Literature DB >> 23961512

Comment on: Shriraam et al., awareness of gestational diabetes mellitus among women in a primary health center in south India.

Yashdeep Gupta1.   

Abstract

Entities:  

Year:  2013        PMID: 23961512      PMCID: PMC3743396          DOI: 10.4103/2230-8210.113787

Source DB:  PubMed          Journal:  Indian J Endocrinol Metab        ISSN: 2230-9500


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Sir, I read with great interest the article by Shriraam et al., in which the authors observed high proportion of unawareness of gestational diabetes mellitus (GDM) among the antenatal women in South India.[1] Only 17.5% of women had good knowledge for the disease. In this study, the authors have highlighted 2 very important points of concern. First, the knowledge about the risk factors for GDM and increased risk of future Type 2 diabetes was found to be low. Second, authors found that health-care providers were quoted as a source of information by only a 5th of women. The above two factors culminate into poor post-partum screening and subsequently high conversion rates to diabetes mellitus. Even in best of the scenarios across the world, the post-partum screening rate varied from 14% in usual care to 60% in randomized controlled studies.[2] In a meta-analysis of 20 studies from January 1960 to January 2009, Bellamy et al., found seven-fold increased risk of developing type 2 diabetes in women with the gestational diabetes as compared to women with normoglycemic pregnancy.[3] Now, the important question arises, how we can overcome this problem. The authors have interestingly highlighted some of the measures like role of mass media in creating awareness about the condition. The other important step is integration of awareness about GDM with routine health-care education programs organized for antenatal women. The doctors have to educate the health-care workers and both doctors and health-care workers have to play a greater role in creating awareness among antenatal women. Coupled to authors’ suggestion in this field, I would like to add, that we should also not miss any opportunity of post-partum screening in women with GDM. Employing Nurse educators during antenatal visits for imparting education on healthy life-style measures during pregnancy and highlighting importance of post-partum screening, postal reminders, telephonic contacts, investigation incentives for poor women, arranging for convenient testing are other parameters seen to increase the rates of postpartum screening.[45] This gives an additional opportunity to promote health care among these high risk women.
  5 in total

1.  The effectiveness of implementing a reminder system into routine clinical practice: does it increase postpartum screening in women with gestational diabetes?

Authors:  A K Shea; B R Shah; H D Clark; J Malcolm; M Walker; A Karovitch; E J Keely
Journal:  Chronic Dis Can       Date:  2011-03

2.  Do postal reminders increase postpartum screening of diabetes mellitus in women with gestational diabetes mellitus? A randomized controlled trial.

Authors:  Heather D Clark; Ian D Graham; Alan Karovitch; Erin J Keely
Journal:  Am J Obstet Gynecol       Date:  2009-03-09       Impact factor: 8.661

3.  Who returns for postpartum glucose screening following gestational diabetes mellitus?

Authors:  Kelly J Hunt; Deborah L Conway
Journal:  Am J Obstet Gynecol       Date:  2008-02-01       Impact factor: 8.661

4.  Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis.

Authors:  Leanne Bellamy; Juan-Pablo Casas; Aroon D Hingorani; David Williams
Journal:  Lancet       Date:  2009-05-23       Impact factor: 79.321

5.  Awareness of gestational diabetes mellitus among antenatal women in a primary health center in South India.

Authors:  Vanishree Shriraam; M Anitha Rani; B W C Sathiyasekaran; Shriraam Mahadevan
Journal:  Indian J Endocrinol Metab       Date:  2013-01
  5 in total

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