interest: None.Funding disclosure: None.References1. Metzger BE, Buchanan TA, Coustan DR, De Leiva A, Dunger DB,Hadden DR, et al. Summary and recommendations of the fifthinternational workshop-conference on gestational diabetes mellitus.Diabetes Care. 2007; 30:S251-60.2. International Association of Diabetes and Pregnancy Study GroupsConsensus Panel. International association of diabetes andpregnancy study groups recommendations on the diagnosis andclassification of hyperglycemia in pregnancy. Diabetes care. 2010;33:676-82.Changing prevalence of Gestational Diabetes Mellitus during pregnancy overmore than a decadeAisha Sheikh1, Lumaan Sheik21Department of Medicine, The Aga Khan University, Karachi, Pakistan;2Department of Obstetrics and Gynaecology, The Aga Khan University, Karachi.Correspondence: Aisha Sheikh. e-mail: aisha.sheikh@aku.eduFigure: Prevalence of GDM per 100 live-births from year 2005-2018 in AKUH.Vol. 70, No. 8, August 2020J Pak Med Assoc1478 A. Sheikh, L. Sheik3. Basit A, Fawwad A, Qureshi H, Shera AS. Prevalence of diabetes,pre-diabetes and associated risk factors: second National DiabetesSurvey of Pakistan (NDSP), 2016-2017. BMJ Open. 2018; 8:e020961.4. Aamir AH, Ul-Haq Z, Mahar SA, Qureshi FM, Ahmad I, Jawa A, et al.Diabetes Prevalence Survey of Pakistan (DPS-PAK): prevalence oftype 2 diabetes mellitus and prediabetes using HbA1c: a population-based survey from Pakistan. BMJ Open. 2019; 9:e025300.https://doi.org/10.5455/JPMA.65585

Changing prevalence of gestational diabetes mellitus during pregnancy over more than a decade

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Changing prevalence of gestational diabetes mellitus during pregnancy over more than a decade

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