Two new Indian studies involving Dr. V. Mohan and a team of national and international experts reveal that gestational diabetes (GDM) can develop much earlier than previously thought, even in the first trimester.
These first-of-their-kind global studies highlight the prevalence and clinical significance of EGDM and its major implications for women and child healthcare, offering a chance to improve outcomes for both mother and baby. Traditionally, GDM is screened for between 24–28 weeks of pregnancy, but the studies highlight the need for early detection, now classified as ‘Early GDM (EGDM)’, while later-onset cases are called ‘Late GDM (LGDM)’.
The ICMR–INDIAB Study, a nationally representative survey of 1,032 pregnant women across all states and union territories, reported an overall GDM prevalence of 22.4%, with early GDM at 19.2% and late GDM at 23.4%. This study, published in the Indian Journal of Medical Research (IJMR), is the first to report prevalence rates of both EGDM and LGDM across the country. It also revealed no significant urban-rural divide, though Central India showed the highest GDM prevalence at 32.9%.
The STRiDE study (STratification of Risk of Diabetes in Early Pregnancy), a collaborative study between the University of Warwick (UK), seven Indian antenatal clinics, and Kenya, involved 3,070 women recruited before 16 weeks of gestation. Findings showed a prevalence of 21.5% for EGDM and 19.5% for LGDM. The study also found that a previous history of GDM was associated with EGDM, while family history of diabetes was linked to LGDM. EGDM women had significantly higher BMI, HbA1c, and prior GDM history, highlighting the importance of early screening, especially in South Asian populations.
“Our data marks a pivotal moment in understanding gestational diabetes in India,” said Dr. V Mohan, Principal Investigator of the ICMR-INDIAB study and Chairman of Madras Diabetes Research Foundation. “The high prevalence of EGDM across diverse regions underscores the urgent need to implement universal screening protocols starting from the first trimester to safeguard maternal and child health.”
Prof. Ponnusamy Saravanan, lead author of the STRiDE study from the University of Warwick, UK, added, “The prevalence of gestational diabetes in general, and early GDM in particular, is higher in South Asians. Using the risk score developed in STRiDE, it is possible to predict GDM and intervene early.”
Dr. R.M. Anjana, Co-Principal Investigator of ICMR-INDIAB and President, Madras Diabetes Research Foundation, said, “With nearly one in four pregnant women affected, we are seeing an epidemic that impacts pregnancy outcomes and future diabetes burden. Early detection and region-specific strategies are key.”
Dr. Uma Ram, Senior Obstetrician, Chennai, and co-author on both studies, stated, “Early screening and integrated antenatal care could significantly reduce complications such as preterm birth, neonatal hypoglycemia, and long-term type 2 diabetes risks.”
Dr. Deepa Mohan, Epidemiologist and STRiDE co-author, emphasized, “Women from lower socioeconomic groups, despite lower BMI, had higher EGDM prevalence, pointing to unexplored environmental or genetic factors.”
Dr. V. Mohan added, “We now need clear guidelines on screening and treatment of early GDM. The International Diabetes Federation (IDF) is currently developing global recommendations. Early and late GDM management can improve outcomes for both mother and child.”
These findings come at a time when global efforts are underway to strengthen guidelines for diabetes during pregnancy. In line with this, Dr. V. Mohan, Chairman of Dr. Mohan’s Diabetes Specialities Centre and the Madras Diabetes Research Foundation, has been appointed Chairman of the International Diabetes Federation (IDF) Working Group on Diabetes in Pregnancy. This global role acknowledges his extensive contributions to diabetes research, particularly in gestational diabetes. Dr. Mohan will work with international experts to help shape forthcoming global guidelines on diabetes in pregnancy.