Lok Sabha Question No. 2355 (UNSTARRED), answered on 2018-03-09
Subject: Gestational Diabetes Mellitus
Ministry: HEALTH AND FAMILY WELFARE
Asked by: B.V. NAYAK

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2355 TO BE ANSWERED ON 9 TH MARCH, 2018

## GESTATIONAL DIABETES MELLITUS

## 2355. SHRI B.V. NAIK:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  whether  the  capacity  within  the  healthcare  system  for  testing  and  providing  ca Gestational  Diabetes  Mellitus  (GDM)      and  lack  of  awareness  about  the  same  are  causes concern, if so, the steps tak en in this regard;
- (b)  whether  most  women  are  still  not  routinely  tested  for  GDM,  thus  contributing  to maternal  and  new  born  morbidity  and  mortality  and  if  so,  the  necessary  steps  taken  i regard;
- (c) whether it is also a fact that a woman wi th GDM has five times higher risk of developing type- 2 diabetes five years after her pregnancy and nine times thereafter; and
- (d) if so, the corrective steps taken in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI ASHWINI KUMAR CHOUBEY)

(a)& (b) : Government of India has released Guidelines on Diagnosis and Management of Gestational Diabetes Mellitus (GDM) in pregnant women in November 2014 and revised Guidelines  in  February  2018.  As  per  th e  guidelines,  universal  GDM  testing  has  been included in the essential ante - natal care package for all pregnant women.

- States have started implementing these guidelines and based on the proposal received from  states  in  their  Annual  Project  Implementation  P lan  (PIP),  funds  are  being released  to  states  towards  screening  and  management  of  GDM  including  training. Monitoring and review of implementation is done on regular basis.
- National  level  orientation  workshop  on  revised  GDM  guidelines  for  State  level programme managers was conducted in February 2018. State officers were oriented on  universal  screening  and  management  of  pregnant  women  for  GDM.  Further, resource package for capacity building of field level functionaries along with state district leve l planning were  shared.

Contd……..

(c ):WHO Global Report on Diabetes says that Gestational diabetes (GDM) is a condition that occurs in pregnancy and carries long - term risk of type 2 diabetes. As per research study by Kim etal. titled gestation al diabetes and the incidence of type 2 diabetes: the cumulative incidence  of  diabetes  ranged  from  2.6% -70%  in  studies  that  examined  women  from 6 weeks  postpartum  to  28 years.  Further,  they  showed  that  this  incidence  increased markedly in the first 5 years after delivery and appeared to plateau after 10 years.

As  per  another  study  published  by Thomas  A.  Buchanan in    Nature  Reviews Endocrin ologyvolume  8,    Women  who  are  diagnosed  with  GDM  are  at  high  risk  of developing diabetes mellitus later in life. An estimated ~10% of women with GDM have diabetes mellitus soon after delivery. The rest appear to develop diabetes mellitus at ra 20 -60%  within  5 -10  years  after  pregnancy  in  the  absence  of  specific  interventions  to reduce their risk of diabetes mellitus.

(d): All GDM positive women are screened for diabetes after 6 weeks of delivery.

If  normal,  women  are  advised  to  get  annual  screening  for  diabetes  mellitus    and counseled about life style and dietary modification and regular exercise.

If they test positive, women are linked with Non Communicable Disease programme fo further managemen t.

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