The key phrase is ‘focus on the foetus, for the future’ 

Context: In 2019, the government declared March 10, as “National Gestational Diabetes Mellitus Awareness Day”. It was declared on the birthday of Prof. Seshiah who was conferred the Padma Shri in the field of medicine (as a part of the Republic Day honours this year).

Further, the novel coronavirus pandemic has shifted focus on a silent ‘pandemic’ called as the Non-Communicable Disease (NCDs) which spans across the world over the last few decades. 

In general, the NCDs include diabetes and related conditions such as obesity, hypertension and heart disease. Women can have pre-existing diabetes (or ‘pre-gestational diabetes’) and Pregnancy-related diabetes (or ‘gestational diabetes’). Both of these diseases can be categorized as ‘Hyperglycemia-in-Pregnancy (HIP)’.  

How can diabetes become a pandemic in coming years?
In the year 2021, As per estimates of the International Diabetes Federation (IDF), 537 million people were infected with diabetes. However, there are chances that the tally may reach 783 million people by 2045.  

What are the reasons for increasing NCDs, especially Diabetes? 

These include an aging population, urbanisation, genetic predisposition, nutrition and lifestyle transition. 

In the 1980s, Prof. David Barker hypothesised that most of the adult disease can be traced to the foetus stage. Any adverse stimulus (say, an increased blood sugar level in mother) inside the woman’s womb, may permanently affects the structure, the functioning and the metabolism of the developing human body. It happens at the cellular and tissue levels. The borne children develop diabetes or pre-diabetes at this stage. He is also prone to other related NCDs such as hypertension and heart disease. 

In fact, the diabetes/HIP disease may even extend to next generations through unfavourable genetic and epigenetic effects from parent to the offspring. A baby girl is also prone to develop pregnancy-related diabetes. 

Ways Forward 

The health of offspring and of further generations depends upon the metabolic health of the pregnant woman.  

The ‘Diabetes-in-Pregnancy–Study Group of India’ (DIPSI) recommended ‘all pregnant women’ should be subjected to testing for diabetes in the ‘early weeks of pregnancy’.  

The diabetes and other NCDs can be checked well before conception. For example, A woman having pre-existing diabetes should maintain blood sugar level and a healthy weight.  

Targeting pregnancy-related diabetes can help in breaking the vicious cycle of transgenerational transmission. It can significantly bring down the expanding burden of diabetes and other NCDs. 

Source: The post is based on the following article, “The Key phrase is ‘focus on the foetus. For the future” published in The Hindu on 14th Apr 22.