Global framework for action on GDM

The International Federation of Gynecology and Obstetrics (FIGO) launches a global framework for action to improve the diagnosis and care of women with gestational diabetes mellitus (GDM) and to improve adolescent, preconception and maternal nutrition

Vancouver, BC, Tuesday, October 6, 2015 - The International Federation of Gynecology and Obstetrics (FIGO) announced today at the XXI World Congress of Gynecology and Obstetrics important guidelines aimed at improving maternal health, decreasing the incidence of maternal, fetal and neonatal morbidity and reducing the burden of non-communicable diseases globally. These two sets of guidelines provide recommendations to improve the diagnosis and care of women with gestational diabetes mellitus (GDM) and to improve adolescent, preconception and maternal nutrition.

The comprehensive guidelines, created collaboratively with international experts in GDM and maternal nutrition, set out evidence-based guidance which will support the recently adopted UN Sustainable Development Goals (SDG), in particular 3.4, which includes reducing by one third premature mortality from non-communicable diseases through prevention and treatment by 2030, and 2.2, which includes ending all forms of malnutrition by 2030 and addressing the nutritional needs of adolescent girls, pregnant and lactating women.

FIGO’s Gestational Diabetes Mellitus (GDM) Guidelines

Hyperglycemia is one of the most common medical conditions women encounter during pregnancy with one out of six live births impacted by hyperglycemia during pregnancy. Hyperglycemia in pregnancy is associated with the leading causes of maternal mortality and maternal and neonatal morbidity, as well as a several fold increased risk of future obesity, diabetes and cardiovascular diseases in both the mother and child,

says Professor Moshe Hod, Chair of the Expert Group for the FIGO GDM Initiative.

These risks can be considerably mitigated through preventive actions. The relevance of gestational diabetes as a priority for maternal health and its impact on the future burden of non-communicable disease is no longer in doubt,

adds Professor Hod.

Given this important fact, there needs to be a greater global action plan focused on preventing, screening, diagnosing and managing hyperglycemia in pregnancy. The new GDM guidelines and the adolescent, preconception and maternal nutrition guidelines released today are important steps in the right direction to tackle maternal gestational diabetes.

The FIGO GDM Initiative calls for greater attention on the links between maternal health and noncommunicable diseases in the sustainable developmental agenda and encourages all countries and FIGO’s 125 national member associations to adopt and promote strategies to ensure universal testing of all pregnant women for hyperglycemia during pregnancy. It emphasizes that all countries have an obligation to implement the best GDM testing and management practices they can.

The document calls for public health measures to increase awareness and acceptance of preconception counseling and to increase affordability and access to preconception services to women of reproductive age, as this is likely to have both immediate and lasting benefits for maternal and child health.

It also emphasizes that the post-partum period for women with GDM also provides an important opportunity for increased engagement and improved health for both the mother and the child. The document calls upon healthcare providers to support postpartum follow up of GDM mothers linked to the regular check-up and vaccination program of the child to ensure continued engagement of the high risk mother-child pair.

The document recognizes that nutrition counseling and physical activity are the primary tools in the management of GDM and recommends that women with GDM receive practical nutrition education and counseling.

Please see the attached Backgrounder for recommendations taken from: The International Federation of Gynecology and Obstetrics (FIGO) Initiative on Gestational Diabetes Mellitus: A Pragmatic Guide for Diagnosis, Management, and Care is published as a Supplement (Volume 131, Supplement 3 (2015) by the International Journal of Gynecology & Obstetrics (IJGO).

The Gestational Diabetes Initiative is supported by an unrestricted financial grant from Novo Nordisk.

FIGO’s Adolescent, Preconception and Maternal Nutrition Guidelines

Adolescent, preconception, and maternal nutrition represent a major public health issue that affects not only the health of adolescents and women, but also that of future generations. These FIGO recommendations aim to address several issues relating to nutrition in adolescent and young women before, during and after pregnancy,” says Professor Mark Hanson, Chair of the FIGO Adolescent, Preconception and Maternal Nutrition Initiative. “They highlight the importance of balanced nutrition during those critical periods of the life course, for both the woman and her developing baby. FIGO is committed to making a real difference to the prevention of poor nutrition globally as a critical step in reducing the global burden of non-communicable diseases.

The FIGO Adolescent, Preconception and Maternal Nutrition Initiative calls for more awareness of the fact that in many societies, women and adolescent girls are poorly nourished, in terms of the level and balance of both macro-and micronutrients in their diet. This circumstance is detrimental to their current and future health and that of their children, as good health and nutrition before conception are key to a mother’s ability to meet the nutrient demands of pregnancy and breastfeeding, and are vital to the healthy development of her embryo, fetus, infant, and child. The continuum of poor maternal health and poor infant and childhood development contributes substantially to the global burden of disease and disability, affecting the way that individuals respond to a number of environmental challenges— ranging from infections to an obesogenic lifestyle.

The document identifies good versus poor nutrition, as well as under- and over-nutrition and micronutrient malnutrition. Regional case studies are discussed which exemplify local situations and specialised solutions. Specific recommendations are given for optimising nutrition throughout the life cycle, including weight, macro and micronutrient intake.

The adolescent, preconception and maternal guidelines emphasize the overall need for all healthcare providers to “Think Nutrition First”— focusing on optimizing adolescent and maternal nutrition and health, starting in the preconception years. This approach will have considerable positive benefits for ensuring women’s health and that of their children, as well as securing the health, productivity, life expectancy, and well-being of future generations. FIGO makes specific recommendations to achieve this goal, and advocates concerted action by a range of stakeholders, including donors and international organizations to enact them.

See the attached Backgrounder for recommendations taken from: The International Federation of Gynecology and Obstetrics (FIGO) Recommendations on Adolescent, Preconception, and Maternal Nutrition: “Think Nutrition First” is published as a Supplement (Volume 131, Supplement 4 (2015) by the International Journal of Gynecology & Obstetrics (IJGO).

The Think Nutrition First nutrition guidelines were supported by an unrestricted financial grant from Abbott. The next phase for both of these initiatives involves the establishment of FIGO Expert Working Groups who will guide the development of region specific guidelines and toolkits and their dissemination and implementation, as well as further advocacy to ensure these issues remain high on the global health agenda.

Extra resources:

Infographics: Adolescent, Preconception and Maternal Nutrition

Infographics: Gestational Diabetes

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