In 1993, Sonabai, a 21-year-old woman from a drought-prone village near Pune would eat what the family grew in their farm. At 23, she gave birth to her daughter Maina, who weighed 2.6 kg. She grew up on a farm and attended a local school. Over the years, a dam supplied water to the region, transforming subsistence farming into cash crop agriculture. Industrial growth created new jobs,food habits shifted towards fast food and widespread use of two-wheelers made transportation easier. When Maina turned 18, medical tests indicated that she had prediabetes. At 25, during her first pregnancy, she was diagnosed with gestational diabetes.
Both Sonabai and Maina are part of a landmark Pune Maternal Nutrition Study study that began in 1993 in six villages in Pune district to understand how diabetes evolves over a lifetime in Indians. Now, using data from three decades ago, researchers from KEM Hospital and Research Centre have found that high blood sugar during pregnancy is not just related to pregnancy hormones, which make women resistant to insulin. It had to do with elevated glucose levels since their childhood, largely due to an imbalanced diet and malnutrition or undernutrition-induced prediabetes.
In Maina’s case tests had even shown higher glucose levels since 6 years of age.
The findings challenge the conventional classification of gestational diabetes mellitus (GDM) as a condition limited to pregnancy. Published in Diabetologia, the journal of the European Association for the Study of Diabetes, the study suggests that GDM reflects a pre-existing, chronic metabolic disorder that begins early in life. Traditionally, GDM, defined as hyperglycaemia first diagnosed during pregnancy, has been viewed as temporary. The new evidence indicates it is part of a lifelong trajectory.
“Our findings suggest that high blood glucose in pregnancy is not a new condition caused by pregnancy but part of a life-long pattern,” says Dr Chittaranjan Yajnik, lead author of the study and founder director of the Diabetes Unit at KEM Hospital Research.
What was the study about
Between 1994 and 1996, approximately 800 women chosen for the study delivered babies. During this period, both mothers and children were monitored continuously for disease risks, including serial glucose tolerance tests. Earlier findings showed that 28 per cent of children had prediabetes at age 18.
“This tendency towards diabetes was linked to poor growth in the mother’s womb. If one is born small, his/her organs and system are unable to tolerate the stress of the modern lifestyle in later years, which increases the risk of diabetes and related disorders,” Dr Yajnik explains.
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This supports the Developmental Origins of Health and Disease (DOHAD) theory, which says that poor foetal nutrition growth predispose to later disease.This metabolic adaptation, combined with potential genetic factors and stressful modern lifestyle, increases the risk of future diabetes. “It’s evident in measurements from early childhood,” Dr Yajnik explains
What the numbers mean
For the analysis, participants were divided into four groups. At 28 weeks of pregnancy, 44 women fell into the highest quartile of fasting blood glucose, while 38 were in the highest quartile for the area under the glucose curve during glucose tolerance testing (this shows how high the blood glucose rose during the test). These women showed higher blood glucose levels from childhood and puberty through pregnancy and after delivery. They also had higher pre-pregnancy HbA1c levels, reflecting long-term elevated blood sugar.
High childhood glucose levels increased the odds of high glucose during pregnancy two-fold and post-delivery five-fold. “Our results show that higher pregnancy glycaemia reflects persistently higher glycaemia since childhood,” says Dr Yajnik.
Why a critical re-evaluation is required
The study argues that the most critical window for intergenerational programming of diabetes lies before and around conception. This period is missed in current clinical practice, where gestational diabetes is diagnosed only after pregnancy is established. Even screening before 20 weeks may be too late. Tracking metabolism and prioritising girls’ health much earlier is essential.
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Researchers also call for consideration of the genetic background (family history), socio-economic conditions, growth and metabolic status to improve the health of mothers-to-be. Indian babies are among the smallest globally, yet current diagnostic and management guidelines for gestational diabetes are largely based on Western data. “Indian health authorities and researchers must design national studies tailored to local realities and develop customised strategies to address metabolic health challenges,” says Dr Yajnik.
Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues .
Professional Background
Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature.
Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO.
Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives.
Awards and Recognition
Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.”
Recent Notable Articles (Late 2025)
1. Cancer & Specialized Medical Care
"Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease.
Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose.
2. Environmental Health (The "Breathless Pune" Series)
Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs.
"For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune.
3. Lifestyle & Wellness News
"They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions.
At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents.
4. Scientific Recognition & Infrastructure
For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics.
Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far.
Signature Beat: Health, Science & Women in Leadership
Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions.
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