A new series published in The Lancet suggests that a shift in gestational diabetes mellitus (GDM) management to before 14 weeks can prevent health complications for both the mother and baby. The authors challenge the current approach that focuses on late GDM. They also call for better detection and prevention efforts and a personalized approach for those at a higher risk of GDM.Â
GDM is a very common medical pregnancy complication. It affects 14% of pregnant women in the world. As obesity and other metabolic conditions increase, more women of reproductive age experience abnormal glucose/ insulin regulation. It increases the risk of some pregnancy complications and other health conditions such as type 2 diabetes and cardiovascular disease. This is very concerning as more women of reproductive age experience these conditions. Â
According to Prof. David Simmons of Western Sydney University, there is a need for a significant change in diagnosing and managing GDM not only during pregnancy but throughout a mother’s life. He also suggests that a patient’s unique risk factors and metabolic profile should guide their treatment. It can improve health outcomes for mothers and babies.Â
Globally, GDM prevalence has increased by two to three times over the past 20 years. Women with GDM often experience high blood glucose from early pregnancy and it increases the risk of worse pregnancy outcomes. GDM also increases the risks of cesarean delivery, preterm delivery, and large for gestational age babies. Women diagnosed with GDM are 10 times more likely to develop type 2 diabetes later in life. They also have risk of hypertension, obesity and fatty liver. Treatment of GDM can improve quality of life, but sometimes it increases the risk of some health complications. Â
GDM is now found to have roots before pregnancy and can be detected early using oral glucose tolerance testing. Studies show that early detection and treatment can reduce pregnancy and postpartum complications. It can improve quality of life and increase breastfeeding initiation. It can also reduce the risk of obesity, type 2 diabetes and other health complications.Â
Researchers of this series say that understanding the effects of gestational diabetes mellitus (GDM) can help develop new management approaches for prevention and treatment. Some strategies such as early detection, promoting health at the population level, improving antenatal care can reduce the risk of GDM. There is also a need for further research to understand more about GDM and its effect on mothers and their children throughout their lives. Â
Reference Link:Â
The Lancet Series on Gestational Diabetes, The Lancet (2024). Â
DOI: 10.1016/S0140-6736(24)00827-4Â
Â
