SAFES identifies to focus on Gestational Diabetes Mellitus during 2015-2017


 The Dhaka Declaration 2015

SAFES identifies to focus on Gestational
Diabetes Mellitus during 2015-2017

DHAKA (BANGLADESH): The SAFES SUMMIT held here from 24-26th April 2015 which was attended by diabetologists and endocrinologists from India, Bangladesh, Pakistan, Nepal and Sri Lanka approved the Dhaka Declaration 2015 which has identified to focus on Gestational Diabetes Mellitus during 2015-2017. South Asian Federation of Endocrine Societies (SAFES) it may be mentioned here consists of associations of The Endocrine Society of Bangladesh, Endocrine Society of India, Diabetes and Endocrine Association of Nepal, Pakistan Endocrine Society and Endocrine Society of Sir Lanka.

The incidence of GDM, the declaration states, is one the rise in all South Asian nations and many predict the future prevalence of type 2 diabetes mellitus as well. Asians are particularly at increased risk of GDM as found in multi-ethnic studies.  Prevalence of GDM in South Asian countries varies substantially according to the screening strategy and diagnostic criteria applied and ranges from 1% to 20% with evidence of an increasing trend over recent years.

India has a higher age standardized prevalence of hyperglycemia in pregnancy with estimates of 27.5%. The prevalence in Bangladesh and Sri Lanka has been reported to be around 10%.  Researchers from Pakistan and Nepal have reported a prevalence of around 1% in low risk subjects. GDM is a condition which is unique in many ways. Affecting two lives at a time, it has an inter-generational impact as well. The offspring of mothers with GM have adverse cardio metabolic profiles and are at increased risk of diabetes and obesity which further contributes to the epidemic of non-communicable diseases. GDM lends itself to timely management and to prevention as well. All levels of prevention; primary, secondary, tertiary and quaternary, find a suitable playing field in GDM. The management of GDM is predominantly non-pharmacological but may require the support of medication such as insulin too.

Our aim, the declaration further states, should be to improve short and long term outcomes, for both mother and her offspring. GDM is a perfect example of the need for a life cycle, approach, and interdisciplinary care, long term follow up and of fostering of patient-physician-family interaction. GDM impacts not only the individual or family but public health as well. There is a need for large scale prevention and intervention programmes to improve glucose control a maternal health during pregnancy and sustain them postpartum, the declaration concluded.