Women with Gestational Diabetes more likely to develop Type-2 Diabetes

Type -2 diabetes is the world’s fastest growing chronic disease.  35-40% of women in India with Gestational Diabetes Mellitus run the risk of developing type-2 diabetes within 5 years of giving birth while only 17.5% of women in India are aware of this disease and its complications.

Over 380 million people suffer from diabetes across the world, out of which, almost 180 million are women.

Gestational Diabetes Mellitus (GDM) is a form of diabetes which develops during pregnancy among women because the hormones secreted by the placenta for the development of the baby also block the action of the mother’s insulin. These hormones may cause resistance to the actions of insulin and lead to higher blood sugar levels in women who have risk factors for diabetes.

Previously, Gestational Diabetes Mellitus was thought to be a relatively benign condition, however, not it is known to put women at high risk of subsequently developing Type 2 diabetes – a condition that needs lifelong treatment and is associated with a number of serious complications. Women who have had Gestational Diabetes Mellitus are at higher risk for type-2 diabetes later in life.

Around 15% of pregnant women worldwide are diagnosed with gestational diabetes annually. 

To explore whether a lifestyle modification program can delay the onset of type- 2 diabetes in women with Gestational Diabetes Mellitus (GDM), researchers from The George Institute for Global Health teamed up with All India Institute of Medical Sciences(AIIMS) to conduct research. The LIVING (LIfestyle interVention IN Gestational diabetes) study aims at determining whether an affordable and culturally acceptable lifestyle intervention, provided to women with Gestational Diabetes Mellitus soon after the delivery of their child, can help reduce the incidence of type-2 diabetes.

Dr Josyula Lakshmi, Senior Research Fellow, The George Institute for Global Health says that,

“The impact of gestational diabetes mellitus on the pregnant woman and her baby are acknowledged and addressed to some extent. However, GDM is not be taken as seriously as it should be. With a substantial proportion of women with GDM going on to develop Type-2 diabetes mellitus within 5 years, GDM should be taken as a call for increased and sustained attention to the health of affected women.”

The LIVING study is a trial of a cost-effective, efficient, low-intensity intervention to prevent, or at least delay, the onset of type 2 diabetes mellitus in South Asian women who have had GDM. This randomised controlled open-label trial will be based in around 24 public and private hospitals across India, Bangladesh and Sri Lanka. The intervention will comprise group sessions and text/voice message prompts on physical activity, healthy diet, and stress management. Trained study staff will deliver the intervention, and monitor the outcomes over the study period of approximately three years.

14th November is World Diabetes Day and the theme this year is 'women and diabetes'. We hope more women become aware of gestational diseases and the LIVING study generates knowledge related to the implementation of a preventive strategy embedded in existing resource-constrained health systems. If shown to be successful, the intervention could be scaled up across the region and has the potential to help prevent or delay the development of type-2 diabetes in more than a quarter of a million South Asian women with prior Gestational Diabetes Mellitus.