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Gestational diabetes mellitus is fast becoming an important heath issue in India. Traditionally quoted prevalence figures are around 5-7% and the prevalence of GDM directly reflects that of type 2 diabetes in a given population and therefore can be expected to be on the rise. With newer diagnostic thresholds the prevalence in the general population may be up to 18%.1 Out of 1-14% of pregnancies which are complicated by diabetes mellitus majority (88%)2 are gestational diabetes mellitus. There is growing evidence that elevated plasma glucose concentrations or hyperglycemia, below what is currently considered GDM are also pathological to fetus.3 Uncontrolled maternal GDM exposes the fetus to an abnormal glucose load, leading to a compensatory increase in fetal insulin secretion. The resulting hyperinsulinemia often leads to excess fetal growth and these large -for-gestational-age (LGA ) fetus face a significantly increase risk for morbidity at the time of vaginal birth such as shoulder dystocia4 brachial plexus injury and new born asphyxia. Consequently, most obstetricians prefer to deliver LGA infants via caesarean section.5 Fetus exposed to a high intrauterine glucose environment also have elevated risks for a number of other complications upon delivery, including neonatal respiratory distress syndrome, cardiomyopathy, hypoglycaemia, hypocalcemia, hypomagnesia, polycythemia and hyperviscocity.6 Armed with the knowledge gained over years and the acute awareness that GDM in pregnancy is associated with poor fetal outcomes and the recent proposition that even milder forms of hyperglycemia are associated with LGA babies and adverse perinatal outcome, the need of the hour is to correctly diagnose the biochemical changes at the right time. This will help to achieve a good metabolic control and improve the perinatal as well as maternal outcome.

Comparison of Perinatal outcome in pregnant patients with one abnormal value in OGTT as compared to more than two values as per the IADPSG criteria