Addressing the intrauterine environment through early detection of hyperglycemic pregnancy is a vital primordial prevention strategy for reducing adult cardiovascular disease.

The escalating epidemic of diabetes necessitates a clinical shift from managing established disease toward primordial prevention. The root of this metabolic crisis often begins well before birth within the intrauterine environment.

Addressing the practice gap in primary prevention, Dr. P. C. Manoria, Executive President, WCCKMM, questioned how clinicians can reduce the colossal figures of new diagnoses. He identified a clinical urgency regarding the growing national disease burden.

In an interview at TheRightDoctors studio at the 4th World Congress on Cardio-Kidney-Metabolic Medicine (WCCKMM 2026) at the Leela, Mumbai, Dr. P. C. Manoria, Executive President, WCCKMM, spoke with Dr. Sunil Gupta, President-elect, RSSDI, on the fetal origin of adult diseases.

Dr. Gupta emphasized that the intrauterine environment leaves a permanent physiological imprint on the fetus. Probing the clinical gap, Dr. P. C. Manoria asked how this environment predisposes infants to hypertension and coronary artery disease.

Dr. Gupta explained that babies exposed to hyperglycemia in the womb become physiologically predisposed to diabetes and cardiovascular disease. He noted that most planning or programming of a person occurs during the intrauterine phase.

Dr. P. C. Manoria asked about the assessment of glycemic control and ideal targets for pregnant patients. Dr. Gupta stressed that many pregnancies are unplanned, leading to suboptimal metabolic environments at the time of conception.

Dr. Gupta stated that for women with known diabetes, targets should be achieved before getting pregnant. He advocated for rigorous screening in the first trimester to improve neonatal outcomes and the future health of the offspring.

Could focusing on the early detection of the mildest forms of hyperglycemic pregnancy finally bend the curve of the metabolic epidemic? Dr. Sunil Gupta suggests this remains a vital, yet overlooked, frontier in cardio-protection.

<p>TheRightDoctors | Official Digital Knowledge Partner | WCCKMM 2026</p>