One of the most striking findings from the research is the unexpectedly high prevalence of early gestational diabetes among women from lower socioeconomic backgrounds.
Published Dec 15, 2025 | 11:01 AM ⚊ Updated Dec 15, 2025 | 11:01 AM
Gestational Diabetes. Representative Image.
Synopsis: An Indian study has found that gestational diabetes can develop as early as the first trimester, challenging long-held assumptions about when the condition begins and who is most at risk. The findings suggest that millions of pregnant women may be slipping through the cracks of India’s current antenatal screening system.
A first-of-its-kind global study led by Indian researchers has found that gestational diabetes can develop as early as the first trimester, challenging long-held assumptions about when the condition begins and who is most at risk.
The findings suggest that millions of pregnant women may be slipping through the cracks of India’s current antenatal screening system.
For decades, gestational diabetes mellitus (GDM) has been screened between 24 and 28 weeks of pregnancy, based on the belief that blood sugar abnormalities emerge later in gestation.
The new evidence, however, shows that a significant proportion of women already have elevated glucose levels much earlier, when routine testing is rarely conducted.
“Our data marks a pivotal moment in understanding gestational diabetes in India,” said Dr V Mohan, Chairman of the Madras Diabetes Research Foundation. “The high prevalence of early gestational diabetes across diverse regions underscores the urgent need to rethink when and how we screen pregnant women.”
One of the most striking findings from the research is the unexpectedly high prevalence of early gestational diabetes among women from lower socioeconomic backgrounds. Contrary to conventional wisdom, many of these women had a lower body mass index, a factor traditionally believed to reduce diabetes risk.
The Stratification of Risk of Diabetes in Early Pregnancy (STRiDE) study, which recruited women before 16 weeks of gestation, found that early gestational diabetes was common even among those who did not display visible risk markers such as obesity. This challenges the assumption that gestational diabetes is primarily driven by excess weight or sedentary lifestyles.
“Women from lower socioeconomic groups, despite lower BMI, had higher early gestational diabetes prevalence,” said Dr Deepa Mohan, epidemiologist and co-author of the STRiDE study. “This points to unexplored environmental or genetic factors that may be driving risk in ways we do not yet fully understand.”
The implications of missing early gestational diabetes are significant, particularly for women who already face barriers to quality healthcare. Without early detection, abnormal blood sugar levels can persist for months, increasing the risk of complications during pregnancy and childbirth.
Doctors warn that untreated EGDM is associated with preterm birth, neonatal hypoglycaemia, and delivery complications.
Beyond immediate outcomes, the condition also raises the likelihood that both mother and child will develop type 2 diabetes later in life, contributing to India’s growing non-communicable disease burden.
“Early screening and integrated antenatal care could significantly reduce complications such as preterm birth and neonatal hypoglycaemia,” said Dr Uma Ram, Senior Obstetrician in Chennai and co-author of both studies. “The longer early gestational diabetes remains undiagnosed, the greater the risks for both mother and baby,” she added.
The studies also highlight how selective, risk-based screening may be failing Indian women.
In another ICMR–INDIAB study, which assessed pregnant women across all states and union territories, found no significant urban–rural divide in gestational diabetes prevalence, suggesting that risk is widespread and not confined to specific populations.
Central India reported the highest prevalence of gestational diabetes, underlining the need for region-specific strategies alongside nationwide policy changes.
Experts argued that universal screening in the first trimester could help identify cases early, particularly among women who might otherwise be overlooked due to socioeconomic status or physical appearance.
“With nearly one in four pregnant women affected, we are seeing an epidemic that impacts pregnancy outcomes and the future diabetes burden of the country,” said Dr RM Anjana, Co-Principal Investigator of the ICMR–INDIAB study. He added that detection and region-specific strategies are key to preventing long-term consequences.
The growing recognition of early gestational diabetes is also influencing global discussions on maternal health. The International Diabetes Federation (IDF) is currently working on updated guidelines that reflect the need to detect and manage diabetes earlier in pregnancy.
India’s role in shaping this conversation has become increasingly prominent. Dr Mohan has recently been appointed Chairman of the IDF Working Group on Diabetes in Pregnancy, a move that underscores the global relevance of findings emerging from Indian research.
“We now need clear guidelines on screening and treatment of early gestational diabetes,” Dr Mohan said. “Early and late GDM management can significantly improve outcomes for both mother and child,” he noted.
(Edited by Muhammed Fazil.)
