DIPSI 2024 — Delhi Declaration — A futuristic approach towards primordial prevention of diabetes

Abstract

Gestational diabetes mellitus (GDM) has conventionally been defined as any degree of glucose intolerance with onset or first recognition during pregnancy (Hinkle et al. in Sci Rep 8:12249, 2018). GDM has both short-term as well as long-term adverse materno-fetal consequences and increases the risk of future non-communicable diseases (NCDs), including type-2 diabetes. Probable epigenetic changes in children exposed to hyperglycemia in-utero predispose them to an increased risk for developing insulin resistance, obesity, type-2 diabetes, and associated NCDs in later life. Therefore, early detection and optimum management of GDM can go a long way in combating this rising epidemic of NCDs. It is pertinent to screen all pregnant women for glucose intolerance in pregnancy with the simple, economical and reliable single step test recommended by DIPSI and approved by the Ministry of Health & Family Welfare Government of India. An optimized strategy to achieve euglycemia can prevent the epidemic of NCD. Gestational programming is a distinctive process. The adverse stimuli (like hyperglycemia) or stresses that occur at critical or sensitive periods of fetal development ultimately lead to permanent changes in the structure, physiology, and metabolism of the growing fetus. This, in turn, predisposes these babies to increased NCD risk in their adult life — the famous J Endocrinol 2004;181:11–23 (Piper et al., 2004).