The difference may be explained by the mismatch between the predicted environment for survival programming and the actual environment in adult life due to rapid urbanisation and economic, nutritional and lifestyle transition. In India, on the other hand, studies indicate that GDM may be associated with increasing socio-economic status, and similar trends have been found for type 2 diabetes. Studies from high income countries generally find that pregnant women belonging to lower socio-economic groups have a higher risk of developing GDM compared to their counterparts from higher socio-economic strata. , but much remains to be understood particularly about socio-economic factors behind the high rates of GDM. Several studies have reported various risk factors associated with higher rates of GDM, mainly focused on traditional risk factors such as age, BMI etc. Some of these studies have used the Diabetes In Pregnancy Study group India (DIPSI) criteria, a modified version of the World Health Organization (WHO) 1999 criteria relying solely on the two hour 75 g oral glucose tolerance test (OGTT), administered irrespective of last meal time (fasting or non-fasting). A number of studies from India have found GDM prevalence rates ranging from around 5% to 18%. A number of studies from low and middle income countries have reported relatively high GDM prevalence rates in recent years, and studies from high income countries have repeatedly identified pregnant women of Indian/South Asian ethnicity as being at increased risk of GDM. GDM also increases the risk of future type 2 diabetes in the mother and her offspring, thereby fuelling the increasing burden of diabetes seen in many countries, including India, where currently 65 million people have diabetes. Gestational diabetes mellitus (GDM) is one of the most common medical conditions associated with pregnancy and is known to increase the risk of various adverse pregnancy outcomes.
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