[Symposium] Diabetes Mellitus (2)
20 Mar 2026
13:50
15:20
102
Gestational Diabetes in Asian Countries
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13:50
14:20
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Ling-Jun LiSingapore
Speaker
Is Continuous Glucose Monitoring Ready for Screening and Monitoring of Gestational Diabetes in Asian Populations?Gestational diabetes mellitus (GDM) is highly prevalent across Asia, where genetic susceptibility, rapid urbanization, and uneven access to antenatal care contribute to rising maternal and neonatal complications. Current screening and monitoring rely on oral glucose tolerance testing (OGTT) and self-monitored blood glucose (SMBG), but both have limitations, including sparse capture of glycaemic variability, patient burden, and missed postprandial excursions. Continuous glucose monitoring (CGM) provides near real-time glucose profiles that can support more responsive management, and emerging studies suggest that early-pregnancy CGM metrics may help predict GDM diagnosed later in pregnancy. However, the evidence remains heterogeneous, with variation in diagnostic criteria, population characteristics, device type, adherence, and background care pathways.
Given Asia’s high and growing GDM burden, region-specific evidence is needed to inform guideline and policy development. This talk will synthesize findings from Asian studies, with a particular focus on work from Singapore, and discuss what is required for CGM to move from promising tool to routine practice in GDM screening and management in Asian populations.
102
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14:20
14:50
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Hirohito SoneJapan
Speaker
The Impact of Underweight in Young Women on GDM and the Next Generation In Japan and some neighboring East Asian countries, it is somewhat surprising given their socio-economic level that underweight, rather than obesity, is a significant health issue for young women. According to the National Health and Nutrition Survey in Japan, the proportion of underweight women in their 20s (BMI < 18.5) has remained above 20% for decades. Despite this, many young women overestimate their own body size, with numerous individuals attempting to lose weight even though they are actually within the normal range. This reveals a discrepancy between perceived and actual body size, alongside the existence of a desire to be thin. The ideal thin body shape is influenced by social trends and traditional values that posit thinness as more attractive, as well as the influence of mass media and social media. Entertainers and fashion models are often seen as being too thin.
The health effects of being underweight in young women are known to include increased osteoporosis and mortality, but adverse effects on pregnancy and pregnancy outcomes have also been observed. Underweight women have a higher risk of gestational diabetes mellitus (GDM), a higher rate of low birth weight, and a lower birth rate compared to women of normal weight. Indeed, in Japan, the rate of low birth weight infants has been increasing in parallel with the proportion of thin women. Recent findings from DOHaD (Developmental Origins of Health and Disease) and fetal programming research have revealed that low birth weight infants face a higher future risk of developing metabolic diseases such as diabetes and hypertension. Consequently, maternal underweight before pregnancy and weight-control behaviors after pregnancy likely have adverse health effects on future generations. Based on this background, Japan has revised the standards for appropriate weight gain during pregnancy, and discussions are currently underway regarding GDM pregnant women. Furthermore, as part of preconception care, education on the importance of maintaining a healthy weight and body image is being promoted, starting from junior high and high school.
The trend toward underweight among young Japanese women, even during pregnancy, is a major national health issue, as it affects not only the health of the women themselves but also the next generation. However, its causes are complex, and multifaceted measures involving society as a whole are required. These countermeasures are also expected to be useful for prevention of same issues in other East Asian countries as well in the future.
102
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14:50
15:20
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I-Lynn LeeAustralia
Speaker
Gestational Diabetes and Perinatal Outcomes in A Large Multi-Ethnic Australian PopulationGestational diabetes (GDM) is highly prevalent in a multi-ethnic Australian population in West Melbourne with high representation from South Asian, South East/Central Asian, Middle Eastern, African and Pacific communities. These ethnicities carry a disproportionate higher risk of GDM with earlier diagnosis in pregnancy.
Australia adoped the IADPSG screening method in 2015 for which GDM prevalence rose sharply there after accompanied by rising rates of maternal obesity and changes in migration patterns from high risk ethnicities.
GDM education is delivered in a group setting and sometimes individualised for culturally and liguistically diverse women. Dietary advice is also delivered in a culturally specific and sensitive manner. Treatment initiation differed with South Asian women requiring pharmacotherapy earlier and insulin use was highest among Middle Eastern women. A smartphone and internet based interactive glucose management system for managing women with GDM is being trialled with an aim to improve efficiency of care delivery.
Despite rising GDM prevalence and maternal obesity, the large for gestational age remains unchanged over time. Maternal BMI remains a dominant risk factor for LGA. Induction of labour rates also rose significantly over the last 10 years.
It is important to develop multilingual education resources and delivering culturally adapted nutritional counselling is essential to optimising care for women with GDM living in Melbourne's rapidly growing cultural diverse metropolitan communities.
102
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