Focus of World Diabetes Day is on education and prevention

The focus and theme this World Diabetes Day (on November 14) is on education and prevention.

Diabetologists say the importance of prevention cannot be over emphasised, especially in the context of diabetes, the complications of which can affect every organ in the body.

While a certain amount of awareness on the condition already exists and is probably growing, there is one segment that gets less attention than it deserves, experts add.

Awareness on gestational diabetes, or diabetes induced by pregnancy, is less than what is necessary, says V.Seshiah, Chairman, Dr. V Seshiah Diabetes Research Institute.

“Keeping the mother's blood sugar under control during pregnancy is in the realm of primordial prevention. It is possible that we can prevent the child from getting diabetes at a later stage. It is now known as intra-uterine programming and it is very important,” Dr. Seshiah adds.

The key lies in two important precautions the mother takes during the full term of the pregnancy – taking in good nutrition and keeping the blood sugar at an acceptable level.

Acceptable levels are blood sugar levels around 90 in the fasting phase and 120 in the postprandial test.

“We can then hope that the foetus inside has a good chance at being free of diabetes,” he explains.

V. Balaji, director, Dr. Balaji Diabetes Care Centre, says, “Actually, preventing Gestational Diabetes Mellitus is a window of opportunity to prevent diabetes for both the mother and the child.”

Normal weight

While the normal weight gain during pregnancy of 7-10 kgs is allowed, getting back to normal weight after pregnancy and lactation, following a healthy diet and getting good physical activity is very important, he adds.

The conversion from GDM to Type 2 diabetes, which used to be 30 per cent in 10 years, is now increasing steadily, according to Dr. Balaji.

“We are now seeing a lot of mothers who had GDM coming back within the first 1-2 years with diabetes,” he adds.

Conducting regular blood sugar checks during pregnancy is essential, Dr.Seshiah says.

“That is the diagnostic aspect. The government of Tamil Nadu has made mandatory testing all pregnant women for diabetes – it is a good step in the right direction.”

However, as far as treatment goes, it is not just insulin shots as many fear, he adds.

Diabetologists first try medical nutrition therapy, a diet that would be adequate for the mother and the foetus and at the same time not raise her blood sugar levels.

“Almost 90-95 per cent of women respond to this, once the diabetes is diagnosed. It is only when this fails that we think of insulin,” Dr. Seshiah adds.

He also predicts that GDM is likely to climb in importance in the global arena.

Dr. Seshiah has just been made the Vice Chairman of the International Association of Diabetes Pregnancy Study Groups and says this gives India a significant role in deciding the agenda.

At the end of the month, there is also a meeting convened by the WHO to discuss GDM and its prevention and education further, he adds.