Why in news?
New research from India has highlighted that high blood sugar detected early in pregnancy is more common than previously thought. Studies conducted under programmes such as the ICMR‑INDIAB survey and the STRiDE trial show that roughly one in five pregnant women screened before 20 weeks develop elevated glucose levels, drawing attention to the need for early testing and management of gestational diabetes.
Background
Gestational diabetes mellitus (GDM) refers to high blood sugar that first appears during pregnancy. Traditionally, doctors test for GDM between 24 and 28 weeks, when hormones from the placenta make the mother’s body less responsive to insulin. However, some women show high glucose levels much earlier, sometimes in the first trimester. Known risk factors include being overweight or obese, a family history of diabetes, advanced maternal age, previous GDM and conditions like polycystic ovarian syndrome. Uncontrolled GDM can lead to complications such as large babies, pre‑eclampsia and a higher chance of developing type‑2 diabetes later in life.
Key findings
- High prevalence of early GDM: The STRiDE study screened more than 3,000 pregnant women before 16 weeks at seven antenatal clinics in south India. It found that around 21 percent already had blood glucose levels in the diabetic range. Later testing identified another 19 percent with GDM.
- Risk factors: Women with early GDM tended to have higher body weight, body‑mass index and haemoglobin A1c levels than those who developed diabetes later. A previous history of GDM was more strongly associated with early onset, while a family history of diabetes was linked to late onset.
- Implications for screening: The researchers recommend screening pregnant women between 12 and 16 weeks and again at 24–28 weeks. Early detection allows doctors to advise on diet, exercise and medication sooner, reducing risks for both mother and baby.
Significance
- Protecting maternal health: Managing blood sugar early can lower the chances of hypertension, caesarean delivery and future diabetes in mothers.
- Healthy birth outcomes: Controlling glucose levels reduces the likelihood of excessive birth weight, birth trauma and respiratory problems in newborns.
- Need for guidelines: The growing evidence of early GDM calls for national guidelines and risk‑scoring tools to help obstetricians decide who should be tested early and how to manage borderline cases.
Conclusion
Gestational diabetes is a serious yet manageable condition. By acknowledging that many cases arise much earlier than the customary testing window, India can update screening practices to protect maternal and child health. Health‑care providers and expectant families should be aware of risk factors and work together on healthy eating, physical activity and regular check‑ups.
Source: TH
