1. IDF Atlas 2017 documented that the total number of persons with diabetes increased from 151 million in 2002 to 425 million in 2017. Is there a hope to reverse this trend? Whom should we focus on?
2. David Barker conceptualized that the body’s susceptibility to lifestyle diseases was programmed intrauterine “Fetal origin of adult diseases”.
3. Women with a history of gestational diabetes mellitus (GDM) are at increased risk of future noncommunicable diseases (NCD) as are their children “Transgenerational transmission” occurs. Hence, it has become imperative that all pregnant women should be screened for GDM, even if they have no symptoms.
4. The Ministry of Health, Government of India has recommended that GDM can be diagnosed if 2 hr PG is ≥140 mg/dL with 75 g of oral glucose administered to a pregnant woman without regard to the time of the last meal. This guideline has also been approved by IDF, WHO and FIGO.
5. The aim is to have the newborn’s birth weight, appropriate for gestational age (2.5-3.5 kg) to prevent the offspring developing NCD in the future. For this, in women with hyperglycemia in pregnancy, FPG has to be maintained <90 mg/dL and 2 hr post meal <120 mg/dL, which are the glycemic level in the normal pregnancy.

Key points

1. One test with 75 g oral glucose in the fasting or non-fasting state.
2. One value to diagnose GDM: 2 hr PG ≥140 mg/dL.
3. One target for monitoring 2 hr PG <120 mg/dL and (estimating FPG may not necessary if 2 hr PG <120 mg/dL).