The global prevalence of diabetes is increasing, prompting a shift in focus towards the primordial prevention of diabetes. Gestational diabetes mellitus (GDM) presents an ideal opportunity for this prevention. First time NIH study in 2018 suggested HbA1c 5.3 (2hr PPBS>110mg/dl) in the 10th week of gestation predicts GDM, hence for prevention, blood sugar has to be brought to <110mg/dl, at 10th week, as fetal beta cells start secreting insulin around 11th week. Therefore, at the 8th week itself, post-prandial blood sugar (PPBS) has to be estimated because in case PPBS is >110 mg at the 8th week, the grace period of 2 weeks is available to attain 2hr PPBS < 110mg at the 10th week. The objectives of this study were: 1. To determine the risk for GDM in the first trimester at 8 Weeks; 2. To manage the risk for GDM (BG between 110 and 119) at 8-10 weeks of gestation by MNT and metformin; and 3. To compare the maternal-fetal outcomes in both groups. At 8 weeks of gestation, pregnant women were recruited and divided into 2 groups. Group A included those with a 2-hour PPBS of < 110 mg/dL; they received no intervention(82 participants). Group B ((69 Participants) included women with 2-hour PPBS of 110-119 mg/dL(+2SD) and they received Medical Nutrition Therapy (MNT) and Metformin intervention. The prediction of GDM is based on a 2-hour PPBS ≥110 mg/dL at 10weeks. Therefore, at the 8th week, the 2-hour PPBS needs to be estimated. In group A, one (1.2%) of the subjects got GDM in the third trimester due to being a grand multipara, while in group B, one (1.4%) developed GDM in the third trimester due to non- adherence to management measures. In conclusion, screening for early gestational glucose intolerance (EGGI) at 8 weeks of pregnancy and intervention will benefit in preventing GDM and its sequelae.

Anjalakshi Chandrasekar is an accomplished obstetrician and gynecologist with extensive experience in maternal healthcare and gestational diabetes research. She has served as Professor and Head of the Department of Obstetrics and Gynaecology at SRM Medical College Hospital and Research Centre, Tamil Nadu, India. Her academic contributions focus on gestational diabetes screening, maternal-fetal medicine, and preventive strategies for diabetes during pregnancy. She has authored and co-authored several peer-reviewed publications and has collaborated with leading experts in diabetes research to advance evidence-based approaches for the prevention and management of gestational diabetes.