Study shows evidence of growing early gestational diabetes among pregnant women

A study conducted at seven antenatal clinics with over 3000 women, found that early gestational diabetes mellitus (GDM) affects about one in five pregnant women, and also indicates a distinct higher risk for developing diabetes later in life, compared to GDM contracted later in pregnancy.

The results of the STRiDE study, conducted among 2700 odd pregnant women who came to clinics in Chennai, Hyderabad and Puducherry, were published in a recent edition of Diabetes Research and Clinical Practice. They showed that while the rates of both early and late GDM were climbing steadily, it was 21.5 % for the former and 19.5 % of the latter. Women were classified as having early GDM if they had a fasting blood sugar of 92-125 mg/dl, and late GDM if the reading was under 92 mg/dl.

GDM is defined as glucose intolerance first diagnosed during pregnancy and affects approximately 14 % of pregnancies worldwide. It is usually between 24–28 weeks – as late GDM. When diagnosed before 20 weeks, it is called early GDM (EGDM). This study aimed to assess the prevalence and risk factors of EGDM compared to LGDM in Asian Indian women.

The aim of the STRiDE study was to develop a risk scoring system to predict late GDM in early pregnancy itself. An early screening was done before 16 weeks of pregnancy using fasting plasma glucose (FPG) and HbA1c, the three month average. If they had higher sugar levels, they were tested once again at 24-28 weeks.

The study was a collaboration between research institutions in India, Australia, Kuwait and the Great Britain Women concluded that women with early GDM had higher early‑pregnancy weight, BMI, waist circumference, blood pressure, HbA1c, and more frequent prior GDM and family history of GDM. Late GDM was more strongly associated with a family history of diabetes.

“It is clear that further studies are needed,” explains V.Mohan, an author of the paper, and chairman of the Madras Diabetes Research Foundation, Chennai, one of the collaborating institutions. “In another ICMR study among 1000 women, early GDM was diagnosed in 19.2 % and late GDM, in 23.4 %, the results are consistent.

We need to evaluate when best to do a test for GDM, what test would be ideal and what treatment methodologies would improve outcomes and reduce side effects even for the foetus. In the West, only women with a family history are screened, but in India where GDM is nearly three to four times what is seen there, we need to be prepared. In fact, further genomic and genetic studies are being planned to study this in detail.”