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Review
. 2021 Dec;10(12):4350-4363.
doi: 10.4103/jfmpc.jfmpc_653_21. Epub 2021 Dec 27.

Clinical practice recommendations for the detection and management of hyperglycemia in pregnancy from South Asia, Africa and Mexico during COVID-19 pandemic

Gagan Priya  1 , Sarita Bajaj  2 , Bharti Kalra  3 , Ankia Coetzee  4 , Sanjay Kalra  5 , Deep Dutta  6 , Vivien Lim  7 , Hema Diwakar  8 , Vaishali Deshmukh  9 , Roopa Mehta  10 , Rakesh Sahay  11 , Yashdeep Gupta  12 , J B Sharma  13 , Arundhati Dasgupta  14 , S Patnala  15 , Faria Afsana  16 , Mimi Giri  17 , Aisha Sheikh  18 , Manash P Baruah  19 , A R Asirvatham  20 , Shehla Sheikh  21 , Samanthi Cooray  22 , Kirtida Acharya  23 , Y A Langi  24 , Jubbin J Jacob  25 , Jaideep Malhotra  26 , Belinda George  27 , Emmy Grewal  28 , Sruti Chandrasekharan  29 , Sarah Nadeem  30 , Roberta Lamptey  31 , Deepak Khandelwal  32
Affiliations
Review

Clinical practice recommendations for the detection and management of hyperglycemia in pregnancy from South Asia, Africa and Mexico during COVID-19 pandemic

Gagan Priya et al. J Family Med Prim Care. 2021 Dec.

Abstract

The human coronavirus disease 2019 (COVID-19) pandemic has affected overall healthcare delivery, including prenatal, antenatal and postnatal care. Hyperglycemia in pregnancy (HIP) is the most common medical condition encountered during pregnancy. There is little guidance for primary care physicians for providing delivery of optimal perinatal care while minimizing the risk of COVID-19 infection in pregnant women. This review aims to describe pragmatic modifications in the screening, detection and management of HIP during the COVID- 19 pandemic. In this review, articles published up to June 2021 were searched on multiple databases, including PubMed, Medline, EMBASE and ScienceDirect. Direct online searches were conducted to identify national and international guidelines. Search criteria included terms to extract articles describing HIP with and/or without COVID-19 between 1st March 2020 and 15th June 2021. Fasting plasma glucose, glycosylated hemoglobin (HbA1c) and random plasma glucose could be alternative screening strategies for gestational diabetes mellitus screening (at 24-28 weeks of gestation), instead of the traditional 2 h oral glucose tolerance test. The use of telemedicine for the management of HIP is recommended. Hospital visits should be scheduled to coincide with obstetric and ultrasound visits. COVID-19 infected pregnant women with HIP need enhanced maternal and fetal vigilance, optimal diabetes care and psychological support in addition to supportive measures. This article presents pragmatic options and approaches for primary care physicians, diabetes care providers and obstetricians for GDM screening, diagnosis and management during the pandemic, to be used in conjunction with routine antenatal care.

Keywords: COVID-19; gestational diabetes mellitus; hyperglycemia; pandemic; pre-gestational diabetes mellitus; pregnancy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Classification of Hyperglycemia in Pregnancy (2; Adapted from WHO 2013)
Figure 2
Figure 2
Screening for GDM in women with risk factors during the evolving COVID-19 pandemic. (Figure adapted from the Royal College of Obstetricians and Gynecologists’ Guidance for maternal medicine in the evolving coronavirus (COVID-19) pandemic, 20). FPG: Fasting plasma glucose; RPG: Random plasma glucose
Figure 3
Figure 3
Algorithm for the management of diabetes in pregnant women with pre-existing diabetes during the COVID-19 pandemic
Figure 4
Figure 4
Algorithm for the management of gestational diabetes mellitus during the COVID-19 pandemic
See this image and copyright information in PMC

References

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