by Vishnuprasad on  September 30, 2015 at 2:02 PM Health In Focus
 Global Leaders in Diabetes Introduce New Model of Care for Gestational Diabetes Mellitus
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 type 2 diabetes 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 Specialties

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 components:
  • 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.
  • Following up women with GDM, treated with the model of care, to ensure safe delivery.
  • Following 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.




    Source: Medindia

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