By: Dr. Abhishek Kumar Pandey, Asstt. Editor-ICN
LUCKNOW: It is a condition in which a women without diabetes develops high blood sugar levels during pregnancy. Diagnosis and prompt management during pregnancy are absolutely essential for a favourable outcome for both the mother and foetus.
Pregnant women who are obese, with a family history of diabetes mellitus or who have had menstrual abnormalities should undergo tests to rule out the presence of gestational diabetes even in the first and second trimesters. The majority of patients with gestational diabetes need not take insulin during pregnancy. In fact the blood sugar level of 80% women with gestational diabetes mellitus can be controlled by dietary modifications, especially restricting the intake of carbohydrates along with proper exercise and eating regular meals.
Congenital malformations of the heart, CNS, kidneys as well as sacral agenesis is 3-5 times greater in infants born to mother’s with uncontrolled gestational diabetes and hence medical termination of pregnancy may become necessary in many cases to avoid further complications. Other common neonatal complications includes intrauterine growth retardation, low IQ, hypoglycaemia ( deficiency of glucose in blood stream), hypocalcaemia ( low calcium level in blood) , hypomagnesemia (deficiency of magnesium in blood), hyperbilirubinemia (too much bilirubin in the blood), shoulder dystocia (infants shoulder become lodged in the mother’s pelvis).
Women with gestational diabetes are vulnerable to antenatal complications like hypertension, hydramnios (increased amount of amniotic fluid), increased weight and premature labor.
What to do ??
- A lady who is obese with a family history of diabetes or polycystic ovarian syndrome or menstrual irregularities, should take a Glucose tolerance test ( GTT), before planning a pregnancy.
- Dietary modifications is strictly required.
- Tablets like Metformin will help to reduce the blood sugar level. Insulin is needed only for patients with Type I diabetes or those with uncontrolled blood sugar levels.
- High risk patients should take a glucose tolerance test even in 1st and 2nd trimesters.
Gestational diabetes mellitus can contribute to a number of complications during pregnancy, including Preeclampsia, foetal hypoglycaemia and excessive foetal weight gain, along with other complications. Hence, women who are at higher risk of developing gestational diabetes should be appropriately screened to reduce maternal and foetal morbidity. A successful combination of nutrition therapy, exercise, and insulin therapy will help to control gestational diabetes mellitus and it’s potential complications.