Spike in gestational diabetes a risk for both mothers & newborns

NEW DELHI: Gestational diabetes -- a form of high blood sugar affecting pregnant women -- is significantly rising in India, posing severe risk to both the mother and the baby, according to health experts.

The prevalence of gestational diabetes among pregnant women is known to be high around the world, including in India. The increase in instances of gestational diabetes can be attributed to several causes, including lifestyle modifications, urbanisation, sedentary habits, and genetic susceptibility.

According to a recent report by Chennai-based Diabetes in Pregnancy Study Group India (DIPSI), the prevalence rate of gestational diabetes in India is between 10-14 per cent.

Speaking to IANS, Arathi Bharat, Consultant - Obstetrician & Gynaecologist, Motherhood Hospitals, Bengaluru, said that she is seeing "2 to 3 diabetes complicating pregnancy per week".

"Sometimes 20 plus patients in a month. I am seeing more diabetic patients than those with hypertension.”

The increase could also be attributed to the recent Covid-19 pandemic, where gestational diabetes rose from 21 per cent pre-pandemic to 25 per cent in the second year, revealed a recent research presented at ENDO 2023, the Endocrine Society’s annual meeting in Illinois, the US.

The team from the University of Sydney in Australia discovered statistically significant increases in pre-pregnancy body-mass index, obesity, and other risk factors for gestational diabetes, including those with South Asian ethnicity and a previous history of gestational diabetes.

“The prevalence of gestational diabetes is increasing in India. While the exact reasons for this increase are not fully understood, it is likely due to a combination of factors, including increased obesity rates, changes in diet and lifestyle, and late age of childbearing,” Farah Ingale, Director-Internal Medicine, Fortis Hiranandani Hospital Vashi, told IANS.

“Gestational diabetes may also be a genetic tendency in some women. The management of glucose and insulin sensitivity may also be impacted by hormonal changes during pregnancy,” Bharat said.

Importantly, “half of the women with gestational diabetes do get diabetes post-pregnancy", said Bharat.

This was also seen in the DIPSI study, which found that nearly half of all women with gestational diabetes go on to develop Type 2 diabetes resulting in a chronic disease after pregnancy.

Gestational diabetes also highly increases the risk of Type-2 diabetes in the progeny and that too at a relatively younger age.

It impacts placental hormone production and inflammation markers, making the placenta -- a vital organ that nourishes the baby in the mother’s womb -- to function abnormally, according to a recent study, published in The Journal of Physiology.

The study also showed that gestational diabetes often coexists with obesity and together may cause placental changes, leading to intrauterine death and stillbirths, and increased future non-communicable disease risk for both mother and baby.

While gestational diabetes cannot always be avoided, there are numerous things one can do to lower the risk: Maintain a healthy weight before pregnancy, avoid gaining too much weight when pregnant, regular physical activity and keep hydrated.

The health experts also advised eating a nutritious diet: A mix of fruits, vegetables, whole grains, lean proteins, and healthy fats. It is best to avoid consumption of processed food, sugary snacks or beverages, and to assist regulate blood sugar levels, spread out your carbohydrate intake throughout the day and combine it with protein and healthy fats.

According to doctors, screening of gestational diabetes is crucial by the eighth week and can help manage the condition early before it can affect the foetus.

Diabetologist V. Seshiah maintains the post-prandial blood sugar level (after a meal) of pregnant women should not exceed 110 mg per decilitre at the tenth week as it could be an indication that they would develop gestational diabetes.

Importantly, it can adversely affect the foetus as well as the foetal beta cells, which start secreting insulin around the eleventh week of pregnancy.