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en for glucose intolerance, achieving euglycemia in its complications, 1: Diabetes Med 1998; 15 :539-53.
them and ensuring adequate nutrition. This in turn in
all probability, will help in preventing the epidemic of Inadequacy of FPG to diagnose GDM
diabetes and CVD.DuringPostpartum period, women * In relation to FPG, there is a considerable variability
should be screened periodically for glucose intoler- between countries noted in the HAPO study with FPG
ance and advised proper diet plan and physical ac- diagnosing only 22% of GDM in women in Bangkok
tivities. Their off-springs should also be advised to and Hong Kong compared with up to 71% in some
follow the healthy diet and healthy lifestyle.
US centres .
References * A low diagnostic rate of FPG has also been report-
1. Hunt KJ, Schuller KL. The increasing prevalence of diabetes in pregnancy. ed in Asian Indians with a fasting plasma glucose
ObstetGynecolClin North Am 2007;34:173-99. 5.1 mmol/l (92 mg/dl) diagnosing only 24% of GDM .
2. Henry OA, Beischer NA. Long-term implications of gestational diabetes ( Strategies for Implementing the WHO Diagnostic
for the mother.BaillieresClinobstetGynaecol 1991;5:461-83.
Criteria and Classification of Hyperglycaemia First
3. Bernard L Silvermen, Nam H Cho, et al. Long-term effects of the intra- Detected in Pregnancy. Stephen Colagiuri, Maicon-
uterine Environment . Diabetes care 1998;21:B142.
Falavigna, Mukesh M. Agarwal, Michel Boulvain,
4. Wing Hung Tam, Ronald Ching Wan Ma, Risa Ozaki, et al. In Utero Edward Coetzee, Moshe Hod, Sara Meltzer, Boyd
Exposure to Maternal Hyperglycemia Increases Childhood Cardiometabolic Metzger, Yasue Omori, Ingvars Rasa, Maria Inês,
Risk in Offspring. Diabetes care 2017;40:679-686.
Veerasamy Seshiah, David Simmons, Eugene Sob-
5. KrishnaveniGV ,Hill JC, Leary SD, etal. Intrauterine exposure to maternal ngwi, Maria Regina Torloni, Hui-xia Yang. DRCP. 103
diabetes is associated with higher adiposity and insulin resistance and (2014) 364-372 )
clustering of cardiovascular risk markers in Indian children. Diabetes Care
33;402-404, 2010 * FPG is not an appropriate option to diagnose GDM
6. V.Seshiah,David McIntyre, Moshe hod et al.Matching diagnosis and man- in Asian Indian women as insulin resistance is higher
agement of diabetes in pregnancy to local prioritis and resources: An compared to Caucasians.
international approach.2009. IJGO.
* Increased IR during pregnancy in Asian Indian
7. Maternal Environment and the Transgenerational Cycle of Obesity and
Diabetes - Dana Dabelea and Tessa Crume – Diabetes, Volume 60 – July Women and escalates further in GDM
2011 – P 1849-1855
(Das S, Behera MK, Misra S, Baliarsihna AK. β-cell
8. McMillen IC, Edwards LJ, Duffield J, Muhlhausler BS. Regulation of leptin function and insulin resistance in pregnancy and
synthesis and secretion before birth: implications for the early program- their relation to fetaldevelopment.MetabSyndrRelat
ming of adult obesity. Reproduction 2006;131:415–427
disorder 2010; 8(1): 25-32.
9. Catalano PM. Obesity and pregnancy-the propagation of a viscous cycle?
J ClinEndocrinolMetab 2003;88:3505-3506 * In all GDM, FPG value do not reflect the PPG, which
10. Strategies for Implementing the WHO Diagnostic Criteria and Classifica- is the hallmark of GDM
tion of Hyperglycaemia First Detected in Pregnancy. Stephen Colagiuri, (Weiss PA, Haeusler M, Tanmussino K, Haas J. Can
MaiconFalavigna, Mukesh M. Agarwal, Michel Boulvain, Edward Coetzee,
Moshe Hod, Sara Meltzer, Boyd Metzger, Yasue Omori, Ingvars Rasa, glucose tolerance test predict fetal hyperinsulinism?.
Maria Inês, Veerasamy Seshiah, David Simmons, Eugene Sobngwi, Maria British Journal of Obstetrics and Gynecology 2000
Regina Torloni, Hui-xia Yang. DRCP. 103 (2014) 364-372 (107) 1480 – 1485)
11. C. Anjalakshi, V.Balaji, MadhuriBalaji, Et Al. A Single test procedure to * Fasting may be impractical and questionable in set-
diagnose gestational diabetes mellitus.ActaDiabetologia (2009) 46:51-54
tings where the detection of hyperglycemia in preg-
12. Thomas A Buchanan, Anny Xiang, Siri L Kjos, Richard Watanabe. “What nancy based on fasting values is low.
is gestational diabetes?” Diabetes Care 30(2): S105-111, July 2007
(Strategies for Implementing the WHO Diagnostic
Diagnostic Criteria:- Criteria and Classification of Hyperglycaemia First
Detected in Pregnancy, 2013)
GDM is diagnosed if any one value is abnormal But FPG
is given importance(International workshop conference ((South-East Asians had the lowest BMI, lowest fast-
on gestational diabetes diagnosis and classification: ing yet highest 2-hr glucose level on 75-g glucose
Consensus Forum Report. November 7 , 2008) tolerance test.
th
GDM 2-hour PG >140mg/dl similar to that of IGT out- V. W. Wong etalDiabet. Med. 29, 366–371 (2012)))
side pregnancy (WHO).
* A Prospective study was undertaken to elucidate a
Alberti K, Zimmett P. WHO Consultation, Definition, test procedure irrespective of the last meal timing to
diagnosis and Classification of diabetes mellitus and diagnose GDM

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