Why is gestational diabetes becoming more common in today's pregnant women?

Gestational diabetes mellitus (GDM) has shown a steady rise globally over the past decade, and this trend is influenced by a combination of lifestyle, demographic, and physiological factors. While pregnancy itself induces a natural state of insulin resistance to ensure adequate glucose supply to the growing fetus, certain changes in modern living have intensified this risk, leading to more women developing GDM today than ever before.One of the most significant contributors is the increasing maternal age. Women are now conceiving later in life due to career priorities, delayed marriages, and planned family decisions. Advancing maternal age is closely linked to reduced insulin sensitivity and a higher baseline risk of metabolic disorders, making these women more susceptible to developing GDM during pregnancy. Another major factor is the rise in sedentary lifestyle and obesity. Over the years, reduced physical activity, desk-based work patterns, and easy access to calorie-dense foods have created a widespread environment of weight gain and metabolic imbalance. Excess adipose tissue increases insulin resistance, and when pregnancy adds its natural hormone-driven resistance on top of that, the pancreas often cannot cope with the increased demand for insulin—resulting in gestational diabetes.Dietary habits have also shifted considerably. Consumption of processed foods, refined carbohydrates, sugary beverages, and irregular meal patterns have become common. These foods cause rapid spikes in blood glucose levels and strain the insulin-producing cells over time. In contrast, traditional diets rich in whole grains, vegetables, and natural fiber—which once helped maintain metabolic health—are now being replaced by modern convenience foods.Family history and genetic predisposition continue to play a role, but they have become more pronounced due to environmental triggers. Women with a family history of diabetes, a previous history of GDM, or conditions such as polycystic ovary syndrome (PCOS) face a substantially higher risk. As the prevalence of type 2 diabetes rises in the general population, this hereditary component naturally reflects in pregnant women as well.Ethnicity also influences the trend. South Asian women, in particular, have inherently higher insulin resistance and a lower threshold for developing diabetes. With India experiencing rapid urbanisation and lifestyle transitions, the incidence of GDM has risen sharply in recent years.Finally, increased awareness and improved screening practices have contributed to higher detection rates. Earlier, many cases went undiagnosed. Today, routine glucose testing in pregnancy ensures timely identification, which may give the impression of a rise, although the actual incidence is genuinely increasing.Overall, gestational diabetes is the result of evolving lifestyle patterns, later maternal age, and growing metabolic stress in women. Recognising these trends is essential for early prevention, timely diagnosis, and better pregnancy outcomes.Dr Preety Aggrawal, Director of Gynecology and Obstetrics, Motherhood hospital Gurgoan