Awareness Creation Screening procedures & Management
(Guidelines)
Aim:
• Gestational Diabetes mellitus – awareness creation
• Screening for glucose intolerance during pregnancy
• Prevention and control in the community
Screening procedure
• Project Co-ordinator/ Project Medical Officers will be in constant touch with the Maternity centres/PHC/HSC
• Medical officers of PHC/Corporation Health Post (FW centres), PHN, MPHW/VHN will identify the pregnant women
• The pregnant women will be asked to come on her convenient day or Ante-natal clinic day on empty stomach (she can take water)
• She will be given 75gm of glucose in 300ml of clean water. She can drink the glucose water in 5 to 10 minutes.
• The blood sample will be taken after 2 hrs.
• For the women who has diabetes before pregnancy, she will be tested for fasting and 2 hrs after food instead of 2 hrs after glucose
The blood test will be done by capillary method by using ‘Accucheck’ glucometer.
The amount of blood required will be less than a drop. Disposable needle will be used for each patient.
Diagnosis
• 2 hr ≥ 140mg%
• If GDM is diagnosed, she will be given meal plan and asked to come after two weeks.
Screening
• To start with all pregnant women will be screened if they are meeting the criteria of 16th,24th and 32nd week of pregnancy.
• If screening is done around 16th week and if the test is negative for GDM, she will be asked to come again around 24th week.
• If the test is negative for GDM at 24th week, it will be repeated around 32nd week.
The blood testing, recording the case sheet and follow up will be done by the medical officer concerned.
• The gestational diabetes woman would be advised regarding the importance of maintaining the blood sugar at normal level.
Follow Up
• The blood glucose of the GDM woman will be monitored periodically once in 15 days / 1 month and advise would be given.
• After delivery, the new born weight and Apgar score will be recorded.
After the delivery-
• Many women may not require any treatment for diabetes as most of them return to normal glucose tolerance. If required they will be advised accordingly.
• Two months after delivery, Women who had GDM will be given 75g of glucose orally and blood tested after 2 hours.
• The same procedure will be repeated after Six months, one year and there after every year.
• In case, she conceives within this period, the same procedure that has been performed in their earlier pregnancy will be followed.
