Muhammad Abul Hasanat
Bangabandhu Sheikh Mujib Medical University, Bangladesh
Title: Gestational diabetes mellitus- experience in BSMMU, Bangladesh
Biography
Biography: Muhammad Abul Hasanat
Abstract
South-East Asia has the highest prevalence of hyperglycemia in pregnancy (24.2%). Screening for gestational diabetes mellitus (GDM) is important owing to adverse fetal and maternal outcomes and risk of developing diabetes in future. Different methods of screening has hindered the development of a universal diagnostic criterion for GDM. An alarming frequency of GDM in Bangladeshi population following World Health Organization (WHO) 1999 and WHO 2013 diagnostic criteria respectively (36.6% and 40.9%) was observed. Comparison of WHO 1999, modified O’Sullivan and WHO 2013 criteria for GDM revealed discrepancy among these criteria despite good agreement. We observed higher frequency of risk allele, TCF7L2 rs7903146 in Bangladeshi GDM mothers under pilot study. Association was stronger in women having lower age and body mass index (BMI). Postpartum persistence of abnormal glucose tolerance (AGT) in GDM was also higher (50%); AGT in early gestation, use of insulin during pregnancy, higher maternal age and BMI were predictors for it. Adverse events were relatively higher in mothers with AGT than those with normal glucose tolerance (NGT) despite treatment (not significant). Implementation of 03-sample OGTT in resource poor setting is difficult. We are comparing diagnostic efficiency of simpler Diabetes in Pregnancy Study Group India (DIPSI) criterion with intention to implement for screening of GDM in community level. The extent of thyroid dysfunction in mothers with GDM is also being evaluated by our group. Multinational broad-based comparative studies are needed to explore the genetic predisposition and risk factors for GDM among the ethnic groups of different countries in Asia.