Global leaders in diabetes care
have sought the support of the Indian government to implement a new model of
care for gestational diabetes mellitus (GDM).
The new model of care is a part of
the 'Women in India with GDM Strategy' (WINGS) program developed by the expert
members of the International Diabetes Federation (IDF), Madras Diabetes
Research Foundation (MDRF) and the Abbott Fund. The WINGS program offers
community-based interventions for women with gestational diabetes
in low resource settings.
Dr.V.Mohan, Director of Madras
Diabetes Research Foundation, in a press meet, said that the team would ask
support from the Indian government to implement the program across the country.
"India has highest rates of
women with GDM. If the government extends support to implement the program, we
will be able to help more than 5 million women affected with GDM in the
country," Dr. Mohan said.
The new model of care was piloted
in Tamil Nadu, India and involved more than 2,100 women. Around 60 physicians
were trained on the model of care, and around 250 community health workers were
involved in the outreach program to increase awareness of GDM. The program also
gave significance to close follow-ups and interaction between healthcare
workers and patients.
Results of the New Model of Care
The most significant return from
the study was that participants with GDM were identified to have pregnancy
results similar to the pregnant women without GDM. Also, the program obstructed
most of the adverse outcomes of GDM such as obstructed labor, primary cesarean
delivery, and Preeclampsia
In India, post-partum follow-up
rates are usually between 10 to 20%. However, the project saw about 96% of
women return for follow-up after delivery. About 4% women had already developed
during the follow-up testing. This shows the need for
follow-up check for diabetes after the delivery.
The new model of care proved that
through an intensive and continued effort, universal post-partum follow-up and
prevention of type 2 diabetes are attainable.
Dr. Mohan noted that the project
had helped local women manage GDM and raise awareness about GDM in Tamil Nadu.
"The project has also helped
train medical and paramedical personnel on GDM," Dr. Mohan said.
Ms. Anne Belton, Vice-President,
IDF, said that with the new model of care we have a big opportunity to uplift
the lives of two generations and prevent type 2 diabetes in mothers.
"The success of the study in
Tamil Nadu is good news for Indian social and economic development, which may
set the example for other low-resource settings," Ms. Belton said.
Andy Wilson, Vice President, the
Abbott Fund said that gestational diabetes is a hidden epidemic, and there is a
lack of awareness among Indian women about the disease.
"The lack of awareness leads
to increased risks for women and their babies. The program provides mothers
with the information and support they need. The program can also create
healthier families across India," Wilson said.
The WINGS-model and its
The new model of care was
developed using the best practice of care and established clinical guidelines.
The model gets perfection with the help of practitioners from the urban and
rural healthcare centers in Chennai to ensure that the approach is culturally
applicable and feasible.
The program also aimed to respond
to some of the critical gaps about gestational diabetes mellitus care by the
suggestions put forward in the IDF Global Call to Action and Policy Brief on
Diabetes in Pregnancy.
The model has the following
- Screening of all pregnant women for GDM: The project
suggests testing to be done at the first visit to the antenatal clinic and
doing fasting oral glucose tolerance test at 24 - 28 weeks. Screening all
pregnant women is an important first step to providing them with the care to
help them stay fit for delivery.
- Providing women with
diabetes education and guidance on diet, exercise, and appropriate medical
care. The diet must be rich in protein. They must also exercise a minimum of 30
minutes every day.
- Mobilizing healthcare providers and the
broader community in the prevention and care of GDM.
up women with GDM, treated with the model of care, to ensure safe delivery.
up women with DGM after delivery, analyzing pregnancy results and checking for
diabetes status at six weeks post-delivery.
These results were presented at a
function held in Chennai on the 26th and 27th of September 2015. The event was
attended by Dr. J. Radhakrishnan, Secretary to Government, Health and Family
Welfare Department, Govt of Tamil Nadu and over 300 delegates representing
physicians, obstetricians and gynecologists. Prof. V. Seshiah was conferred the
DMDSC Lifetime Achievement Award at the event. The "WINGS Educational Tool
Kit" was released on the occasion.
References: 1. http://www.idf.org/