By Abdul Qadir Qureshi
(Pakistan News & Features Services)
The World Diabetes Foundation (WDF) has launched a three-year ‘Gestational Diabetes Mellitus Prevention and Control Program’ project in Pakistan with the collaboration of the Baqai Institute of Diabetology (BID), Karachi.
The Head of the Institute, Prof Dr. Abdul Basit, while explaining the salient features of the project said in an interview that the WBF is helping the developing countries in combating the rapidly rising epidemic of diabetes with the BID being its strategic partner in Pakistan.
“Our country has a high prevalence of diabetes while in the past years, the occurrence of high blood pressure had doubled and that of obesity tripled in the ages of 15 to 25 years, therefore even younger population, (18 years or less) is getting afflicted with Type 2 Diabetes,” he remarked.
According to him nearly 9.6 million children are overweight and obese. There is increased risk of rise in the prevalence of Type 2 Diabetes, causing huge economic burden.
He said that health needs to be a priority of our policy makers and there ought to be national policies for the prevention of diabetes and it has become important to launch diabetes-related international projects in Pakistan.
Prof Dr Basit pointed out that diabetes occurring first time during pregnancy is called Gestational Diabetes. Women of south Asian origin are more likely to have Gestational Diabetes and its adverse consequences.
Over 10% of pregnancies in our population are complicated by Gestational Diabetes which creates risk of developing diabetes, high blood pressure and heart disease in the mother, later in the life and increased risk of developing obesity, high blood pressure and diabetes in the offspring during child hood and adolescence.
Continuing, he said, Gestational Diabetes should be considered as an early warning sign of Type 2 Diabetes occurrence (40% - 60% risk of developing Type 2 diabetes in 5 to 15 years) and efforts should be made to prevent it through lifestyle modification strategies such as improving physical activity, reducing weight and improving diet of Pakistani women of reproductive age and the project is a major step in that direction.
On the occasion, Dr Shabeen Naz Masood said that women with uncontrolled blood sugar levels during pregnancy may have immediate adverse consequences such as deranged lipid levels, high blood pressure, pre-eclampsia and eclampsia.
They are more prone to obstetric complications, such as abortions, preterm deliveries and Shoulder Dystocia and have greater probability of undergoing caesarian section, she said and added that offspring of women with GDM are at an increased risk of developing congenital malformations such as defects in the heart , central nervous system and musculoskeletal system, hypospadias, polydactyl and fetal growth restriction. The birth of a large and heavy baby may cause complication during labour. The newborn may suffer from respiratory distress, jaundice or low blood sugar. Fetal mortality is also high.
Dr Musarrat Riaz, another noted Diabetic specialist, said that our ethnic predisposition to diabetes necessitates universal screening of all pregnant women for Gestational Diabetes and the simplest test is the estimation of blood sugar 2 hours after giving a drink of 75 gm glucose, at the first visit of pregnant lady to a doctor irrespective of that the patient is fasting or not. Patient education is the key to the management and medical nutrition therapy and exercise are the first steps.
If blood sugar is still not within normal limit insulin therapy is initiated. Insulin is the gold standard treatment. Blood sugar of the mother should be monitored during pregnancy and at regular intervals after delivery.
Accompanying Prof. Basit, another specialist, Dr Asmat Nawaz, informed that main objectives of this project are to create awareness in the community, to train doctors and health care professionals and to establish Gestational Diabetes screening as a regular procedure.
He said that Public Awareness Campaign through print and electronic media would be initiated, awareness literature in Urdu and Sindhi languages would be developed, doctors, midwives and paramedics would be trained, three major Gestational Diabetes canters and 30 minor Gestational Diabetes clinics would be established and over 13000 pregnant women would b e screened.