Pregnancy is a time of joy, but a silent threat is looming: early gestational diabetes is on the rise, and it’s affecting one in five expectant mothers. A groundbreaking study across seven antenatal clinics involving over 3,000 women has uncovered alarming trends—not only is early gestational diabetes mellitus (GDM) becoming more common, but it also significantly increases the risk of developing diabetes later in life. This finding, published in Diabetes Research and Clinical Practice, sheds light on a growing concern that demands our attention. But here’s where it gets controversial: should all pregnant women be screened early, or are current practices sufficient?
The STRiDE study, conducted among 2,700 pregnant women in Chennai, Hyderabad, and Puducherry, revealed that early GDM affects 21.5% of women, compared to 19.5% for late GDM. Women were classified as having early GDM if their fasting blood sugar levels ranged between 92–125 mg/dl, while late GDM was diagnosed with readings under 92 mg/dl. Globally, GDM impacts approximately 14% of pregnancies, typically diagnosed between 24–28 weeks. However, when detected before 20 weeks, it’s labeled as early GDM (EGDM)—a condition this study aimed to better understand in Asian Indian women.
The study’s primary goal was to develop a risk scoring system to predict late GDM as early as possible. Researchers screened women before 16 weeks using fasting plasma glucose (FPG) and HbA1c levels, which reflect a three-month average of blood sugar. Those with elevated levels were retested between 24–28 weeks. The findings were striking: women with early GDM had higher early-pregnancy weight, BMI, waist circumference, blood pressure, and HbA1c levels. They also had more frequent prior GDM diagnoses and a stronger family history of the condition. Late GDM, on the other hand, was more closely tied to a family history of diabetes.
But this is the part most people miss: the study highlights a critical need to reevaluate when and how we test for GDM. In Western countries, only women with a family history are screened, but in India, where GDM rates are three to four times higher, a more proactive approach is essential. As V. Mohan, chairman of the Madras Diabetes Research Foundation, explains, ‘Further studies are needed to determine the optimal testing time, ideal diagnostic methods, and treatment strategies that improve outcomes for both mother and fetus.’
Interestingly, another ICMR study involving 1,000 women found similar results, with early GDM diagnosed in 19.2% and late GDM in 23.4% of cases. This consistency underscores the urgency of the issue. Future research, including genomic and genetic studies, is already in the pipeline to explore this phenomenon in greater detail.
Here’s the burning question: Should early GDM screening become mandatory for all pregnant women, especially in high-prevalence regions like India? Or are we overreacting to a condition that may not always require intervention? Share your thoughts in the comments—this is a conversation that needs your voice!
