Managing gestational diabetes early in pregnancy can help prevent complications and improve delivery outcomes, researchers have found. Gestational diabetes, one of the most prevalent pregnancy complications globally, is becoming more common and complicated due to rising obesity rates, according to a new series published in The Lancet journal.
A group of researchers from various countries, including the All India Institute of Medical Sciences, reported that gestational diabetes impacts approximately one in seven pregnancies worldwide. Typically, diagnosis and treatment occur late in the second or third trimester. If not addressed, gestational diabetes can result in elevated blood pressure, heightened chances of needing a caesarean section, mental health issues, and delivery complications for the infant.
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.
The authors indicate that factors leading to gestational diabetes may already be present before pregnancy, and metabolic alterations like glucose levels and blood pressure can be identified during the early stages of pregnancy, specifically before 14 weeks.
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 researchers discovered that a significant proportion of women with gestational diabetes experience elevated blood glucose levels early in their pregnancy, specifically by 20 weeks or earlier. These individuals also faced poorer outcomes compared to those who developed the condition later in 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 recommended early screening for gestational diabetes in women at risk, ideally before the 14th week of pregnancy. They also proposed enhancing postpartum care by monitoring blood sugar levels after meals. Additionally, they advocated for annual check-ups for women who have had gestational diabetes to prevent potential complications, emphasizing the need for further research on this medical condition.
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