title: Clinical profile, outcomes, and progression to type 2 diabetes among Indian women with gestational diabetes mellitus seen at a diabetes center in south India.
abstract: OBJECTIVE
  To describe the clinical profile, maternal and fetal outcomes, and the conversion rates to diabetes in women with gestational diabetes mellitus (GDM) seen at a tertiary care diabetes center in urban south India.
  
  
  METHODS
  Clinical case records of 898 women with GDM seen between 1991 and 2011 were extracted from the Diabetes Electronic Medical Records (DEMR) of a tertiary care diabetes center in Chennai, south India and their clinical profile was analyzed. Follow-up data of 174 GDM women was available. To determine the conversion rates to diabetes, oral glucose tolerance test (OGTT) was done in these women. Glucose tolerance status postpartum was classified based on World Health Organization (WHO) 2006 criteria.
  
  
  RESULTS
  The mean maternal age of the women was 29 ± 4 years and mean age of gestation at first visit were 24 ± 8.4 weeks. Seventy percent of the women had a family history of diabetes. Seventy-eight percent of the women delivered full-term babies and 65% underwent a cesarean section. The average weight gain during pregnancy was 10.0 ± 4.2 kg. Macrosomia was present in 17.9% of the babies, hypoglycemia in 10.4%, congenital anomalies in 4.3%, and the neonatal mortality rate was 1.9%. Mean follow-up duration of the 174 women of whom outcome data was available was 4.5 years. Out of the 174, 101 women who were followed-up developed diabetes, of whom half developed diabetes within 5 years and over 90%, within 10 years of the delivery.
  
  
  CONCLUSIONS
  Progression to type 2 diabetes mellitus (T2DM) in Indian women with GDM is rapid. There is an urgent need to develop standardized protocols for GDM care in India that can improve the maternal and fetal outcomes and help prevent future diabetes in women with GDM.
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Non communicable Diseases Prevention and Control, Chennai, Tamil Nadu, India.
authors.forename: Manni Mohanraj
authors.initials: MM
authors.lastname: Mahalakshmi
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Non communicable Diseases Prevention and Control, Chennai, Tamil Nadu, India.
authors.forename: Balaji
authors.initials: B
authors.lastname: Bhavadharini
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Non communicable Diseases Prevention and Control, Chennai, Tamil Nadu, India.
authors.forename: Maheswari
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Non communicable Diseases Prevention and Control, Chennai, Tamil Nadu, India.
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.affiliation: Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Vanderbilt University Nashville, Tennessee, USA.
authors.forename: Sapna S
authors.initials: SS
authors.lastname: Shah
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Non communicable Diseases Prevention and Control, Chennai, Tamil Nadu, India.
authors.forename: Akila
authors.initials: A
authors.lastname: Bridgette
authors.affiliation: Diabetes Division of Medtronic, Inc, Tennessee, USA.
authors.forename: Mridusmita
authors.initials: M
authors.lastname: Choudhury
authors.affiliation: Diabetes Division of Medtronic, Inc, Tennessee, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Henderson
authors.affiliation: Diabetes Division of Medtronic, Inc, Tennessee, USA.
authors.forename: Lane
authors.initials: L
authors.lastname: Desborough
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Non communicable Diseases Prevention and Control, Chennai, Tamil Nadu, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Viswanathan
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, World Health Organization Collaborating Centre for Non communicable Diseases Prevention and Control, Chennai, Tamil Nadu, India.
authors.forename: Harish
authors.initials: H
authors.lastname: Ranjani
keywords: American Diabetes Association; Asian Indians; WHO; gestational diabetes; progression to type 2 diabetes