Gestational diabetes mellitus or GDM is a term used to describe diabetes which occurs during pregnancy. GDM can be detrimental to the health of both the mother and the child if not addressed early on.
When a pregnant woman develops diabetes, the sugar levels in her blood goes up. Now, this is the same blood which circulates in the womb and therefore the baby. Depending on the timing of pregnancy,eg, first trimester,second or third , the fetus may develop several complications ranging from neural tube defects ( nerve damages) ,spontaneous abortions,still birth to big baby syndrome and neonatal hypoglycemia( low blood sugar at birth). In order to prevent such complications ,all care must be ensured to maintain strict diabetes control,and at the same time ensuring adequate nutrition to the mother and the baby, to achieve healthy growth of the foetus .
1) Who are at risk of getting GDM?
- All women above the age of 30
- Family history of diabetes
- Hypothyroidism( low functioning thyroid gland)
- Insulin resistance syndromes
2)When does it occur?
Typically GDM occurs in 7 th month .Almost 80-90%of the cases are diagnosed by the end of 28 weeks. But in some cases the mother may develop diabetes as early as 1st trimester.
3)How is gestational diabetes diagnosed?
The diagnosis of GDM is done by a Glucose Tolerance Test or the GTT. There are 2 methods being followed . One is by giving 75 gms of glucose to the and measuring blood sugar in 2 hours .A value above 140 mg/dl is indicative of GDM
The second method is a little extensive , by giving 100gm glucose and measuring every half an hour for 2 hours.
3) What is the treatment?
Just like other types of diabetes, the treatment includes diet,exercise and medications.
Diet is an integral part of management of GDM.Gestational diabetes diet plan includes avoiding all junk and refined foods..We encourage mothers to eat right,not eat less.3 major meals including complex carbohydrates ,protein and healthy fats,and 2-3 minor low carb high protein snack, a lot of fruits and vegetables and lean meat ensuring a balanced calorie intake of 2000-2500 kcal/day.
4) Do we have to take insulin ?
We recommend frequent monitoring of blood sugar levels at home using a glucometer and maintaining a log. This is used to decide on the medications. According to gestational diabetes guidelines, a lot of oral medicines are not approved for use in pregnancy, Insulin is the mainstay of treatment, when it comes to GDM
5)Will the diabetes continue after delivery?
Depends on the time of onset.Most cases of GDM, become normal after delivery.However a majority of the mothers develop over diabetes in middle age.And no, the child will not contract diabetes after delivery,although the chances of childhood obesity and future diabetes are higher for children born to GDM mothers .
6) How to prevent developing GDM?
The same methods recommended to prevent any diabetes apply here too.
- Maintain an ideal pre pregnancy weight,especially if you have a family history
- Exercise regularly. It will improve insulin resistance
- If possible, complete your family before 30 yrs. Chances of GDM increases after 30 yrs
- Reduce stress levels.