Test antenatal women for diabetes early in pregnancy, says specialist

V. Seshiah calls for universal screening by 8th week of pregnancy

January 02, 2023 01:34 am | Updated 01:34 am IST - CHENNAI

Universal screening of women early in the first trimester of pregnancy would prevent gestational diabetes and stem the condition from manifesting in the offspring as well, according to V. Seshiah, founder patron of Diabetes in Pregnancy Study Group in India (DIPSI).

For several years now researchers have been calling for screening women early and treating them for diabetes. But the question is how early should the signs be picked up. Also, the definition of what is the permissible level of blood glucose.

“We have to test the woman in the eighth week of pregnancy so that the fetus will not secrete insulin. The whole problem starts due to foetal hyperinsulemia in the 10th week (of pregnancy),” he explained.

In a study published in the international journal Cureus, Dr. Seshiah and his team said predication of gestational diabetes mellitus (GDM) can be done in early pregnancy itself if the HbA1C is over 5.3% or the two-hour post-prandial blood glucose level is more than 110mg/dL at the 10th week.

Until now doctors had accepted a post-prandial blood glucose reading of 140 mg/dL. But recent studies have shown differently, said Dr. Seshiah. “In a normal pregnancy blood sugar levels do not cross 70-80 in fasting and is less than 110 two hours after food,” he explained, adding: “We achieved this a decade ago but we followed the western guidelines. We have missed the diagnosis much earlier.”

The only way to prevent diabetes in unborn offspring at a later date is to test pregnant women as early as the eighth week of pregnancy, pick up the indications and treat them. This would prevent the woman from progressing to gestational diabetes and also save the child from developing the condition at a later date, he averred.

He has written to the Union government as well, he said. His study, Prediction and Prevention of Gestational Diabetes Mellitus and Its Sequelae by Administering Metformin in the Early Weeks of Pregnancy published in Cureus had called for early testing of pregnant women.

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