Prevalence and risk factors associated with gestational diabetes mellitus in urbanised villages of East Delhi

Kalpesh Gohel, Pragti Chhabra, S. V. Madhu, Priyanka Mody, Shiv Pujari


Background: Gestational diabetes mellitus (GDM) is caused by an inability to increase insulin secretion in response to the insulin resistance experienced during pregnancy. This transient hyperglycemia poses immediate health-risks for the baby and long-term in the mother. Thus, GDM offers an experimental opportunity to study strategies for diabetes management.

Methods: A cross-sectional study of two urbanized villages in East Delhi was performed over 1.5 years. 290 subjects with >12 weeks gestation, who were residents of the villages for at least 6 months, were enrolled. Detailed demographic and medical history with laboratory findings were collected and glucose challenge test (GCT) and Oral glucose tolerance test (OGTT) were used for screening and diagnosis of GDM.

Results: Prevalence of GDM was found to be 9.1% in urbanized villages. High gravida (OR:2.97; 95% CI:1.24-7.12; p<0.014), longer duration of stay at the present residence (OR:2.48; 95% CI:1.05-5.84; p<0.037) and the presence of a family history of diabetes (OR:3.93; 95% CI:1.54-10.02; p<0.04) were found to be significantly associated with the chance of developing GDM in regression analysis. Pregnant women located in urban India for more than three years were 2.48 times more likely to have GDM as compared to those who were residing for lesser duration.

Conclusions: As more women reside in urban localities and experience childbearing at a higher age, burden of diabetes mellitus in the community increases. This rising prevalence indicates importance of prevalence studies in a changing Indian geography.


GDM, Insulin resistance, Pregnancy hyperglycemia, GCT, OGTT

Full Text:



World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation Part 1: Diagnosis and classification of diabetes mellitus. Geneva: WHO. WHO/NCD/NCS/99.2 Available at: WHO_NCD_NCS_99.2.pdf. Accessed on 18 August 2009.

American Diabetes Association. Gestational diabetes mellitus. Ann Intern Med. 1986;105(3):461.

Dabelea D, Snell-Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, McDuffie RS. Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort-Kaiser permanente of Colorado GDM screening program. Diabetes Care 2005;28:579-84.

Deierlein AL, Siega-Riz AM, Chantala K, Herring AH. The association between maternal glucose concentration and child BMI at age 3 years. Diabetes Car. 2011;34:480-4.

Seshiah V, Balaji V, Madhuri SB. Scope for Prevention of Diabetes-Focus Intrauterine milieu Interieur. J Assoc Physicians India 2008;56:109-13.

American Diabetes Association. Standards of Medical Care in Diabetes-2015. Classification and diagnosis of diabetes. Diabetes Care. 2015;38(1):S8-16.

World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: A World Health Organization guideline. Diabetes Res Clin Pract. 2014;103(3):341-63.

Kalyani KR, Jajoo S, Hariharan C, Samal S. Prevalence of gestational diabetes mellitus, its associated risk factors and pregnancy outcomes at a rural setup in Central India. Int J Reprod Contracept Obstet Gynecol. 2014;3(1):219-24.

Krishaveni GV, Hill JC, Veena SR, Geetha S. Gestational diabetes and the incidence of diabetes in the 5 years following the index pregnancy in South Indian women. Diabetes Res Clin Pract. 2007;78(3-2):398-404.

Seshiah V, Balaji V, Balaji MS. Gestational diabetes mellitus in India. J Assoc Physicians India. 2004;52:707-11.

Sahu L, Satyakala R, Rani R. Comparison of the American Diabetes Association and World Health Organization criteria for gestational diabetes mellitus and the outcomes of pregnancy. Obstet Med. 2009;2:149-53.

Balaji V, Balaji M, Anjalakshi C, Cynthia A, Arthi T, Seshiah V. Diagnosis of gestational diabetes mellitus in Asian-Indian women. Indian J Endocrinol Metab. 2011;15(3):187-90.

Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis: BMC Preg Childbirth. 2018;18(1):494.

Nielsen KK, Damm P, Kapur A, Balaji V, Balaji MS, Seshiah V. Risk Factors for Hyperglycaemia in Pregnancy in Tamil Nadu, India: Plos one. 2016.

Ebrahim S, Sanjay K, Liza B, Andersen E. The effect of rural to urban migration on obesity and diabetes in India; A cross sectional study. PLoS Med. 2010;7(4):e1000268.

Badikillaya VU, Adusumalli P, Venkata RG, Pernenkil S. Effectiveness of Diabetes in Pregnancy Study Group India Test (DIPSI) Diagnostic Criterion in Detecting Gestational Diabetes Mellitus- a Pilot Study in a Rural Population. Indian J Basic App Med Res. 2013;2:614-61.

Rajput M, Bairwa M, Rajput R. Prevalence of gestational diabetes mellitus in rural Haryana: A community-based study. Indian J Endocrinol Metab. 2014;18(3):350-4.

Nilofer AR, Raju VS, Dakshayini BR, Zaki SA. Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes. Indian J of Endocrinol Metab. 2012;16:74-8.

Basu J, Datta C, Chowdhury S, Mandal D, Mondal NK, Ghosh A. Gestational Diabetes Mellitus in a Tertiary Care Hospital of Kolkata, India: Prevalence, Pathogenesis and Potential Disease Biomarkers: Clin Endocrinol Diabetes: 2020;128(4):216-23.

Rajasekar G, Muliyil DE, Cherian AG, Prasad JH, Mohan VR. Prevalence and Factors Associated with Gestational Diabetes Mellitus among Antenatal Women at a Rural Health Center in Vellore. J Assoc Physicians India. 2019;67(4):42-7.

Sharma K, Wahi P, Gupta A, Jandial K, Bhagat R, Gupta R, et al. Single Glucose Challenge Test Procedure for Diagnosis of Gestational Diabetes Mellitus: A Jammu Cohort Study. J Assoc Physicians India. 2013;61:558-9.