The latest Lancet Series calls for the urgent need to adopt a holistic life-course approach in how we manage the disease.

Managing gestational diabetes, aka gestational diabetes mellitus (GDM), the most common medical pregnancy complication worldwide, early in pregnancy can prevent complications and improve long-term health outcomes for mothers and babies. Speaking at the ongoing American Diabetes Association 84th Scientific Sessions, authors of a new Lancet Series called for the urgent need to adopt a holistic life-course approach in how we manage the disease.

GDM cases – affecting one in seven pregnancies – are increasing globally and becoming more complex due to higher levels of risk factors such as obesity. Without timely treatment, gestational diabetes can lead to high blood pressure, increased risk of Caesarean sections, mental health conditions, and complications for the baby at delivery, alongside health complications for the mother later in life, such as type 2 diabetes and cardiovascular disease.

Catching it early 

Recent evidence suggests that the foundations for developing GDM occur before pregnancy, with metabolic changes often detectable in early pregnancy (before 14 weeks). However, GDM is typically only tested for and treated late into the second or third trimester of pregnancy (24-28 weeks).

A shift in testing for and managing GDM to much earlier in pregnancy (before 14 weeks) can prevent health complications for both the mother and baby, according to the latest Series published in The Lancet. Series authors call for better detection and prevention efforts, alongside a personalised, integrated life-course approach for those who experience, or are at risk for GDM. 

No one-size-fits-all approach

 “Our new Series emphasises the urgent need for a major shift in how GDM is first diagnosed and managed, not only during pregnancy but throughout the lifetime of mothers and their babies,” said Series lead Prof. David Simmons of Western Sydney University, Australia.  “GDM is an increasingly complex condition, and there isn’t a one-size-fits-all approach to managing it. Instead, a patient’s unique risk factors and metabolic profile should be considered to help guide them through pregnancy and support them afterward to achieve the best health outcomes for women and babies everywhere.” 

“GDM 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 GDM, and improve their overall pregnancy experience,” Series author Dr Yashdeep Gupta of the All India Institute of Medical Science, noted.

Read More: 17 steps to combat obesity and diabetes: ICMR-NIN