Reduction of risk on newly detected gestational diabetes mellitus by multi model intervention - A hospital based study

Gestational diabetes mellitus is one of the most common complications of pregnancy, and it is associated with significant maternal and fetal morbidity. GDM can be controlled by the multi model intervention which is the holy grail of health care. It is the key to patient adherence – a prerequisite to achieve better outcomes. It is easy to recognize an engaged patient – they do what their health care providers recommends …what their health care team knows what is right for them. The aim of the present study was to evaluate the effectiveness of patient engagement package on glycemic control in Gestational Diabetes Mellitus. Prospective interventional study was conducted at a Government Hospital, Tambaram. Antenatal mothers (n = 212) with GDM were randomized into study group (n = 104) and Control groups (n = 108). Power analysis and nonprobability-purposive sampling technique were applied to analyze sample size and sample selection, respectively. Quasi-experimental time-series design was adopted. The study group received patient engagement package which includes Counseling on diet, exercises, and regular monitoring of blood glucose level, Insulin therapy based on the blood glucose level and regular dose of Iron, folic acid and Calcium tablets and adjunct therapy as Yoga which includes Yogic sukshma vyayama(20 -25 mts), Nadishodana pranayama(5-10 mts) and Dhyanam(5 mts).They were instructed to follow up the visits regularly in the antenatal outpatient department.The Control group (n = 108) received only the standard care. Fasting and postprandial blood glucose levels were continuously monitored from 24^th week to till delivery. At 24^th week statistically no significant difference was found between mean and standard deviation of blood glucose level of Gestational Diabetes Mellitus in study group and control group (t=0.29 p=0.76).Statistically positive improvement was found between study group and control group in the post test which was done at 28^th,32 and 36^th week and the “t” values were respectively t=3.41 p=0.001***, t=4.82 p=0.001***, t=6.34 p=0.001*** which was having very high significance at p= 0.001*** in blood glucose level of Gestational Diabetes Mellitus. Our findings show that multi model intervention brings marked reduction in blood glucose level of Gestational Diabetes Mellitus and yoga can be used as an adjunct therapy to control and maintain the blood glucose level of Gestational Diabetes Mellitus. If patient engagement package practiced regularly by the antenatal mothers with Gestational Diabetes Mellitus will provide beneficial effect in terms of reduction in the fasting, postprandial blood glucose.