Nearly half of women who developed diabetes during pregnancy have abnormal blood sugar levels years later: KEM study | Mumbai news

Mumbai: Nearly half of women with gestational diabetes continue to have abnormal blood sugar levels years after childbirth, according to a new study by Mumbai’s King Edward Memorial (KEM) Hospital.

Of the 531 mothers tracked, 48.6% developed diabetes or pre-diabetes over time, challenging the long-held assumption that gestational diabetes mellitus (GDM) resolves after delivery. Doctors warned that this under-recognised risk demands urgent attention, particularly in India, where diabetes is on the rise and postpartum care remains inconsistent and inadequate.

GDM is a form of high blood sugar that develops during pregnancy due to hormonal interference with insulin. Its incidence is steadily rising among pregnant women, particularly in urban settings. Though GDM often resolves after delivery, it significantly increases the risk of developing type 2 diabetes later in life.

The KEM Hospital study enrolled 531 women who had been newly diagnosed with GDM during their most recent pregnancy. The average age at diagnosis was 30.5 years, ranging between 21 and 43. The average postpartum follow-up period was nearly three years, extending up to eight years in some cases.

A significant proportion—48.6%—were found to have abnormal blood glucose levels at follow-up, with 22% developing type 2 diabetes and 26.6% classified as pre-diabetic (impaired fasting glucose or impaired glucose tolerance). Notably, 45% of the women had been diagnosed with GDM before 24 weeks of gestation, which is considered a higher-risk early-onset group.

Additionally, 9.6% had a previous history of GDM, highlighting the recurrence risk. Most participants were either first-time (46.2%) or second-time (43.8%) mothers, suggesting that even early pregnancies can trigger long-term metabolic risks. The data underscores a substantial postpartum burden of dysglycemia, calling for targeted screening and sustained follow-up care in this high-risk group.

Doctors at KEM Hospital, which runs the largest diabetes outpatient department under Mumbai’s civic body, say they are seeing a consistent rise in GDM cases. “We used to think gestational diabetes ends after delivery, but that’s clearly not true for a large percentage of women. Many of them continue with dysglycemia for years without knowing it,” said Dr Tushar Bandgar, a professor at the hospital’s endocrinology department. “If not detected early, this silent progression can put them at serious risk for type 2 diabetes, heart disease, and other complications.”

Adding to the concern are social pressures and cultural practices that may worsen women’s health after delivery. Many new mothers are either advised or feel compelled to retain weight to ensure sufficient milk supply for breastfeeding. “There’s a belief that women should eat more and avoid any effort to lose weight postpartum. But this retained weight contributes to insulin resistance and increases their risk of developing chronic disease,” added Dr Bandgar.

For women like 35-year-old Rani Kumari, a domestic worker from Sion, the lack of guidance has had serious consequences. Diagnosed with GDM during her second pregnancy, she was never told to follow up after childbirth. Two years later, she began feeling persistently tired and dizzy.

“I thought it was just from working too much and looking after my kids,” she said. “When I finally went to the doctor, they told me I had diabetes. Nobody warned me this could happen.” Rani now spends over ₹1,500 a month on medication and blood sugar tests, a significant financial burden for her family.

KEM doctors are calling for routine annual blood sugar testing for all women with a history of GDM, regardless of how much time has passed since childbirth. “Pre-diabetes is reversible if caught early,” Dr Bandgar said. “But if we continue to ignore this window, we’re allowing thousands of women to slip into a preventable, lifelong disease.”

Supporting young warriors: KEM Hospital offers free insulin to children with type 1 diabetes

In a first for a civic hospital in Mumbai, the KEM Hospital has begun providing free insulin to around 250 paediatric patients with type 1 diabetes visiting its outpatient department (OPD). The initiative, launched in November 2023, marks the first time a civic-run hospital in the city is offering this life-saving medication free of cost on an OPD basis.

These 250 children, who live in and around the hospital area, now receive insulin regularly, bringing significant relief to families that earlier struggled to afford the monthly expense of ₹1,500 for treatment. “Many of these parents were forced to skip or reduce doses due to cost. This initiative ensures uninterrupted therapy,” said Dr Tushar Bandgar, head of endocrinology.

So far, over 400 paediatric type 1 diabetes patients have registered at KEM, with numbers steadily rising. The hospital had previously provided insulin only to admitted patients, but later extended the services to OPD cases after securing the BMC’s approval.