SUBJECTS & METHODS

Duration of study: 3 years from January 1990 to December 1992.

Total no. of subjects: 192.

Inclusive criteria: All pregnant women registered for antenatal care & delivery who were not known to be diabetics were included.

Every registrant was subjected to glucose challenge test with 50g glucose load.

Blood glucose exceeding 130mg% 1 hour after glucose ingestion was considered as positive & followed by a 3-hour oral glucose tolerance test with 100 g glucose load.


Women with negative result were retested at 24 weeks gestation.

GDM was diagnosed on basis of O'Sullivan's criteria.

Plasma glucose values of 105mg%, 190mg%, 165mg%, 145mg% for fasting, 1hour, 2hour & 3hour samples were considered abnormal.

To give diagnosis of GDM, 2 readings had to exceed or equal these values.
A detailed history of every woman was noted, followed by an extensive physical examination.

Diet free of refined sugar was prescribed.

It comprised 30-35 calories/kg ideal body weight/day divided into 3 main meals, 2 in-between snacks & 1 bedtime snack.

Glycemic level was closely monitored.

If after a week of dietary restrictions, optimal control (fasting blood glucose (FBG) 95mg% & 2-hour post prandial 125mg%) was not achieved, insulin therapy was started.
Home blood-glucose monitoring, though highly desirable, could not be practised for economic reasons.

Each subject was seen every 2 weeks until end of pregnancy.

Spontaneous labour was allowed unless contraindicated.

After delivery, dietary restrictions & insulin were withdrawn & blood glucose was monitored.

The infants birth weights were noted.

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Drug Rehab

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