Diabetes in Pregnancy

Diabetes in Pregnancy

Diabetes in Pregnancy or Gestational Diabetes Mellitus is a medical condition when the blood sugar levels are higher than normal range. Milder forms of Gestational Diabetes can be managed with diet and exercise whereas more severe forms will require the administering of insulin or other medicines to achieve glycemic targets. Gestational Diabetes have found to occur in around 10% of all pregnancies, in India. The Asians are 10 times more prone, therefore, every pregnant woman in our country needs to have her sugars tested at least twice during her pregnancy. The condition is at times picked up as early as 3rd month of pregnancy, but more often diagnosed during the second trimester, around the 24th week, most often, the woman will have no symptoms.

All women of childbearing age with diabetes should be counseled prior to conception, so most risks associated with this can be averted to some extent. Some women are more prone to have gestational diabetes; like those who are obese, or with less physical activity, those with a history of gestational diabetes in the previous pregnancy  and those with Polycystic ovary syndrome. They need to have a check even before they embark on a plan for pregnancy.

The typical treatment for Gestational Diabetes is following a nutrition plan that avoids simple carbohydrates, such as potatoes, french-fries, white rice, candy and other sweets and increasing the intake of vegetables. Exercise can also lower blood sugar. Blood sugar level will be closely monitored to make sure it stays within a healthy range. Around 10 to 20 percent of women with Gestational Diabetes will need insulin for better diabetes management. An important part of the treatment plan is close observation of the baby’s growth and development with repeated ultrasounds or other tests.

The high sugar levels in pregnancy , if uncontrolled ,  can affect the health of the baby .The risk of birth defects and miscarriage is also more if diabetes is present in an early pregnancy when compared to that of mothers without diabetes. The immediate short term complications in pregnancy or at birth include large birth weight, birth injuries and breathing difficulties, often requiring admission in to neonatal intensive care.  More importantly, these babies growing in a high sugar atmosphere are programmed to develop long term problems. Childhood obesity and early onset adult diabetes as they grow ,  are a serious threat to millions of babies born to mothers with improper management of sugars and will affect the well being of generation next.

The incidence of non-communicable diseases being passed on to the next generation and congenital anomalies can also be brought down drastically when the new mothers are well informed. The preconception counseling visits should address Diabetes-specific testing like A1C, thyroid-stimulating hormone exam. Gestational Diabetes normally tends to go away after pregnancy but, they are likely to convert into type 2 diabetes in a span of 2 to 5 years . These women should be guided to have their sugars tested every year, for an early diagnosis and advice on life-style to prevent the worsening.

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