GESTATIONAL DIABETES GDM WITHIN A SOUTH ASIAN CONTEXT

GESTATIONAL DIABETES (GDM) WITHIN A SOUTH ASIAN CONTEXT SUJANE KANDASAMY, PHD CANDIDATE/VANIER SCHOLAR

WHAT IS GDM?

CONSEQUENCES OF GDM FOR THE MOTHER • Increased risk for a Cesarean delivery • Pre-eclampsia (high blood pressure) • Increased risk of developing future type 2 diabetes

CONSEQUENCES OF GDM FOR THE CHILD

WITHIN A SOUTH ASIAN CONTEXT… • Compared to other ethnic populations, South Asians who move to highincome countries (e. g. , UK, USA, Canada) have a higher prevalence of • Abdominal obesity • Type 2 diabetes • GDM (2 -fold increase) • We need to better understand the increased risk for GDM among South Asian women

THE SOUTH ASIAN BIRTH COHORT STUDY (START) • Goals: 1) To determine the maternal factors associated with GDM 2) The impact of GDM on newborn characteristics (e. g. , birth weight, body fat, insulin sensitivity) • Between 2011 and 2015, we recruited 1012 pregnant South Asian women from the Peel Region – Study period: 24 weeks gestation to 5 years of age – Women completed health surveys, physical measures, and provided bio-samples (including the oral glucose tolerance test)

KEY FINDINGS FROM START The incidence of GDM in South Asian women 36% (considered a high burden compared to the general population)

WHAT INCREASES SOUTH ASIAN WOMEN’S CHANCES OF DEVELOPING GDM? Family history of diabetes Older age at pregnancy (> 31 years of age) Higher weight before pregnancy Diet

AVENUES FOR PREVENTION Main output: Achieving a healthy pre-pregnancy weight and diet prior to having children Focus: Healthy-active living Objective: Preventative measures that commence before or during pregnancy

DIET High quality foods Vegetables (Raw and Cooked) Legumes Nuts and seeds Dairy products Whole grains Fruits

STEPS TO FURTHER STRENGTHEN THE DIALOGUE • Patient-facing and Provider-facing Toolkits built upon the following FOUR components: NEED: High rates of GDM indicated by the SOUTH ASIAN BIRTH COHORT STUDY EVIDENCE: Systematic Review exploring the successful components of Social and Behaviour Change Communication (SBCC) for South Asian families CONTEXT: Formative qualitative interviews with pregnant South Asian women and their healthcare providers CREATIVITY: Collaboration with a local graphic design/film team to develop content in a visually appealing and culturally-appropriate way

kandas 3@mcmaster. ca