Gestational diabetes

In addition to the 32 million people living with diabetes in India, recent data indicate that about 16% of pregnant Indian women have gestational diabetes.  Despite medical and scientific advancement many remain in the dark about basic knowledge on diabetes and its prevention and control measures - not least information and awareness on gestational diabetes mellitus. This is true not only for the lay public but also among health care professionals. The problem of gestational diabetes and its potential influence on the development of diabetes in the mother and child at a later stage has been largely un-addressed. Objective The project seeks to create awareness among the public - in particular women's groups - on gestational diabetes and to build capacity in the health care system to prevent, manage and control the problem. Approach The first three years of intervention are considered a pilot phase of the project. In this phase, the project will focus on one urban and one rural setting. These will be the city of Chennai and Kanchipuram district in the state of Tamil Nadu. The surveillance aspect of the project covers 1000 pregnant women in Chennai city and 1500 in Kanchipuram district attending primary health centres and child welfare centres spread over the selected areas. These women will form the primary target group to be followed for a period of three years. Capacity building will take place at different levels. Medical professionals in the project area will be trained for monitoring and guiding the field staff to run the project activities. The field staff will be trained to be able to perform the various activities, including enlisting pregnant women, administering glucose tolerance test, identifying gestational diabetes, medical nutrition therapy, insulin administration, follow up etc. Last but not least, local NGO's women self help groups are trained for their effective participation to educate their families, other women and the communities at large. The awareness component of the project will focus on first identifying message contents for dissemination among the target groups. Production and distribution of posters, handbills, pamphlets and stickers will take place and mass media will be used to disseminate the messages. Specialist agencies will be used for the mass media aspect, whereas local NGOs play a key role in raising the awareness in the communities.   Expected Impact An estimated 2,450 health care staff, including doctors, nurses, dieticians and extension educators will be trained directly or indirectly on symptoms, treatment and preventive/control measures Automatic screening for gestational diabetes among pregnant women will become institutionalised in the target areas An estimated 400 women with gestational diabetes will be treated and taught how to prevent subsequent type 2 diabetes for themselves as well as their families 2100 women at risk of gestational diabetes will be taught how to prevent subsequent diabetes for themselves as well as their families   Results to date Repeat training was given to 310 multi purpose health workers and 160 village health nurses In urban Chennai, Saidapet (Chennai) and in rural Tiruvallur pregnant women are screened and followed for 3 years after first contact. In Chennai 739 of 4131 screened women had GDM, in Tiruvallur, 391 of 4072 screened women had GDM and in Saidapet district of Chennai 653 of 5131 screened women had GDM Overall prevalence of GDM found during screening is 16,8% in urban Chennai and 10,8% in rural Tiruvallur Glucose intolerance six months after delivery has been detected in 17-26% of all the GDM cases The prevalence survey also indicates that 95% of women with gestational diabetes may be controlled with a meal plan and only 5% require insulin treatment A campaign has been held, targeting pregnant women, and women ranging from adolescent girls to elderly women with awareness about GDM, symptoms, population at risk and complications. Hour long television participation ensured that the message of GDM could be reached throughout Tamil Nadu and by Tamil speaking people nationwide. Slides on GDM were shown in cinemas As a result of the project's activities, the government of Tamil Nadu has issued a government order that screening for GDM in all antenatal women should be mandatory and it will be done free of cost. The government is planning to introduce standard GDM screening among all pregnant women by 1st or 2nd quarter 2008.   The intervention is continued under WDF08-312.

Project data

Area Partner Project responsible Duration Project budget WDF contribution Project number

Tamil Nadu, India Dr. V. Seshiah Diabetes Care and Research Institute Prof. V. Seshiah August 2004 - April 2008 EUR 328,996 EUR 328,996 WDF04-067

This page was last updated 9-23-2008 by sfh.wdf