Pune, 15th November, 2018: Prevalence of Gestational Diabetes Mellitus (GDM) that can impact the health of both the mother and the baby during and after pregnancy is rising in India and may affect every one in five pregnant women in coming years.
Expecting mothers in India suffering from Gestational Diabetes Mellitus (GDM) suffer from impaired glucose tolerance (IGT) and can even affect those women who were not diabetic before becoming pregnant. The incidence rate of GDM in India is likely to increase by 20 per cent.
“The prevalence of GDM does not need a woman to be diabetic before conception; neither it is a permanent state of ailment. However, experiencing diabetes during pregnancy poses a risk to both the mother and the child. The awareness about GDM and how it can set in, is rather poor, even among urban and educated people. As a reason, it has become a silent illness that keeps on growing in the expecting mother only to be detected at a later stage in pregnancy, when some complications arise. Women with GDM have a 70 per cent lifetime risk of developing type 2 diabetes during their lifetime as compared to a 10 per cent risk in the general population,” says Dr. Bhavana Mangal, Senior Consultant - Obstetrics and Gynaecology, Columbia Asia Hospital, Pune.
About 5 to 10 per cent of women with GDM develop type 1 Diabetes sometime in their life. These women have a slowly developing form of Type 1diabetes that is 'unmasked' during pregnancy. There is an immediate need to ensure that criteria are set for testing for GDM in pregnancy like family history, etc. This will help to assess the pregnancy better,” says Dr. Bhavana Mangal.
Some criteria for developing GDM can be obesity, a family history of type 2 diabetes in parent or sibling, an unexplained stillbirth or neonatal death in a previous pregnancy, a very large infant in a previous pregnancy (4.5 kg or over), gestational diabetes in previous pregnancy.
Gestational Diabetes Mellitus (GDM) paves way for maternal risks including polyhydramnios, pre-eclampsia, prolonged labour, obstructed labour, cesarean section, uterine atony, postpartum hemorrhage, infection and progression of retinopathy, which are the leading global causes of maternal morbidity and mortality. For the fetus, GDM in mother may risk spontaneous abortion, intra-uterine death, stillbirth, congenital malformation, shoulder dystocia, birth injuries, neonatal hypoglycemia and infant respiratory distress syndrome. In fact, long-term effects of GDM are important contributors to the burden of non-communicable diseases (NCD) in many countries and increases chances of Type 2 diabetes in future for both the mother and the child.
“One of the biggest reasons of GDM is our sedentary lifestyle and carbohydrate-rich food. As pregnancy changes the way hormones in female body works, the poor effects of our unhealthy lifestyle become visible. The risk increases for those who have a family history of diabetes. There are medical interventions available in form of nutritional therapy and insulin therapy but the best way certainly is to be aware of the possibility and start taking precautions beforehand,” says Dr. Bhavana.