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Table of Contents
LETTER TO THE EDITOR
Year : 2014  |  Volume : 18  |  Issue : 1  |  Page : 120-121

Converting disability to opportunity: GDM women as new role models of diabetes care


1 Department of Medicine, Government Medical College and Hospital, Chandigarh, India
2 Department of Obstetrics and Gynaecology, Bharti Hospital, Karnal, Haryana, India

Date of Web Publication6-Feb-2014

Correspondence Address:
Bharti Kalra
Department of Obstetrics and Gynaecology, Bharti Hospital, Kunjpura Road, Karnal - 132 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.126595

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How to cite this article:
Gupta Y, Kalra B. Converting disability to opportunity: GDM women as new role models of diabetes care. Indian J Endocr Metab 2014;18:120-1

How to cite this URL:
Gupta Y, Kalra B. Converting disability to opportunity: GDM women as new role models of diabetes care. Indian J Endocr Metab [serial online] 2014 [cited 2021 Feb 28];18:120-1. Available from: https://www.ijem.in/text.asp?2014/18/1/120/126595

Sir,

Four million women are diagnosed with gestational diabetes mellitus (GDM) annually in India and 50% develop type 2 diabetes within 5 years of the index pregnancy. [1] This adds to the already existing huge burden of 'diabetics' (61.3 million in 2011), pressurizing the healthcare system in terms of both direct and indirect costs.

With less stringent criteria recommended by American Diabetes Association (ADA) in 2011, prevalence of GDM is expected to rise further. Even the developed economies have concerns, in terms of dramatic increase in requirement of finances and healthcare resources to cater the additional burden of 'gestational diabetics'. The calculations have not been made for India, but the concerns can be well foreseen.

Can India benefit by investing at present for better future? Yes! Asians have an early onset of diabetes with more than one-third developing diabetes before the age of 44 years. [2] Thus, the opportunity for action for primary prevention is narrow for Asians. Glucose intolerance detected during pregnancy easily provides the population which is at risk for future diabetes and cardiovascular disease. Women with 'gestational diabetes' are very much receptive for diabetic education and a recent study in GDM found diabetes prevention interventions to be highly cost effective in India. [3]

The cost effectiveness would increase further if the risk of subsequent diabetic complications in mother and adverse long - term outcomes in offspring are accounted for. Unfortunately, none of the cost effective analysis has taken this into account due to lack of well-designed trials to prove such benefits.

By virtue of Indian culture, women enjoy a strategic position in household. The family practice of common kitchen gives her control for diet modification of family. Family history of diabetes, means additional family members from her parent's side afflicted with diabetes. Her offspring stands at high risk for obesity, diabetes, and cardiovascular disease in future. If she is imparted diabetic education about lifestyle modifications, empowered with other health promotion education and motivated regarding her important role in primary/secondary prevention of diabetes for the entire family; it will not only reduce risk of diabetes for her, but will also help in reducing risk for others.

This will change her position from a socially stigmatized one to a role model in society and will mark the new dawn of diabetes care in India.

 
   References Top

1.Veeraswamy S, Vijayam B, Gupta VK, Kapur A. Gestational diabetes: The public health relevanceand approach. Diabetes Res Clin Pract 2012;97:350-8.  Back to cited text no. 1
    
2.Ramachandran A, Ma RC, Snehalatha C. Diabetes in Asia. Lancet 2010;375:408-18.  Back to cited text no. 2
    
3.Marseille E, Lohse N, Jiwani A, Hod M, Seshiah V, Yajnik CS, et al. The cost-effectiveness of gestational diabetes screening including prevention of type 2 diabetes: Application of a new model in India and Israel. J Matern Fetal Neonatal Med 2013;26:802-10.  Back to cited text no. 3
    




 

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