A comparative study of maternal and fetal outcomes in women with gestational diabetes mellitus and overt diabetes mellitus diagnosed during pregnancy: a prospective observational comparative study.

Authors

  • Dr. Keerti Shivaputrappa Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Author
  • Dr. Sonia H Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Author
  • Dr. Swetha K. M Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. Author

DOI:

https://doi.org/10.51168/r73knv50

Keywords:

gestational diabetes mellitus, overt diabetes mellitus, pregnancy, maternal outcome, obstetric outcome, neonatal outcome

Abstract

Objectives

To compare maternal, obstetric and neonatal outcomes among women with gestational diabetes mellitus and overt diabetes mellitus diagnosed during pregnancy.

Methods

A prospective observational comparative study was conducted among 100 pregnant women diagnosed with diabetes during pregnancy at a tertiary care hospital. Participants were categorized into two groups: 50 women with gestational diabetes mellitus and 50 women with overt diabetes mellitus. Detailed demographic, clinical, obstetric and glycaemic assessments were performed.

Results

The mean maternal age was higher among women with overt diabetes mellitus than those with gestational diabetes mellitus (30.62 ± 4.56 vs. 28.74 ± 4.21 years; p=0.036). The mean gestational age at diagnosis was significantly lower in the overt diabetes group (15.82 ± 4.71 vs. 25.16 ± 3.84 weeks; p<0.001). Fasting blood glucose, postprandial blood glucose and HbA1c were significantly higher among women with overt diabetes (p<0.001 for all). Insulin therapy was required more frequently in the overt diabetes group (82.0% vs. 36.0%; p<0.001). Preeclampsia occurred in 22.0% of women with overt diabetes compared with 8.0% with GDM (p=0.048). Caesarean delivery was also more frequent in overt diabetes (72.0% vs. 52.0%; p=0.039). Mean birth weight was higher in the overt diabetes group (3.38 ± 0.61 vs. 3.08 ± 0.48 kg; p=0.008). Neonatal hypoglycaemia (34.0% vs. 14.0%; p=0.024) and NICU admission (26.0% vs. 10.0%; p=0.043) were significantly more frequent among neonates born to women with overt diabetes.

Conclusion

Overt diabetes mellitus diagnosed during pregnancy was associated with a greater burden of maternal, obstetric and neonatal complications compared with gestational diabetes mellitus. Early diagnosis, intensive glycaemic monitoring and appropriate antenatal and intrapartum management are important for improving pregnancy outcomes.

Recommendations

Early screening for hyperglycaemia, appropriate differentiation of GDM from overt diabetes, individualized glycaemic management and close maternal and fetal surveillance should be emphasized.

Author Biographies

  • Dr. Keerti Shivaputrappa, Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India.

    is an Assistant Professor in the Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. She contributed as an author to the present comparative study of diabetes diagnosed during pregnancy and maternal-fetal outcomes.

  • Dr. Sonia H, Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India.

    is an Assistant Professor in the Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India. She is a co-author of the present study examining maternal, obstetric and neonatal outcomes associated with hyperglycaemia in pregnancy.

  • Dr. Swetha K. M, Assistant Professor, Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India.

    is an Assistant Professor in the Department of Obstetrics and Gynecology, ESIC Medical College, PGIMSR and Model Hospital, Rajajinagar, Bengaluru, Karnataka, India, and is the corresponding author of this manuscript. She contributed to the study on gestational and overt diabetes diagnosed during pregnancy and their associated maternal and fetal outcomes.

References

1. Abourawi FI. Diabetes mellitus and pregnancy. Libyan J Med. 2006 Jul 4;1(1):28-41. PMID: 21526019; PMCID: PMC3081498.https://doi.org/10.4176/060617

2. Goyal A, Gupta Y, Tandon N. Overt Diabetes in Pregnancy. Diabetes Ther. 2022 Apr;13(4):589-600. doi: 10.1007/s13300-022-01210-6. Epub 2022 Feb 2. Erratum in: Diabetes Ther. 2022 Apr;13(4):601. PMID: 35107789; PMCID: PMC8991291.https://doi.org/10.1007/s13300-022-01232-0

3. Choudhury AA, Rajeswari VD. Gestational diabetes mellitus - A metabolic and reproductive disorder. Biomed Pharmacother. 2021;143:112183.https://doi.org/10.1016/j.biopha.2021.112183

4. Oppermann ML, Campos MA, Hirakata VN, Reichelt AJ. Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study. Diabetol Metab Syndr. 2022 Nov 23;14(1):177. PMID: 36419098; PMCID: PMC9685976.https://doi.org/10.1186/s13098-022-00939-1

5. Yang Y, Wu N. Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors. Front Cardiovasc Med. 2022 Feb 16;9:831297. PMID: 35252402; PMCID: PMC8889031.https://doi.org/10.3389/fcvm.2022.831297

6. Karcz K, Królak-Olejnik B. Impact of Gestational Diabetes Mellitus on Fetal Growth and Nutritional Status in Newborns. Nutrients. 2024 Nov 27;16(23):4093. PMID: 39683486; PMCID: PMC11643953.https://doi.org/10.3390/nu16234093

7. Rezai S, LoBue S, Henderson CE. Diabetes prevention: Reproductive age women affected by insulin resistance. Womens Health (Lond). 2016 Jul;12(4):427-32. PMID: 27638898; PMCID: PMC5373272.

https://doi.org/10.1177/1745505716653691

8. Bhattacharya S, Nagendra L, Krishnamurthy A, Lakhani OJ, Kapoor N, Kalra B, Kalra S. Early Gestational Diabetes Mellitus: Diagnostic Strategies and Clinical Implications. Med Sci (Basel). 2021 Sep 23;9(4):59. PMID: 34698239; PMCID: PMC8544345.https://doi.org/10.3390/medsci9040059

9. Buhary BM, Almohareb O, Aljohani N, Alzahrani SH, Elkaissi S, Sherbeeni S, Almaghamsi A, Almalki M. Glycemic control and pregnancy outcomes in patients with diabetes in pregnancy: A retrospective study. Indian J Endocrinol Metab. 2016 Jul-Aug;20(4):481-90. PMID: 27366714; PMCID: PMC4911837.https://doi.org/10.4103/2230-8210.183478

10. Al Ghadeer HA, Mohamed AA, Alali MA, Al Mahdi KA, Almishal SM, Aljubran TM, Alneamah AA, Alduhmush RS, Alobaid MJ, Alsaad TS, Almoagal HS, Albuali AM, Alsuliman MF, Althafar NA, Al-Shaalan EF. Infants of Diabetic Mothers and Associated Complications in the Neonatal Intensive Care Unit. Cureus. 2024 Dec 21;16(12):e76137. PMID: 39840172; PMCID: PMC11745833.https://doi.org/10.7759/cureus.76137

11. Wong T, Ross GP, Jalaludin BB, Flack JR. The clinical significance of overt diabetes in pregnancy. Diabet Med. 2013 Apr;30(4):468-74. Erratum in: Diabet Med. 2013 Jul;30(7):887. PMID: 23278460.https://doi.org/10.1111/dme.12110

12. Pal A, Rawat D, Sadananda S, Goyal A, Haldar P, Garg D, Gupta Y, Tandon N. Pregnancy and postpartum cardiometabolic outcomes among women with overt diabetes compared to women with normoglycaemia, gestational diabetes and pre-existing diabetes: A systematic review and meta-analysis. Diabetes Obes Metab. 2025 Jul;27(7):3747-3756. Epub 2025 Apr 11. PMID: 40212010.https://doi.org/10.1111/dom.16400

13. Regnault N, Lebreton E, Tang L, Fosse-Edorh S, Barry Y, Olié V, Billionnet C, Weill A, Vambergue A, Cosson E. Maternal and neonatal outcomes according to the timing of diagnosis of hyperglycaemia in pregnancy: a nationwide cross-sectional study of 695,912 deliveries in France in 2018. Diabetologia. 2024 Mar;67(3):516-527. Epub 2024 Jan 5. PMID: 38182910; PMCID: PMC10844424.https://doi.org/10.1007/s00125-023-06066-4

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Published

2026-05-30

Issue

Vol. 3 No. 2 (2026): May 2026 issue

Section

Original Research Articles

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Copyright (c) 2026 Dr. Keerti Shivaputrappa, Dr. Sonia H, Dr. Swetha K. M (Author)

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This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Shivaputrappa, K., H, S., & Swetha, K. (2026). A comparative study of maternal and fetal outcomes in women with gestational diabetes mellitus and overt diabetes mellitus diagnosed during pregnancy: a prospective observational comparative study. SJ Gynecology and Obstetrics Africa, 3(2), 13. https://doi.org/10.51168/r73knv50

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