Home » Gestational Diabets Mellitus : Effects on mother and baby and how to manage

Gestational Diabets Mellitus : Effects on mother and baby and how to manage

  • What is gestational diabetes mellitus (GDM)?
    Diabetes that develops for the first time in pregnancy is called gestational diabetes mellitus. It is a condition in which too much of blood glucose stays in your blood because your body cannot produce enough insulin (hormone that lowers the blood glucose) to meet the extra demands in pregnancy. Pregnant women with GDM and their babies need special care during and after pregnancy.
  • Who can develop gestational diabetes mellitus?
    Any pregnant women can develop gestational diabetes mellitus. Indian women have 11-fold increased risk compared to Caucasian women. Some women with risk factors may be more affected than the other women like
    • Body mass index is 30 or higher.
    • Previous big baby at birth.
    • Gestational diabetes in previous pregnancy.
    • Diabetes in family members- parents, sisters, brothers.
    • Family origin is South Asian, Chinese, African-Caribbean or Middle Eastern.
  • How do we detect gestational diabetes mellitus?
    All pregnant women will be screened for diabetes in pregnancy by oral glucose tolerance test at early pregnancy/12-16 weeks, 24-28 weeks and 32 – 34 weeks of pregnancy. It is simple blood test where pregnant women will be given a specific concentration of glucose solution to drink and the blood sample is taken after 2 hours to measure the blood glucose level.
  • How does GDM affect pregnancy and the baby?
    Many pregnant women with gestational diabetes mellitus have healthy pregnancy and healthy baby with proper care during and after pregnancy. Few patients can have problems if this condition is not detected or treated. In such women high sugar levels during pregnancy can lead to increased weight of the baby which can lead to complications in the mother and the baby.

    Effects on the mother:
    • High blood pressure during pregnancy
    • Difficulty in delivery
    • More chances of cesarean section
    • Increased chances of excessive bleeding after delivery

      Effects in the baby :
    • Big baby
    • Shoulder dystocia – babies shoulder getting stuck during delivery
    • Still birth – baby dying at or around the time of birth
    • Baby dying in the womb
    • Increased need for neonatal care in NICU
    • Increased risk of obesity in childhood and type 2 diabetes mellitus later in lifeProper control of the blood sugar during pregnancy will help to reduce the above complications.
  • Management of gestational diabetes mellitus:
    Multidisciplinary team consisting of obstetrician, physician and dietitian will be taking care of pregnant women with GDM. These pregnant women will need more frequent visit to the doctor to keep check on their blood glucose level and the growth of the baby. They will also be taught how to monitor their blood glucose levels at home. Good Control of the blood sugar level will be achieved with a combination of healthy diabetic diet , exercise, tablets and insulin injections. If the blood glucose levels are not controlled with diet and exercise or the ultrasound scan shows that the baby is larger than normal then tablets(oral hypoglycemic agents ) or insulin injections may be needed. Baby will be monitored by ultrasound scan with biophysical profile , NST -test to detect the changes in the babies heart beat during pregnancy and fetal movement counting.
  • What extra care pregnant women with GDM need to take ?
    Doing these will reduce the risk to the pregnant women and the baby :
    • Healthy eating
    • Exercise as advised
    • Self monitoring of blood glucose
    • Fetal movement counting
    • Regular check ups with the doctor.
  • Does gestational diabetes mellitus affect delivery ?
    Most women with good control of blood sugar levels will be delivered at completion of 9 months of pregnancy. Few pregnant women with complications may need early induction of labour or caesarean section. Most pregnant women with GDM will have vaginal delivery , but there are more chances of having a caesarean section than normal pregnant women especially when there is increased weight of the baby.
  • Follow up after delivery :
    All these women will tested for blood glucose levels at 6 weeks ,6 month and yearly.
  • Future health concerns for pregnant women with GDM and her baby :
    These women are at increased risk of developing gestational diabetes in future pregnancy and type 2 diabetes mellitus later in life. Babies of these mothers are at increased risk of developing obesity and overweight in childhood and type 2 diabetes later in life.

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