THE SAIDIP JOURNEY …..
In the past few years it has become apparent that diabetes in pregnancy is starting to become a public health issue impacting both the immediate maternal and neonatal health as well as fueling the diabetes and NCD epidemic in South Asia. With close geographic proximity, long history of neighborly relations (despite occasional conflicts) common traditions and similar socio economic developments, it makes sense that responses and experiences of tackling similar health challenges be shared to allow better practices in the region to become more widely known and to provide opportunities for exchange of ideas and help build capacity in the region for the common good. This will also provide a greater share of voice to articulate common issues and views of the region at international fora more strongly.
In line with this thinking key opinion leaders and participants from South Asia, in particular Bangladesh, Pakistan and Sri Lanka were invited to the DIPSI meeting in Bangalore and Udhagamandalam (Ooty). A special session on diabetes in pregnancy in South Asia was built in the congress program where esteemed colleagues made enlightening presentations reflecting a sense that the problem is similar to that in India. The application of the DIPSI approach was seen relevant and meaningful to these colleagues and several expressed the intention to adapt the same principles in their countries.
As a consequence a few key people working in the area of the gestational diabetes in countries in South Asia (some of them WDF project partners) decided earlier this year to create an informal group called the South Asia Initiative for Diabetes In Pregnancy.
As you are well aware hyperglycemia is one of the most common medical conditions women encounter during pregnancy. It is estimated that one in six live births (16.8%) occur to women with some form of hyperglycemia in pregnancy. The occurrence of GDM parallels the prevalence of impaired glucose tolerance (IGT), obesity and type 2 diabetes mellitus (T2DM) in a given population. These conditions are on the rise globally but particularly so in South Asia and Asia Pacific Regions and women with ethnic origins in this part of the world are considered to be at the highest risk of GDM. There is also an increase in the rate of overweight and obese women of reproductive age; thus more women entering pregnancy in this part of the world have risk factors that make them even more vulnerable to hyperglycemia during pregnancy.
South Asia and Asia Pacific regions account for 50% of the annual global deliveries; 55% of the global diabetes burden and about 30% of maternal and perinatal deaths and poor pregnancy outcomes. Despite this staggering data the majority of women in the region are either not screened or improperly screened for diabetes during pregnancy.
The relevance of GDM as a priority for maternal health and its impact on the future burden of non-communicable diseases is no longer in doubt; but how best to deal with the issue remains contentious as there are many gaps in knowledge on how to prevent, diagnose and manage GDM to optimize care and outcomes. The International Federation of Gynecology and Obstetrics (FIGO) has recently produced a document to frame the issues and suggest key actions to address the health burden posed by GDM.
In line with this document the purpose of SAIDIP is
- Encourage all nations in South Asia to form a National Society for the study of diabetes in pregnancy and carry out activities relevant to their local national context.
- Ensure that credible solutions identified are implemented on the ground through capacity building of the work force
- Advocate for policy initiatives to support implementation of agreed actions
- Conduct, share, encourage, and support research in South Asia that addresses the challenge of diabetes during pregnancy and offers pragmatic solutions to help the individual person, her “at risk” offspring, her family in general, the society and national health systems to cope with and prevent the consequences of diabetes in pregnancy and to break the cycle of trans generational transmission of risks through intra uterine programing.
- Collaborate and engage with different professional organizations and stakeholders in the region to promote the cause
- Represent the unified voice of South Asia (a region with the highest burden of diabetes as well as the worst maternal health and pregnancy outcomes) forcefully at relevant international fora
- Organize an annual scientific meeting by rotation within South Asia at a suitable and convenient venue with a focus on Diabetes in pregnancy to bring together relevant researchers, professional bodies and stakeholders from within the region and outside. The host nations in consultation with core group will be responsible for this.
Raise resources (volunteer human resources and financial) to achieve the above objectives.