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Year : 2021  |  Volume : 12  |  Issue : 5  |  Page : 3-42

IDF-MENA region guidelines for management of hyperglycemia in pregnancy

1 Department of Obstetrics and Gynaecology, ISRA University, Karachi Campus, Karachi, Pakistan
2 Private Clinic, Jordanian Society for the Care of Diabetes, Rawalpindi, Pakistan
3 GDM Guidelines Committee, Society of Obstetricians & Gynaecologists of Pakistan (SOGP), Department of Obstetrics & Gynaecology, CMH Lahore Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
4 Imperial College London Diabetes Centre, Sudan Diabetes Association, Abu Dhabi, UAE
5 American Board Diabetes, Endocrinology and Metabolism, King Hamad University Hospital, Royal College of Surgeons, Ireland—MUB, Scientific Committee at Bahrain Diabetes Society, Al Sayh, Bahrain
6 Tripoli University, Diabetic Pregnancy Unit (DPU), Al-Jalaa Maternity Hospital, National Libyan Diabetes Programme Committee (NLDPC), Abu Dhabi, UAE
7 Corniche Hospital, UAE, Emirates Diabetic Society, Sudan Diabetes Association, Abu Dhabi, UAE
8 Seethapathy Clinic & Hospital, Chennai, India, FOGSI, India
9 Faisalabad Medical University, Faisalabad, Pakistan
10 Arabian Gulf University, Manama, Bahrain
11 Division of Neonatology, University of Jordan, Jordan University Hospital, Jordanian Society for the Care of Diabetes, Amman, Jordan
12 Abdalla Khalil Diabetes Center, Sudan Diabetes Association (SUDA), Sudan
13 AGU-Arabian Gulf University, Ministry of Health, Diabetes Society, Bahrain
14 Jordan University Hospital, The University of Jordan, Jordanian Society for the Care of Diabetes, Jordan
15 Dubai Hospital, Dubai, UAE
16 Dubai Hospital, Emirates Diabetes Society, Dubai, UAE
17 Baqai Institute of Diabetology and Endocrinology, IDF Center of Excellence in Diabetes Care, Karachi, Pakistan
18 Sohag University, Egypt
19 Assiut University, South Egypt Association of Diabetes and Endocrinology, Asyut, Egypt
20 Ameer-ud-Din Medical College, PGMI, Lahore, Pakistan
21 Faisalabad Medical University, Allied Hospital Faisalabad, Faisalabad, Pakistan
22 American Boards of Diabetes and Endocrinology, Endocrine Division, Tawam Hospital, SEHA, Al Ain, UAE
23 Dubai Hospital, DHA, UAE, Gulf Medical University, Dubai, UAE
24 Endocrine Department, Dubai Hospital, DHA, Dubai, UAE
25 University Medical and Dental College, Faisalabad, Pakistan
26 Department of Medicine, Punjab Medical College Faisalabad, Faisalabad Medical University/Punjab Medical College, Faisalabad, Pakistan

Correspondence Address:
Prof. Shabeen Naz Masood
Department of Obstetrics and Gynaecology, ISRA University, Karachi-Campus, U-19, Hasan Apartment Extension, Hasan Square, Gulshan-e-Iqbal, Block 13D, Karachi.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jod.jod_58_21

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Introduction: Hyperglycaemia in pregnancy (HIP) is the most common medical disorder complicating pregnancy. This includes women who have pre-existing Type 1 and Type 2 diabetes mellitus (DM) and those diagnosed to have gestational diabetes mellitus (GDM), with glucose intolerance identified for the first time in pregnancy. In the Middle East and North Africa region, the prevalence of DM in women of reproductive age group is high and it varies widely between different regions due to variation in screening and diagnostic criteria for the identification of GDM. Universal blood glucose screening at first antenatal booking visit helps in identifying women with HIP. Women who are screen negative at first antenatal should subsequently be screened with a fasting oral glucose tolerance test (OGTT) around 24-28 weeks to identify GDM. There is a clear evidence that the identification and management of hyperglycaemia improves pregnancy outcomes. Antenatal care involves more visits as these women are at higher risk of fetal malformations, preterm labour and stillbirth. Timing of delivery is based on glycaemic control, fetal wellbeing, and the presence of co-morbidities. Objective: The objective of this article is to provide guidelines regarding the management of hyperglycemia in pregnancy. Materials and Methods: These recommendations are made after reviewing various existing guidelines including American College of Obstetricians and Gynecologists, Royal College of Obstetricians and Gynecologists, and American College of Sports Medicine. A literature search was done using PubMed, Cochrane Database, Google Scholar, EMBASE, various systematic reviews, and original articles. Search was done using key words “Hyperglycemia in pregnancy,” “gestational diabetes mellitus,” and “diabetes in pregnancy.” Conclusion: Hyperglycemia in pregnancy can be managed effectively if appropriate measures are taken and potential consequences can be avoided.

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