Prevalence of gestational diabetes mellitus in India: The ICMR-INDIAB national study (ICMR-INDIAB-24)
Viswanathan Mohan, Mohan Deepa, Nikhil Tandon, Rajendra Pradeepa, Radhakrishnan Subashini, Lunghar Janeline, Lakshmy Ramakrishnan, Sarita Bajaj, Kalpana Dash, Prabha Adhikari, Mary John, Uma Ram, Haritha Sagili, Usha Sriram, Nomita Chandhiok, Ashok Kumar Das, Ranjit Unnikrishnan, Shinjini Bhatnagar, Sadhana Joshi, Tanvir Kaur, Rupinder Singh Dhaliwal, Ranjit Mohan Anjana, ICMR-INDIAB Study Group
Abstract
Background & objectives The prevalence of gestational diabetes mellitus (GDM) is known to be high among South Asians. However, there is no national study on prevalence of GDM in India and few data comparing prevalence of GDM in early pregnancy (Early GDM) and late pregnancy (Late GDM). Methods This is an analysis of pregnant women who participated in the nationally representative Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. Of the 1,206 pregnant women 1,032 who underwent oral glucose tolerance test (OGTT) or had fasting blood glucose measurement and did not have overt diabetes, were included in this study. GDM was diagnosed using the NICE criteria. GDM was classified as Early GDM if diagnosed before 20 wk of gestation and Late GDM if diagnosed ≥ 20 wk of gestation, Results The weighted national prevalence of GDM in India was 22.4 per cent (95% CI: 16.7-28%) with no significant urban rural differences (24.2% vs. 21.6%, NS). The prevalence of Early GDM and Late GDM were 19.2 per cent (9.8-28.7%) and 23.4 per cent (16.7-30.2%), respectively. Central India had the highest prevalence of GDM at 32.9 per cent (17.9-48%), and West India, the lowest at 16 per cent (3.1-29.3%). High systolic blood pressure and family history of diabetes were independently associated with risk of GDM. Interpretation & conclusions Nearly one in four pregnant women in India have GDM with regional variability. The prevalence of Early GDM is also high. Thus, there is a need for screening of all pregnant women for GDM starting in early pregnancy.