All India Institute of Medical Sciences, India
Title: Universal screening and timely intervention in gestational diabetes mellitus: A key to successful feto-maternal outcome
Dr Prasanta Kumar Nayak, has done his post graduation in Obstetrics and Gynecology from the prestigious SCB Medical College and Hospital, in Utkal university. He is presently working as an assistant professor in All India Institute of Medical Sciences, Raipur, which is a prestigious autonomous medical college of Government of India. He has been worked as faculty in Pondicherry central university before joining this premier institute. He is actively involved in patient treatment, teaching of medical students and research work. He has been worked as the chief investigator and co-investigator in various research programmes conducted at institutional level. He has worked as guide and co-guide for research programmes undertaken by students. He has presented papers in many conferences and delivered speeches in some of them. He is a trained laparoscopic surgeon and an expert in obstetric USG. His areas of interest are endocrinology, high risk pregnancy, endoscopic surgery and infertility. He has thirteen publications in various national and international journals to his credit.
Over the last few decades, diabetes has evolved as the most common medical complication of pregnancy. The increasing prevalence of Type 2 diabetes in general, and in younger people in particular, has led to an increasing number of pregnancies with this complication. Gestational diabetes is such a disease that puts two generations at risk of developing future diabetes mellitus. It is a disease which does not discriminate based on race, religion or community. Indications and methods of screening, the diagnostic criteria and management has been the subject of considerable controversy. After the reports of HAPO study, many medical associations including ADA are now in favour of universal screening. Compliance with diet and insulin, close glycemic monitoring, antenatal fetal surveillance for sudden intrauterine demise, management of macrosomia and shoulder dystocia, are only a handful of the numerous tough challenges which obstetricians face. Since complications are directly related to the glycemic status, so a timely diagnosis and optimal management is prudent. Strict glycemic targets, home glucose monitoring and meticulous fetal monitoring are the cornerstones for successful feto-maternal outcomes. It is high time now that all clinicians should unite to fight against this giant enemy. My talk will focus on latest evidence-based management of GDM - medical nutrition therapy, exercise, insulin and oral hypoglycemic agents. I will also discuss about the controversies and dilemma associated with various diagnostic criteria.