Gestational diabetes mellitus is more common in Indian Punjabi women than Swedish women, said a research which studied women from the two countries. As a transient form of diabetes, characterised by impaired insulin secretion and action during pregnancy, the prevalence of gestational diabetes mellitus (GDM) can be explained by lifestyle changes and also a person’s genes, stated the study published in the Journal of Internal Medicine.
Scientists led by Dr Geeti Aurora, a physician in Punjab, with colleagues at the Lund University Diabetes Centre, Sweden, assessed 507 Swedish women from Malmö and 4,018 Indian women from the state of Punjab for gestational diabetes.
It is said to be the largest study to date comparing gestational diabetes in Europeans and non-Europeans, and the first study to compare the incidence of gestational diabetes in India with Sweden.
Gestational diabetes usually starts between weeks 24 and 28 of pregnancy and usually doesn’t have many symptoms. But pregnant women can experience unusual thirst, frequent urination in large amounts (distinguished from the also frequent but usually light urination of early pregnancy), fatigue (which may be difficult to differentiate from normal pregnancy fatigue and sugar in the urine (which could be detected at a routine practitioner visit).
The researchers found that the incidence of gestational diabetes was higher in Indian women from Punjab and they were also on average ten years younger than their Swedish counterparts when they develop the disease. The prevalence differs between different populations and can partly be explained by genetic differences.
Yet the team noted that Indian women are leaner and more insulin-sensitive. “[The fact that] Indian women seem to develop gestational diabetes at a lower body mass index even though they are insulin-sensitive could indicate a more serious defect in insulin secretion,” said Dr Rashmi Prasad at Lund University’s Diabetes Center, the first author on the study.
The researchers further examined 85 previously known risk genes for gestational diabetes and type 2 diabetes. They found that the gene, CRY2, which is of importance to the circadian rhythm, had a protective effect in Indian women but is associated with increased risk of gestational diabetes in Swedish women.
“It is interesting that the same gene has the opposite effect in the Indian and Swedish populations, and the question is whether it can be related to the shifting seasons in Scandinavia which don’t occur in India,” said Prasad.