Our Team's work in the field of Diabetes,
Pregnancy and Birth, is an on-going Project for the past 10 years, with
close collaboration between the diabetology unit (headed by C.V.Krishnaswami)
and the obstetric unit (headed by Prema Krishnaswami) and has resulted
in certain definite understanding in the classification of Diabetic
Pregnancies, nature of the Gestational diabetic state, and their ante-natal,
peri and post natal management and outcomes. These were presented in
detail at a largely attended full-day CME conducted by the Voluntary
Health Services Diabetes Department on the subject in February 1996,
at Chennai, with Prof. Dorothy R. Hollingsworth (University of California
at San Diego, U.S.A.) as the International faculty. The audio/video
transcription of the proceeding, are available at request.
The Voluntary Health Services
Diabetes Department classification of Diabetes & Pregnancy.
Group I Pre Gestational Diabetes
(PGDM) or Pre Conceptional Diabetes (PCDM)
Pre Gestational or Pre Conceptional
Diabetes includes all those who have type 1 diabetes mellitus (IDDM),
type 2 diabetes mellitus (NIDDM), MODY, Pancreatic Diabetes (FCPD),
Impaired Glucose Tolerance (IGT), and other types of diabetes mellitus
before pregnancy.
Group II (or) Overt
Gestational Diabetes Mellitus (OGDM) Those
diagnosed to have overt diabetes for the first time during pregnancy.
The GTT (75 G) values for diagnosis of group II GDM here are
|
Test
|
Fasting
mg/dl (mmol/l)
|
Peak Value - ½ Hr, 1 Hr, 1½ Hr
mg/dl (mmol/l)
|
2 Hr value
mg/dl (mmol/l)
|
| Blood Glucose |
>110 (6.1 ) |
>180 ( 10 ) |
>180 ( 10 ) |
Evidently some of this group may
be type 2 diabetes mellitus occurring for the first time during pregnancy,
presenting as GDM.
Group III or Gestational Diabetes
Mellitus (GDM)
Those diagnosed to have abnormal
carbohydrate tolerance on GTT (75 G load) for the first time during
pregnancy but not an overt diabetic state.
The cut off values here are :
|
Test
|
Fasting
mg/dl (mmol/l)
|
Peak Value - ½ Hr, 1 Hr, 1½ Hr
mg/dl (mmol/l)
|
2 Hr value
mg/dl (mmol/l)
|
| Blood Glucose |
>110 (6.1 ) |
>160 (8.8) |
120 (6.6) |
Group IV or Borderline GDM
(BLGDM)
Those diagnosed to have abnormal
carbohydrate tolerance on GTT (75 G load) for the first time during
pregnancy but the abnormality is confined to
