Hema Divakar
BACKGROUND
The aim of the study is to determine the current practices in the medical college institutions pan India for testing for Hyperglycaemia in Pregnancy (HIP) to detect gestational diabetes and highlight areas that need additional attention in order to ensure adherence to current national guidelines.
MATERIALS AND METHODS
Questionnaires were used to obtain information regarding the testing strategy for hyperglycaemia in pregnancy. The questionnaires were filled out by the teaching faculty of the OB/GYN departments of 47 medical college institutions in India. The perceptions regarding the prevalence of diabetes in pregnancy in India and the needs for capacity building were assessed.
RESULTS
Forty seven respondents answered the questionnaires. The majority of respondents (95.83%) reported that all pregnant women were offered (universal) testing for hyperglycaemia in pregnancy and 37.5% reported that women were screened both in early and midtrimester of pregnancy. Most reported that testing for HIP took place once at booking, irrespective of the gestational age (39.58%). Thirty three (70.21%) respondents reported using the single-step nonfasting method to diagnose hyperglycaemia. Furthermore, 21.28% of respondents reported using a glucometer to determine the concentration of blood glucose in plasma, while 68.08% reported using a lab analyser. The instructions for the testing were offered by consultants and postgraduates in a vast majority of cases (87.5%). The staff communicated with the women in a significantly less number of cases (12.5%). 65.96% of respondents felt that all women readily agreed to follow this advice. The majority of respondents (89.35%) reported having noticed an increase in the number of women with hyperglycaemia. Furthermore, 91% of all the respondents felt there was a need to train medical personnel to test and manage hyperglycaemia.
CONCLUSION
Our study confirms the continued wide variability in testing for HIP in India with respect to timing and frequency. It highlights the need for training initiatives to improve adherence to national guidelines.
Clinical Significance- Increasing adherence to and awareness of national guidelines has the potential to result in earlier diagnosis and management of HIP. This would have an impact, which would improve pregnancy outcomes, maternal and neonatal health both in the short term as well as long term. Building the capacity of the available resource pool of healthcare providers including the staff nurses would empower them by for better communication. This would improve compliance for testing and follow up.
