Gestational Diabetes Mellitus and Associated Impending Non-communicable Disease Epidemic: A Perspective for Actions

Diabetes Mellitus is emerging as an epidemic globally; the major causative factors involved are both environmental and genetic, affecting the intrauterine exposures to the fetus as well. If stimulus occurs to be glucose intolerance during pregnancy, gestational diabetes Mellitus (GDM) establishes. Hyperglycemia poses serious immediate adverse consequences for both mother and foetal development by permanently changing physiology and metabolism. The objective of this review was to identify the global key foetal complications, risk assessment and preventive solutions to avoid T2DM epidemics. Search was done through PubMed, Google Scholar and Aga Khan University, Karachi Campus Library resources. Literature indicated that gestational diabetes is strongly associated with higher birth weights, cesarean section of mother and risk of infant shoulder dystocia, Erbs palsy, clavicular fractures, fetal distress, and birth asphyxia resulting in 30-50 % of perinatal mortality. Respiratory distress syndrome (31 %) of infants and cardiac septal hypertrophy was seen in 35-40 % of cases worldwide. GDM play a crucial role in increasing prevalence of diabetes, obesity and metabolic syndrome. Use of insulin therapy has decreased the incidence of foetal macrosomia however, the extent of any effect on maternal and neonatal health outcomes are uncertain. Policy makers need to work at ; 1) to prevent the development of GDM per se, may implement appropriate guidelines such as ADA/WHO by which patients should be screened for risk factors for GDM at their initial visit and 2) to organize program for reducing the incidence of type 2 DM and non-communicable diseases.