Gestational Diabetes

Hi,

I am Dr. Archana Rajesh Patil, Obstetrics & Gynaecology. I am practicing from last 20 years. Today we will talk about gestational diabetes. Gestational diabetes means diabetes mellitus detected during pregnancy. It can be detected between 2nd trimester. If gestational diabetes is detected before this time, then we will call it diabetes mellitus. Now, why does gestational diabetes occur? It is because some metabolic changes occur during pregnancy, changes the insulin sensitivity of the mother. And when the pancreatic cells are not able to handle this, the patient goes into glucose intolerance and that leads to gestational diabetes. How can it be diagnosed? It can be done in the 2nd trimester by GTT. This test is done empty stomach or with light food, the blood is taken once and then the patient has given 75grams of glucose to drink then after 2 hours again we take the blood.

And then on the values we get, we decide whether the patient is gestational diabetics or diabetic mellitus. Normally when gestational diabetes is detected very much chances that before pregnancy her glucose intolerance was normal and even after pregnancy her glucose intolerance will again become normal. To treat this, most often insulin along with proper exercise and balanced diet is required. What are the high-risk factors? Which patients are likely to develop gestational diabetes? First is obesity. More BMI will indicate that she might suffer from gestational diabetes. History of family diabetes, if she has a history of PCOS or if she has a history of recurrent miscarriages, history of the malformed baby. If these histories are there then the patient should be screened for gestational diabetes. If a patient is having gestational diabetes then chances are there that patient may deliver a big baby. Or the chances of preeclampsia which is an increase in BP during pregnancy. She will have chances of increased incidence of operative intervention during pregnancy. She might require vacuum delivery, c-section delivery.

There are chances that she might land up with perineal trauma if she goes for normal delivery. These patients are more at the risk of developing diabetes in the future. What are the fetal complications? When are we talking about gestational diabetes? Fetal complications like a baby might become macrosomic. Baby has the risk of developing birth trauma. Baby might have shoulder dystocia. The shoulder might get stuck. Chances of prematurity, respiratory issues. There can be some metabolic disturbance. So, the baby has to be screened for all those things if the mother has gestational diabetes. So, whenever a patient is going for a check of pregnancy, they also should go for a diabetes check. So, we should know that glucose intolerance is normal. If everything is normal, then she should go for the screening in 2nd trimester. The best treatment can be given is a mother has to have regular exercises and a properly balanced diet. This is all about gestational diabetes. In case, you have any query regarding gestational diabetes or any other risk factor in pregnancy, you can contact me through Lybrate.

Thank You!