Gestational diabetes: Increased blood sugar levels during pregnancy put both mothers and newborns at risk.

It is known that the prevalence of gestational diabetes among pregnant women is high all over the world including India. The rise in gestational diabetes cases can be attributed to a number of reasons, including lifestyle changes, urbanisation, sedentary habits and genetic susceptibility.

According to a recent report by the 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, Aarti Bharat, Consultant – Obstetrician and Gynaecologist, Motherhood Hospitals, Bengaluru said she is seeing “2 to 3 diabetes-complicated pregnancies per week”.

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“Sometimes as many as 20 patients a month. I see more diabetic patients than hypertensive patients.”

This increase can also be attributed to the recent COVID-19 pandemic, where gestational diabetes increased from 21 percent before the pandemic to 25 percent in the second year, according to recent research presented at ENDO 2023, the annual meeting of the Endocrine Society in Illinois, US.

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

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

“Gestational diabetes can also be a genetic predisposition in some women. The management of glucose and insulin sensitivity can also be affected by hormonal changes during pregnancy,” said Bharath.

Importantly, “about half of women with gestational diabetes develop diabetes after pregnancy,” Bharath said.

This was also observed in the DIPSI study, which found that about half of women with gestational diabetes develop type 2 diabetes, resulting in a chronic disease after pregnancy.

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Gestational diabetes also greatly increases the risk of type-2 diabetes in the offspring and that too at a relatively young age.

According to a recent study published in The Journal of Physiology, it affects placental hormone production and inflammatory markers, making the placenta an important organ that nourishes the baby and functions abnormally in the mother’s womb.

The study also showed that gestational diabetes often co-exists with obesity and together can cause changes in the placenta, which can lead to intrauterine death and stillbirth, and increase the risk of non-communicable disease for both mother and child in the future.

Although gestational diabetes can’t always be avoided, there are several things you can do to reduce the risk: maintain a healthy weight before pregnancy, avoid gaining too much weight while pregnant, get regular physical activity, and stay hydrated.

Health experts also recommend eating a nutritious diet: a mix of fruits, vegetables, whole grains, lean proteins and healthy fats. It’s best to avoid consuming processed food, sugary snacks or beverages, and to spread your carbohydrate intake throughout the day and combine it with protein and healthy fats, to help control blood sugar levels.

According to doctors, checking for gestational diabetes by the eighth week is important and can help control the condition before it affects the foetus.

Diabetologist V. Sesia says that post-meal blood sugar levels in pregnant women should not exceed 110 mg per dl in the tenth week as it can be a sign that they may have gestational diabetes.

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