Gestational Diabetes Mellitus (GDM)

Why in news?

A recent study indicates a surge in early-onset gestational diabetes in India, with glucose intolerance detected earlier than the typical 24–28 weeks of gestation.

• Gestational Diabetes Mellitus (GDM) – It is a condition in which pregnancy hormones block insulin’s effectiveness, leading to high blood sugar levels.
• Causes
  • The placenta produces hormones (estrogen, cortisol, human placental lactogen) that interfere with insulin.
  • This “contra-insulin effect” begins around 20–24 weeks.
  • Normally, the pancreas compensates by producing more insulin. If it cannot, gestational diabetes develops.
• Risk Factors
  • Medical – Heart disease, high blood pressure, obesity, PCOS, prediabetes.
  • Family history – Type 2 diabetes or prior gestational diabetes.
  • Demographics – Age over 25, higher risk in South/East Asian, Latino, Native American, and Pacific Islander women.
• Symptoms – Often develops without clear warning signs, but sometimes  can include increased urination, excessive thirst, fatigue, nausea.
• Diagnosis
  • Early screening at the first prenatal visit for women with risk factors.
  • Standard testing at 24–28 weeks for all pregnant women.
  • Postpartum screening - 6–12 weeks after delivery to check for persistent diabetes.
  • Long-term monitoring - women with GDM should be screened every 3 years for type 2 diabetes.
• Complications
  • For mother – Breathing problems, premature birth, obesity, higher chance of C-section, pre-eclampsia, and later type 2 diabetes.
  • For baby – Macrosomia (large birth weight), Hypoglycemia (low blood sugar after birth)  after birth,
• Treatment – Dietary changes tailored to keep blood sugar normal, regular exercise, daily blood glucose monitoring, insulin injections if lifestyle changes aren’t enough.

India has a diabetes crisis - In 2024, about 90 million adults had the disease, the 2^nd highest number in the world after China. By 2050, this figure may grow to more than 156 million.

References

1. The Hindu | A study conducted to know about Gestational Diabetes
2. John Hopkins Medicine | Gestational Diabetes
3. Cleveland Clinic