Prevalence and outcomes of gestational diabetes mellitus in Indian women: Insights from a large real-world study over ten years at tertiary care research institute

Background Gestational diabetes mellitus (GDM) is commonly noted during the second trimester of pregnancy. There is limited clinical evidence for the diagnosis of GDM during the third trimester of pregnancy, particularly in Indian pregnant women. Objective To assess and validate the clinically suitable strategy for screening, diagnosis, and monitoring of gestational glucose intolerance (GGI) and GDM during pregnancy in Indian women visiting the tertiary care research institute. Methods This was a single-center, retrospective epidemiological data analysis of a real-life scenario. Data of Indian pregnant women visiting tertiary care centers were retrieved and analyzed. Analysis was performed for the prevalence of GDM; progression of GGI to GDM; and neonatal outcome. The Diabetes in Pregnancy Study Group of India (DIPSI) criteria were used and validated. Results The data of 20,232 pregnant women over the period of June 2012 to March 2022 was retrieved and analyzed. A total of 2192 pregnant women reported GDM. These women were further analyzed for the prevalence of GGI and progression of GGI to GDM by using DIPSI guidelines. Out of 2192 pregnant women, 49 women lost follow-up. A total of 646 (29.47%), 1149 (52.42%), and 397 (18.11%) pregnant women were diagnosed with GDM during the first, second, and third trimesters, respectively. Almost 47.77% and 14.83% of women with normal blood glucose levels progressed to GDM in the second and third trimesters, respectively. Few women who had GGI in the first trimester progressed to GDM in the second trimester (4.65%) and third trimester (1.69%). Similarly, only 1.6% of women who had GGI in the second trimester progressed to GDM in the third trimester. Neonatal complications were analyzed, and 14 neonatal deaths were noted. Conclusion The study validated DIPSI guidelines and concluded that DIPSI guidelines are important and clinically relevant for the screening of GDM in resource-limiting settings. The screening of pregnant women for GDM in the third trimester is equally important for the diagnosis, timely management, and prevention of complications. Also, monitoring and treatment of women with GGI play a crucial role to prevent the progression of GGI to GDM.