title: Pregnancy outcome of gestational diabetes mellitus using a structured model of care : WINGS project (WINGS-10).
abstract: OBJECTIVE
  To evaluate the impact of a structured model of care (MOC) prepared for resource-constrained settings, on the pregnancy outcomes of Asian Indian women with gestational diabetes mellitus (GDM).
  
  
  METHODS
  Pregnant women were screened under the Women in India with GDM Strategy (WINGS) MOC for GDM using the International Association of Diabetes and Pregnancy Study Groups criteria. Women with GDM went through a structured MOC that included medical nutrition therapy (MNT), regular physical activity (PA); and insulin when indicated. Fasting blood glucose and post-prandial blood sugar were monitored every 2 weeks. The pregnancy outcomes of women with GDM who underwent the MOC were compared with those without GDM.
  
  
  RESULTS
  Under the MOC, 212 women with GDM were followed through pregnancy, of whom 33 (15.6%) required insulin and 179 (84.4%) were managed with MNT and PA. The maternal and neonatal outcomes of women with GDM were similar to the non-GDM women: there were no significant differences in pregnancy complications such as cesarean section, macrosomia, pre-eclampsia, oligo/polyhydramnios, preterm delivery, neonatal death, fetal distress, hyperbilirubinemia and low birthweight.
  
  
  CONCLUSIONS
  Implementation of a structured MOC for women with GDM helped achieve pregnancy outcomes similar to those without GDM.
authors.affiliation: Seethapathy Clinic and Hospital, Chennai, India.
authors.forename: Ram
authors.initials: R
authors.lastname: Uma
authors.affiliation: Madras Diabetes Research Foundation, Chennai, India.
authors.forename: Balaji
authors.initials: B
authors.lastname: Bhavadharini
authors.affiliation: Madras Diabetes Research Foundation, Chennai, India.
authors.forename: Harish
authors.initials: H
authors.lastname: Ranjani
authors.affiliation: Madras Diabetes Research Foundation, Chennai, India.
authors.forename: Manni Mohanraj
authors.initials: MM
authors.lastname: Mahalakshmi
authors.affiliation: Madras Diabetes Research Foundation, Chennai, India.
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.affiliation: Madras Diabetes Research Foundation, Chennai, India.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Unnikrishnan
authors.affiliation: International Diabetes Federation, Brussels, Belgium.
authors.forename: Arivudainambi
authors.initials: A
authors.lastname: Kayal
authors.affiliation: International Diabetes Federation, Brussels, Belgium.
authors.forename: Belma
authors.initials: B
authors.lastname: Malanda
authors.affiliation: International Diabetes Federation, Brussels, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Belton
authors.affiliation: Madras Diabetes Research Foundation, Chennai, India.
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000517:prevention & control*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011785:Quality Assurance, Health Care; D055815:Young Adult
keywords: Asian Indian; International Association of Diabetes and Pregnancy Study Groups; South Asian; gestational diabetes mellitus; maternal and fetal outcome; model of care