Overweight and Low Activity During Pregnancy Drive Diabetes Risk Among Asian Indian Women: PGDRD Study
India: A recent study published in the International Journal of Diabetes in Developing Countries has highlighted significant pre-conception and pregnancy-related risk factors linked to early-onset type 2 diabetes mellitus (T2DM) among Asian Indian women.
The research, conducted by Surabhi Mishra and colleagues from the Department of Community Medicine, Himalayan Institute of Medical Sciences (HIMS), Swami Rama Himalayan University, Dehradun, analyzed antenatal women recruited under the Prevalence of Gestational Diabetes Mellitus in Rural Dehradun (PGDRD) project.
The study involved 1,223 pregnant women, comprising 597 primigravidae and 626 multigravidae, who were selected through a multistage random sampling technique from rural areas of western Uttarakhand. Data were collected via structured interviews, and standard tools were used to measure blood glucose, blood pressure, and anthropometric parameters. Physical activity levels were assessed using the International Physical Activity Questionnaire short form, while perceived stress was evaluated using Cohen’s Perceived Stress Scale.
The study led to the following findings:
- Hyperglycemia in pregnancy (HIP), known as a precursor to early-onset type 2 diabetes mellitus (T2DM), was observed to be significantly more prevalent among multigravidae when compared to first-time mothers.
- The prevalence of modifiable risk factors, including being overweight or obese before conception and low levels of physical activity during pregnancy, was found to be similar in both primigravidae and multigravidae.
- Overweight and obesity before conception, along with low physical activity during pregnancy, emerged as the most common lifestyle-related contributors to HIP in the study population.
- A prior history of hyperglycemia, either during previous pregnancies or outside pregnancy, demonstrated a strong association with the development of current HIP, thereby increasing the overall risk for these women.
- The analysis further revealed that certain obstetric conditions serve as independent predictors of HIP, emphasizing their clinical significance.
- Multiparity, recurrent vaginal infections, and polyhydramnios during the current pregnancy were each significantly linked to an increased likelihood of developing hyperglycemia, which subsequently predisposes women to early-onset T2DM.
According to the authors, these findings underscore the urgent need for preventive strategies that target weight control before conception and encourage physical activity during pregnancy. Although multigravidae displayed higher HIP prevalence, the comparable distribution of modifiable risks among primigravidae indicates that prevention should not be restricted to women with previous pregnancies or known hyperglycemia.
The researchers concluded that early identification and management of these risk factors are crucial in reducing the burden of diabetes among Indian women. Implementing community-level awareness programs, lifestyle counseling, and routine screening for high-risk individuals can help address the growing challenge of early-onset T2DM linked to pregnancy-related hyperglycemia.
Reference:
Mishra, S., Semwal, J., Mishra, S.K. et al. Risk factors for early-onset type 2 diabetes mellitus in and around pregnancy among Asian Indian women (PGDRD 2). Int J Diabetes Dev Ctries (2025). https://doi.org/10.1007/s13410-025-01535-5
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