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Gestational Diabetes and Pregnancy:

SamanGestational Diabetes and Pregnancy: 

Background: Gestational diabetes (GD) is a type of diabetes that some women suffer during pregnancy. During pregnancy – usually around the 24th week – many women are at high risk of developing GD. About 5 -10 percent of expecting mothers develop this condition, making it one of the most common health problems of pregnancy. The prevalence percentage of GD is increasing rapidly in India. According to a study published in the Journal of the Association of Physicians of India, Indian women have high prevalence of diabetes and their relative risk of developing GD is 11.3 times more compared to white women.

However, women with GD don’t remain diabetic after the baby is born. Once they have had GD, though, they are at higher risk for getting it again during a future pregnancy and for developing diabetes later in life.

Symptoms:

Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. The blood sugar (glucose) level usually returns to normal after delivery.

Symptoms may include:

– Blurred vision

– Increased urination

– Increased thirst

– Fatigue

– Nausea and vomiting

– Weight loss despite increased appetite

Diagnosis:

High risk women should be screened for GD as early as possible during their pregnancies. All other women will be screened between the 24th and 28th week of pregnancy. To screen for gestational diabetes, you will take a test called the oral glucose tolerance test (OGTT). This test measures the body’s ability to use glucose.

Once diagnosed with GD, women can see how well they are doing by testing their glucose level at home. The most common way involves pricking your finger and putting a drop of your blood on a machine (glucometer) that will give you a glucose reading.

Treatment:

The goals of treatment are to keep blood sugar (glucose) levels within normal limits during the pregnancy, and to make sure that the growing baby is healthy. The gynaecologist should closely check both mother and baby throughout the pregnancy. Foetal monitoring will check the size and health of the foetus.

Well-planned diet: To keep glucose levels stable, it’s particularly important that one should not skip meals, especially breakfast, and should avoid sweet items that contain a lot of sugar, such as soft drinks, fruit juices, candies and pastries.

Exercise: Studies show that moderate exercise also helps improve your body’s ability to process glucose, keeping blood sugar levels in check. Many women with gestational diabetes benefit from 30 minutes of aerobic activity, such as walking, each day.

Medication: If blood sugar is not controlled well enough with diet and exercise alone, the health care provider may prescribe oral anti-diabetic drugs or insulin therapy to keep the blood sugar level normal. According to a recent survey, about 15 percent of women with gestational diabetes need medication.

Prevention:

Beginning prenatal care early and having regular prenatal visits help improve mother’s health and the health of the baby.

In India, most pregnant Indian women are forced to eat a lot of carbohydrates by saying that ‘you need to eat for two’. That’s a potentially dangerous habit during pregnancy. A woman needs only 300 calories extra for carrying the baby. Excess carbohydrate intake will only result in extra glucose in mother’s blood leading to high blood sugar and insulin sensitivity problems. That’s why pregnant women should take a balanced diet to avoid such health problems.

It is also necessary to get regular physical exercise. Sometimes, relatives and friends may advise women to restrict physical activities to the minimum so as not to hurt the baby inside. But for sure, it is a myth. Regular physical activity helps lower blood sugar by moving the glucose into your cells and also by increasing body’s sensitivity to insulin.

The research team from Spain looked at the results of enrolling healthy pregnant women, who did little or no exercise, into exercise programmes. Analysis of 13 trials, involving more than 2,800 women, found that exercise reduced the risk of gestational diabetes by more than 30% for women who exercised throughout pregnancy this was even greater (36%). This effect was strongest for women who combined toning, strength, flexibility and aerobic exercise. The study is published in BJOG: An International Journal of Obstetrics and Gynaecology. Source – http://www.dnaindia.com/health

 

Dr. Saman Ahmad, Ph.D ( Clinical Biochemistry), J.N. Medical College, Aligarh Muslim University, India.

January 17, 2015

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