Vagus Nerve Stimulation Could be an Adjunctive Therapy in the Management of Moderate to Severe Gestational Diabetes Mellitus

Abstract

Gestational Diabetes Mellitus (GDM) is any degree of glucose intolerance with onset or first recognition during pregnancy. In the past ten years, the prevalence of GDM has increased to nearly 20%, making it likely that one in every five pregnant women will have GDM. Prevalence of GDM is 17.8% in urban, 13.8% in semi urban and 9.9% in rural India. Due to lifestyle, Indian women are at 11-fold increased risk of GDM. Obesity or being overweight is increasing in young girls which increases the risk for GDM. In 90% cases, GDM disappears after delivery, but 50% of women may develop diabetes in 5-10 years. Increased blood glucose diagnosed in the 1st trimester increases the risk of congenital malformation. Elevated glucose levels during pregnancy raises the likelihood of having a big size fetus, which requires delivery usually by caesarean section. Later, type 2 diabetes and cardiovascular disease develop in women with GDM. Additionally, it raises the infants' risk of macrosomia and subsequent obesity or diabetes.[1] Women with GDM are additionally bound to have recurrent GDM in ensuing pregnancies. In antenatal care programs, the need to concentrate on its prevention, early detection, medical management, and lifestyle changes is highlighted by the high prevalence of GDM even in low-income populations. Though mild GDM is treated mostly by nutrition therapy (Diet Management), moderate to severe GDM requires insulin therapy. Usually, insulin therapy in the later part of pregnancy is not very effective due to various reasons including sociocultural factors. Read more...