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NDDG or C&C?

The current controversies regarding GDM pertain to screening and diagnosis: there is no consensus on optimal protocols. For example, there are two diagnostic criteria, with differing cut-off levels used, following an oral glucose tolerance test. It stands to reason that prevalence rates of GDM in a given population will be influenced by the diagnostic criteria used.

Are there any Indian guidelines to screen and manage GDM?

Pregnancy induces progressive changes in maternal carbohydrate metabolism. As pregnancy advances,  insulin resistance and diabetogenic stress due to placental hormones necessitate compensatory increase in insulin secretion. When this compensation is inadequate gestational diabetes develops. ‘Gestational Diabetes Mellitus’ [GDM] is defined as carbohydrate intolerance with onset or recognition during pregnancy. Women diagnosed to have GDM are at increased risk of future diabetes predominantly type 2 DM as are their children. Thus GDM offers an important opportunity for the development, testing and implementation of clinical strategies for diabetes prevention.  Timely action taken now in screening all pregnant women for glucose intolerance, achieving euglycemia in them and ensuring adequate nutrition may prevent in all probability, the vicious cycle of transmitting glucose intolerance from one generation to another.