Colombo Declaration

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The Preamble:
Whereas


South Asia significantly reduced its maternal mortality ratio (MMR), from 550 in 1990 to 190 per 100,000 live births in 2013, marking a decline of 65%; maternal deaths, a largely preventable tragedy, continue to be a challenge in South Asia, accounting for 24% of global maternal deaths
Hemorrhage, hypertension, sepsis and obstructed labor directly account for a large number of these deaths, a significant proportion of deaths are due to indirect causes. Some of the indirect causes such as hyperglycemia in pregnancy (HIP) also contribute to increasing the risk for the direct causes
With decline in direct maternal deaths because of targeted interventions, efforts to further reduce maternal mortality will have to be refocused on reduction of indirect causes
Diabetes mellitus is escalating worldwide; it already affects over 85 million people in South Asia and is projected to affect over 150 million people by 2040. There is an equally high burden of pre-diabetes - approximately 45 million are estimated to have pre- diabetes
Eight low and middle-income countries that account for over half the global live births, also contribute to more than half of the global diabetes burden; Bangladesh, India and Pakistan among them, also fare poorly on the issue of maternal and child health The Colombo Declaration On Hyperglycemia in Pregnancy - South Asia
The age of onset for diabetes and prediabetes is declining, particularly in South Asia, and now affects many young people in the reproductive age
The majority of people with diabetes, particularly the young and women are unaware of their condition as they have never been tested
Hyperglycemia in pregnancy (HIP) is one of the most common medical condition affecting women during pregnancy - an estimated 25% of live births in South Asia are impacted by hyperglycemia during pregnancy
The majority of women with HIP have gestational diabetes (GDM), which develops due to hormonal changes of pregnancy and is confined to the duration of pregnancy
South Asian women are considered to have the greatest vulnerability for GDM, yet routine testing of all pregnant women for hyperglycemia is not done
Hyperglycemia during pregnancy significantly increases risk of pregnancy complications- hypertension, obstructed labor, postpartum hemorrhage, infections, still births, premature delivery, newborn deaths due to respiratory problems, hypoglycemia and birth injuries
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