besity and sedentary lifestyle, which ups risk of gestational diabetes, could prove a double-edged sword for women, as it also increases risk of developing Type 2 diabetes mellitus (TDM) later in life.
Pregnancy increases insulin resistance in the body for all women, but the pathological onset of diabetes during pregnancy is often viewed as hastening TDM that would have occurred in women at risk. These risk factors are genetic, environmental and lifestyle related, say endocrinologists.
“Both diabetes and GD are increasingly common. Obesity, genetic and environmental factor up the risk of diabetes, which, during pregnancy, can manifest as GD in such high-risk women,” said Dr. G. Arun, senior endocrinologist at Yashoda Hospitals. The risk of TDM notwithstanding, uncontrolled GD is associated with congenital malformations, besides babies being born with abnormal sugar and calcium levels.
The World Health Organization estimates there are about a lakh women aged between 30 and 70 years. If a recently published research paper is any indication, a substantial number of Indian diabetic women who gave birth may have increased their risk of TDM with a history of GD.
Published in the journal ‘Diabetic Medicine’, the paper based its findings on women studied at Owaisi Hospital and MHRT in Hyderabad, and AIIMS in New Delhi. It showed an increased risk of TDM for women with GD. Of the 366 women with GD, 119 had developed DM in five years, while 144 developed prediabetes, a precursor to diabetes characterised by higher than normal sugar levels, which, if left untreated, progresses to DM.
According to a meta-analysis published last year by one of the current study’s authors Dr. Roya Rozati, women with history of GD may have as much as eight times higher risk of developing TDM when compared to women with normal levels of glucose tolerance during pregnancy.
“The incidence of TDM was lowered in our cohort as women underwent lifestyle modification after delivery. Maintaining healthy BMI and capping it at under 27 is key to lowering risk of GDM and subsequent TDM,” said Dr. Rozati, who heads the city-based MHRT Infertility Centre. The paper also showed that the risk of TDM increases with age, higher body-mass index and the presence of condition called acanthosis nigricans, skin hyper-pigmentation seen in those with insulin resistance.
Both diabetes and GD are increasingly common. Obesity, genetic and environmental factor up the risk of diabetes, which, during pregnancy, can manifest as GD in such high-risk women.
Dr. G. Arunsenior endocrinologist
