GDM-GESTATIONAL DIABETES MELLITUS
- GDM has implications beyond the Index pregnancy, identifying two generations (Mother & her Offspring) at risk greater of future diabetes.
- Indian women have 11-fold increased risk of developing GDM compared to white women.
- It is important to detect GDM cases because if unrecognised, pregnancy may end in perinatal morbidity.
- About 30% Of women with GDM will progress to Type2 Diabetes in a period of 2-20 years after pregnancy.
Beta Cell Dysfunction
Pancreatic islet beta-cell dysfunction and loss begin prior to the diagnosis of Diabetes.Only 40-60% of beta-cell function being present by the time of diagnosis of Diabetes.
Insulin therapy is required when progressive loss of beta-cell function leads to deteriorating glycaemic control. Data from UKPDS trial showed that 44% of patients require Insulin Therapy 6 yrs after the diagnosis of T2DM.
Insulin therapy followed by intensification is the most effective treatment for glycaemic control. It is associated with reduction in micro-vascular complications like retinopathy, nephropathy & neuropathy.