One in seven young pregnant women in urban India are diagnosed with gestational diabetes - a condition that occurs during pregnancy and usually disappears after the baby is born - as compared to 1-2% just a decade ago.
“Earlier, one out of every 10 women I treated had the condition. Over the past decade, that number has gone up to 4 in 10 women,” says Dr Pradeep Gadge, a consultant diabetologist at Mumbai’s Seven Hills hospital. “As lifestyle issues such as disrupted sleep-wake cycles become more common, and the average age of the pregnant woman rises, these numbers are set to rise further, since women over 25 are already at higher risk of gestational diabetes.”
“An unhealthy lifestyle that include high junk food consumption, obesity, lack of exercise and a sedentary lifestyle could be a trigger, but there are no conclusive studies to prove the co-relation,” says Dr Bandana Sodhi, senior consultant, gynaecology obstetrics at south Delhi’s Moolchand Healthcare. “That lifestyle has a role to play in developing gestational diabetes is evident as women with lifestyle conditions such as polycystic ovarian disorder (PCOD) are prone to develop the condition,” Dr Sodhi adds.
Standard screening for gestational diabetes is usually prescribed in the 24th week of pregnancy but with the sharp increase in cases, gynaecologists insist diabetes screening should begin in the first trimester. “All women, and not just the high risk ones, should bescreened for diabetes during the first trimester. Waiting till the 24th or 28th week to screen is not recommended as south Asians are already at high risk and there’s the added possibility that some of them may have pre-existing diabetes that they aren’t aware of,” says Dr Neerja Bhatla, professor, department of obstetrics and gynaecology, All India Institute of Medical Sciences (AIIMS).
An AIIMS study of around 500 women with gestational diabetes found that 27% developed diabetes later in life. Alarmed at the results, the departments of endocrinology and gynaecology at AIIMS are currently in the process of initiating a project on preventing the development of Type-2 diabetes in women with a history of gestational diabetes. The project is funded through the Global Alliance for Chronic Disease and is also being executed in Sri Lanka and Bangladesh. “This is a big project spread across 12 centres in India and will track women suffering from gestational diabetes. The idea is to develop a uniform screening and treatment protocol and to ensure better compliance,” said Dr Bhatla.
Usually, just 2%-3% women with gestational need insulin. “Gestational diabetes in a large number of women can be managed with lifestyle modification such as eating a healthy food,regular exercise and getting adequate sleep,” said Dr Neema Sharma, senior consultant obstetrics and gynaecology, Fortis Healthcare.
Aditi Rane*, a 30-year-old ophthalmologist from Mumbai, was diagnosed with gestational diabetes in her fifth month of pregnancy. Knowing that the condition could affect the weight and health of her infant at delivery, Rane decided to manage the condition with all the discipline she could muster. “In addition to medication and a controlled and balanced diet, I would go on half-hour walks every morning and evening, eat lots of fruits and avoid artificial sugars,” she says.Last month, Rane delivered a healthy, 7.06-lb baby boy.
She carried her baby to full term, and he shows no signs of hypoglycemia (low blood sugar) or underdeveloped lungs — both conditions that can result from a mother with gestational diabetes.
“The condition can be easily managed if proper measures are taken by the patient and she is monitored regularly,” says Dr. Ray Sudeshna of Jaslok hospital, who treated Rane through her pregnancy. “It is lack of awareness and delayed treatment that turn it into a big problem among some mothers. Rane’s sustained efforts to stay healthy, for instance, made her condition really easy to manage.”
Awareness and management of the condition become all the more crucial given the rise in the incidence of gestational diabetes in urban India.
The issues to watch out for, doctors add, are weight and blood sugar. “Try and reach a normal weight range at least three months before getting pregnant and have your blood sugar tested to see if it is on target too,” says Dr Sudeshna. “While pregnant, commit to a healthy food plan and try to get at least two-and-a-half hours of gentle exercise a week, to keep your glucose levels stable.”