NEW DELHI: Managing gestational diabetes in the earlier stages of pregnancy could help prevent complications and improve delivery outcomes, according to researchers. Among the most common pregnancy complication around the world, gestational diabetes cases are on the rise and becoming more complex because of increasing obesity, said the authors of a new series published in The Lancet journal.
The international team of researchers, including those from the All India Institute of Medical Sciences, said that the condition affects one in about seven pregnancies globally and is typically tested for and treated late into the second or third trimester.
If left untreated, gestational diabetes can lead to high blood pressure, increased risk of caesarean sections, mental health conditions, and complications for the baby at delivery, they said.
The authors added that the pregnancy-related condition could also increase the chances of the mother developing health complications later in life, such as type 2 diabetes and cardiovascular disease.
Evidence suggests that the reasons for developing gestational diabetes can exist prior to pregnancy and that metabolic changes, such as those in glucose and blood pressure, can be detected in early pregnancy (before 14 weeks), according to the authors.
Therefore, they have called for urgently bringing in strategies, including testing and diagnosing earlier, to prevent and manage gestational diabetes. This could reduce pregnancy and delivery complications, along with lowering the risk of women developing other health conditions later in life, they said.
“(Gestational diabetes) is a tremendous public health challenge. Women who experience it need support from the medical community, policymakers, and society as a whole to ensure they can effectively access proper treatment, reduce the stigma associated with (the condition), and improve their overall pregnancy experience,” said series author Dr. Yashdeep Gupta of the All India Institute of Medical Sciences.
The authors found that 30-70 per cent of women having gestational diabetes experience high blood glucose from early stages of their pregnancy – 20 weeks or sooner. These women were also found to have worse outcomes, compared to those developing the condition in later stages of their pregnancy.
In studies where gestational diabetes was not managed effectively, the authors found these women to be at higher risks of premature delivery (51 per cent), birthing of bigger babies (57 per cent) and caesarean delivery (16 per cent).
Further, women with gestational diabetes were found to be at a 10-fold higher risk of developing type 2 diabetes later in life compared to those not experiencing the pregnancy-related condition, and could possibly be accompanied by hypertension, fatty liver and an increased risk of heart disease.
The authors called for early testing of gestational diabetes in women with risk factors, ideally before 14 weeks of gestation.
They also suggested improving post-pregnancy care, including screening for blood sugar levels after meals.
The authors also urged for yearly check ups of women with prior gestational diabetes to prevent future complications, along with more research into this medical condition.