GESTATIONAL DIABETES MELLITUS

The Department of Gestational Diabetes Mellitus (GDM) Research at  (MDRF) is dedicated to advancing scientific understanding of diabetes that emerges during pregnancy and its long-term consequences for both mother and child. The department focuses on early prediction, effective risk stratification, innovative screening strategies, and improved clinical management of GDM within the Indian population. Through longitudinal cohort studies, clinical trials, biomarker-based research, and technology-supported monitoring, the department aims to reduce adverse pregnancy outcomes and prevent the future development of type 2 diabetes in women with a history of GDM.

The department works closely with national and international collaborators to strengthen evidence-based maternal health policies, refine diagnostic thresholds suitable for diverse populations, and reduce the clinical burden of OGTT-based screening in low-resource settings. It also plays a crucial role in awareness generation, training, and the translation of research into practical guidelines for clinicians, pregnant women, and public health professionals.

Vision

To lead transformative research that enhances the early detection, prevention, and evidence-based management of gestational diabetes mellitus, improving lifelong health outcomes for mothers and their children.

Mission

To identify early predictors of GDM, develop practical and population-specific screening tools, conduct clinical and translational research that improves maternal and neonatal outcomes, and empower healthcare systems, communities, and women through evidence-based awareness, training, and intervention strategies.

The Department of Gestational Diabetes Mellitus Research is headed by Deepa Niranjan, a leading research scientist with expertise in maternal diabetes, early pregnancy risk assessment, and preventive strategies to reduce postpartum diabetes risk. She has played a pivotal role in the design and implementation of several major GDM-focused studies at MDRF, including early screening models, CGM-based monitoring approaches, and postpartum diabetes prevention trials. Her work emphasises population-specific diagnostic thresholds, early biomarkers, and practical risk-stratification tools tailored for Indian women.

Under her leadership, the department continues to expand its scope in early GDM detection, technology-enabled glucose monitoring, large-scale clinical trials, and mother–child health research. Her commitment to maternal wellbeing, scientific rigour, and evidence-based practice drives the department’s mission to improve pregnancy care and long-term metabolic health in women across India.

Dr. V. Mohan

Dr. R. M. Anjana

Dr. Deepa Niranjan

Projects

Ethnic specific risk stratification in early pregnancy for identifying mothers at risk of gestational diabetes mellitus in India [2016–2019]

STratification of Risk of Diabetes in Early pregnancy (STRiDE), is a longitudinal observational study that recruited pregnant women in early pregnancy and prospectively followed them until delivery to derive risk score for gestational diabetes mellitus (GDM), conducted between 2016 and 2019. The project developed a composite risk score that predicts GDM in early pregnancy using the conventional risk factors such as age, BMI and family history of type 2 diabetes along with an early pregnancy HbA1c. Leveraging the infrastructure and networking facility at MDRF (and its associated clinical centres), first-time in the country, a large cohort of pregnant women (>3,000) were recruited for the project as early as in 16 weeks of gestation with a follow-up until delivery. The study showed that early pregnancy HbA1c, on its own or as a composite risk score with common risk factors, can be used to predict about 50% of gestational diabetes at 24–28 weeks of gestation. The risk ratios of developing GDM were different in different populations, highlighting the need for population-specific thresholds. Using two thresholds for rule-in and rule-out gestational diabetes helps with risk stratification in early pregnancy: those at highest risk (rule-in gestational diabetes), lowest risk (rule-out gestational diabetes) and medium risk (requires an OGTT at 24–28 weeks). The need for OGTTs can be reduced by 50–64% in different populations by using venous or point-of-care HbA1c. These findings can help to improve overall screening rates for gestational diabetes in LMICs and reduce the burden of OGTTs. This can help to redirect the resources required for conducting OGTTs to earlier intervention for women at higher risk. For effective risk stratification, population-specific thresholds are needed. Future randomized controlled trials are required to investigate whether this approach helps to reduce adverse pregnancy outcomes or reduce adverse offspring programming.

Funding: Medical Research Council (MRC), UK (Warwick University) & Department of Biotechnology (DBT), India – Newton Fund

Drug Intervention for Prevention of type 2 Diabetes – (DIVINE) - A Randomized Control Trial [2025–2028]

The project titled “Drug intervention for prevention of type 2 diabetes among women with prior gestational diabetes mellitus and pre-diabetes in South Asia (DIVINE): A Randomized Control Trial” is being funded by Indian Council of Medical Research (ICMR).

The primary objective of the study is to evaluate the efficacy of combination of metformin and vildagliptin in prevention of diabetes in women with prior GDM and having prediabetes in the postpartum period. The target population includes women who experienced GDM in a recent pregnancy and who are currently diagnosed with prediabetes.

Study Sites: The trial is being conducted across 10 sites in India, representing diverse regions:

All India Institute of Medical Sciences (AIIMS), New Delhi, VMMC & Safdarjung Hospital, New Delhi, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Seth GSMC & KEM Hospital, Mumbai, Goa Medical College, Goa, Karnataka Institute of Medical Sciences, Hubli, Karnataka, Madras Diabetes Research Foundation (MDRF), Chennai, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry and Government Medical College Hospital, Thiruvananthapuram. The recruitment target is 1,110 participants (approximately 111 women per site). Eligible participants must have a history of GDM within the past five years, and a current diagnosis of prediabetes, confirmed through an oral glucose tolerance test (OGTT). Screening is currently in progress.

Funding Agency: Indian Council of Medical Research (ICMR)

Clinical Trial of use of Continuous Glucose Monitoring in pregnant women (CGM-GDM) [2025–2026]

The main objective of the study is to evaluate the utility of CGM metrics in diagnosing and monitoring eGDM (Early Gestational Diabetes Mellitus) and LGDM (Late Gestational Diabetes Mellitus) and their association with maternal and neonatal outcomes. The study plans to study 200 women in the first trimester of pregnancy i.e., before 14 weeks of pregnancy recruited from antenatal clinics in Chennai in whom a fasting plasma glucose and HbA1c test will be done. In all 200 pregnant women, CGM (Freestyle Libre) will be deployed. These women will be followed throughout the pregnancy and will receive CGM once again in the second trimester.

Funding: Self-funding

Research Strengths

  • Early prediction and risk scoring for GDM

  • HbA1c-based and population-specific diagnostic thresholds

  • CGM technology in pregnancy

  • Clinical trials for postpartum diabetes prevention

  • Maternal and neonatal outcome research

  • Reduction of OGTT burden through innovative screening methods

Collaborations

  • ICMR
  • DBT
  • International institutions including Warwick University
  • Medical colleges and research centres across India

Interested in collaborations ? 

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