title: Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4).
abstract: OBJECTIVE
  The Women In India with GDM Strategy (WINGS) project was conducted with the aim of developing a model of care (MOC) suitable for women with gestational diabetes mellitus (GDM) in low- and middle-income countries.
  
  
  METHODS
  The WINGS project was carried out in Chennai, Southern India, in two phases. In Phase I, a situational analysis was conducted to understand the practice patterns of health-care professionals and to determine the best screening criteria through a pilot screening study.
  
  
  RESULTS
  Phase II involved developing a MOC-based on findings from the situational analysis and evaluating its effectiveness. The model focused on diagnosis, management, and follow-up of women with GDM who were followed prospectively throughout their pregnancy. An educational booklet was provided to all women with GDM, offering guidance on self-management of GDM including sample meal plans and physical activity tips. A pedometer was provided to all women to monitor step count. Medical nutrition therapy (MNT) was the first line of treatment given to women with GDM. Women were advised to undergo fasting blood glucose and postprandial blood glucose testing every fortnight. Insulin was indicated when the target blood glucose levels were not achieved with MNT. Women were evaluated for pregnancy outcomes and postpartum glucose tolerance status.
  
  
  CONCLUSIONS
  The WINGS MOC offers a comprehensive package at every level of care for women with GDM. If successful, this MOC will be scaled up to other resource-constrained settings with the hope of improving lives of women with GDM.
authors.affiliation: Department of Policy and Programmes, International Diabetes Federation, Brussels, Belgium.
authors.forename: Arivudainambi
authors.initials: A
authors.lastname: Kayal
authors.affiliation: Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
authors.affiliation: Department of Policy and Programmes, International Diabetes Federation, Brussels, Belgium.
authors.forename: Belma
authors.initials: B
authors.lastname: Malanda
authors.affiliation: Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.affiliation: Department of Policy and Programmes, International Diabetes Federation, Brussels, Belgium.
authors.forename: Balaji
authors.initials: B
authors.lastname: Bhavadharini
authors.affiliation: Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
authors.forename: Manni Mohanraj
authors.initials: MM
authors.lastname: Mahalakshmi
authors.affiliation: Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
authors.forename: Kumar
authors.initials: K
authors.lastname: Maheswari
authors.affiliation: Department of Obstetrics and Gynecology, Seethapathy Clinic and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Ram
authors.initials: R
authors.lastname: Uma
authors.affiliation: Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Unnikrishnan
authors.affiliation: Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
authors.forename: Gunasekaran
authors.initials: G
authors.lastname: Kalaiyarasi
authors.affiliation: Department of Policy and Programmes, International Diabetes Federation, Brussels, Belgium.
authors.forename: Lyudmil
authors.initials: L
authors.lastname: Ninov
authors.affiliation: Department of Policy and Programmes, International Diabetes Federation, Brussels, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Belton
keywords: Asian Indians; South Asians; WINGS; gestational diabetes mellitus; management; model of care; pregnancy outcomes; screening and diagnosis