The Journal of the Association of Physicians of India recently published a paper that emphasized the importance of screening all pregnant women for high blood glucose, even if no symptoms are present. This process aims to identify and address Gestational Diabetes Mellitus (GDM) as early as possible, preventing both immediate and future health implications for the mother and child.
Understanding Gestational Diabetes Mellitus (GDM)
Gestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance that begins or is first recognized during pregnancy. It impacts not only immediate maternal and neonatal outcomes but also increases the risk of developing Type 2 diabetes in the future for both the mother and child. Prevention early in fetal development is crucial to avoid predisposing children to diabetes and other non-communicable diseases later in life.
When a mother has high blood sugar, more glucose is transferred to the fetus, causing the fetal pancreatic cells to secrete insulin earlier and in larger quantities. This process becomes self-perpetuating once initiated.
Furthermore, when the maternal glucose reading exceeds 110 mg/dl, the amniotic fluid becomes glucose-enriched. After 20 weeks, when the fetus starts swallowing this fluid, it stimulates increased production of insulin.
The State of Gestational Diabetes in India
In India, an estimated 62 million people live with Type 2 diabetes mellitus (DM). This figure is expected to rise to 79.4 million by 2025. As diabetes prevalence increases, so too does the incidence of gestational DM (GDM).
Conversion rates to Type 2 diabetes are incredibly high in India, while healthcare resources are insufficient. Moreover, there is inadequate awareness among the public, resulting in many people being reluctant to access the healthcare system for conditions with less “obvious” implications, such as GDM.
Importance of Interference during Pregnancy
Interventions during and immediately post-pregnancy can have a significant impact on the health of mothers and children, both in the present day and in future generations. The appropriate management of diabetes during pregnancy can help to prevent Type 2 diabetes in two generations.
Impact of Low Awareness
A lack of awareness in society often results in GDM being given low priority within India’s public health delivery system. To combat this, the Ministry of Health has developed national guidelines for testing, diagnosing, and managing hyperglycemia during pregnancy.
| Fact | Data |
|---|---|
| Current number of people with Type 2 DM in India | 62 million |
| Predicted number of people with Type 2 DM in India by 2025 | 79.4 million |
| Global ranking of GDM prevalence in India | Very high |
| Conversion rate from GDM to Type 2 DM in India | Very high |
Early Testing Recommendations
They recommend early testing at the time of initial contact (during the first trimester). If the test result is negative, another examination should be conducted between 24-28 weeks as a precautionary measure.
