International Federation of Gynecology and Obstetrics - Gestational Diabetes. Diagnosis and Management
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International Federation of Gynecology and Obstetrics
WORKING GROUP ON
HYPERGLYCEMIA IN
PREGNANCY (HIP)
Members:
Professor Moshe Hod (Chair) Dr Anil Kapur
Dr Hema Divakar (Co-Chair) Dr Tahir Mahmood
Dr Hector Bolatti Dr Mohamed Momtaz
Professor Luis Cabero Roura Dr David McIntyre
Dr Mary D’Alton Dr Umbeto Simeoni
Dr Blami Dao Dr Huixia Yang
Dr Gernot Desoye Professor Mark Hanson (Ex-officio)
Professor Fidelma Dunn Professor Gian Carlo Di Renzo (Ex-officio)
Dr Yirgu Gebrehiwot Ferede (Ex-officio) Professor Gerard Visser (Ex-officio)
FIGO GUIDELINES ON
DIAGNOSIS, MANAGEMENT & CARE
OF GIRLS AND WOMEN WITH
GESTATIONAL DIABETES
Maternal Malaria
20 million pregnancies
~127 million live births Maternal Undernutrition
26 million pregnancies
Maternal Anaemia
56 million pregnancies
Maternal Obesity
42 million pregnancies
Maternal Hyperglycaemia
~21 million pregnancies
Maternal hypertensive
disorders
~7 million pregnancies
India, China, Pakistan,
Indonesia,Bangladesh, ~21 million /year
Brazil, Mexico complicated by
>65 million deliveries
hyperglycaemia
~3 to 4 million
127 million detected and treated
live births/year
Receive Post partum follow
up and lifestyle advice ?
HIP is a major global health problem
HIP is a major global health problem
“…Facing a “Slow-Motion Disaster”
UN Meeting on Non Communicable Diseases
- Margaret Chan, Director-General,
World Health Organization (WHO),Sept. 2011
• There is an increasing global crisis in NCD
• NCD are associated with mortality, morbidity, and long-term disability
• Two of three deaths globally are attributable NCDs
Diagnosis and management
may help turn the tide of the
Diabetes - NCD pandemic
Dec 2013 Oct 2015
FIGO Expert Group Launch of guidelines on
on GDM established diagnosis, management
and care
Recommendations Provides a call Provides options Identifies key
graded by quality of for action to according to resource points of
evidence policy makers setting intervention
FIGO GDM guidelines
Executive summary
The target audience
Assessment of quality of evidence and grading of recommendation
Gestational Diabetes Mellitus(GDM)–Background, Definition, Epidemiology, Pathophysiology
Diagnosing Gestational Diabetes Mellitus
Glucose Measurement: Technical considerations in laboratory and point of care (POC)testing
Management during pregnancy
Post-Partum Management
Pre Conception Care
Research Priorities
Appendix
Current Approaches to GDM diagnosis in selected high burden developing countries
Gestational Diabetes Formulas for Cost-Effectiveness - GeDiForCE®
Research Priorities in Gestational Diabetes
Recommendations Provides a call Provides options Identifies key
graded by quality for action to according to points of
of evidence policy makers resource setting intervention
FIGO GDM guidance:
1: Describes Some highlights
and differentiates GDMFIGO (WHO) Classification
DIP & GDM = HIP
Significance for global health
FIGO Boxes
highlight
salient pointsAdvocates Universal Testing
Universal criteria for diagnosis
Recommendation for diagnosis While this is the optimal recommendation, alternatives are given in acknowledgement of limitations faced in diverse settings
Standards for lab testing Technical considerations in laboratory and point of care (POC)testing
Management of GDM
Assessing Fetal wellbeing
Delivery for women with GDM
Management of GDM
Lifestyle Management
Treatment of GDM
Pre-conception and inter-
pregnancyPostpartum care
Focus and dissemination
Working Group on
Hyperglycaemia in Pregnancy (HIP)
Dec 2013 Oct 2015
FIGO Expert Group Launch of guidelines on
on GDM established diagnosis, management
and care
Key Milestones
Oct 2018 Jan 2016
Report on successes FIGO Working Group
Training, advocacy and evidence
generation on hyperglycaemia in
at FIGO World on HIP instated pregnancy to reduce poor pregnancy
Congress outcomes; decrease maternal and
Capacity neonatal morbidity and mortality;
Building Awareness and cut future risk of diabetes &
Research
& Training & Advocacy cardio-vascular diseaseThe next three years ….
Working Group
Hyperglycaemia in Pregnancy (HIP)
Awareness and Advocacy
GOAL - International organizations and key governments implementing
targeted communication and advocacy strategies
FIGO will enagage with major organisations (NGOs, UN Organisations, professional
ossociations and government agencies) working in the field of maternal health to recognize
that hypeglycaemia in pregnancy is a key issue impacting maternal and women's health, that
needs to be addressed as part of Sustainable Development Goal 3 on health and welbeing.Working Group
Hyperglycaemia in Pregnancy (HIP)
Capacity Building and Training
GOAL - Comprehensive, role based training programs being rolled-out to healthcare
workers; and to improve the knowledge, skills and attitudes of FIGO affiliates in the
management of HIP
FIGO will develop and implement comprehensive and competancy based learning resource
package (LRP) training on HIP to healthcare workers at all levels. FIGO will assist its member
organizations to roll out the training on HIP using the newly developed LRP.Working Group
Hyperglycaemia in Pregnancy (HIP)
Research Network
GOAL: To identify and implement a research agenda which will address
priority gaps in knowledge of HIP
FIGO will develop a prioritized research agenda based on the broad needs identified by the FIGO
recommendations, create a research network which will work towards conducting research aimed at
addressing priority gaps.
The three year work plan for the FIGO Hyperglycemia in Pregnancy (HIP)Group is relatively short for the
development, funding, conduct and analysis of a major individual research project(s).
Nonetheless, the FIGO Research Network will achieve some short-term goals to demonstrate its key
coordinating role in shaping the global research agenda regarding HIP.
The International Federation of Gynecology and Obstetrics (FIGO) Initiative on Gestational Diabetes
Mellitus: A Pragmatic Guide for Diagnosis, Management and Care which as published in the
International Journal of Gynecology and Obstetrics (IJGO) in October 2015,ØTAKE HOME MESSAGES
Ø Hyperglycemia In Pregnancy
v The most common medical conditions women encounter during pregnancy
v Is associated with :
ü Leading causes of maternal mortality
ü Higher incidence of maternal morbidity
ü Higher incidence of perinatal and neonatal morbidity
ü Later long term consequences for both mother and child
v Pregnancy offers a window of opportunity to:
ü Establish services
ü Improve health
ü Prevent intergenerational transmission no communicable diseasesØ FIGO recommends
All pregnant women should be tested for hyperglycemia during pregnancy
vUniversal testing
vA one-step procedureThe postpartum period
Ø An important platform to initiate early preventive health for
mother and offspring
who are both at higher risk of:
v Future Obesity
v Metabolic Syndrome
v Diabetes
v Hypertension
v Cardiovascular DisordersWorking Group on
Hyperglycaemia in Pregnancy (HIP)
Thank you for
listening
www.figo.org
Contact Jessica@figo.org and Matt@figo.org for more informationYou can also read
