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WORLD HEALTH DAY: KNOWING GESTATIONAL DIABETES
Dr M Najeeb, MBBS, MSc, MRCGP (UK)
Diabetologist & General Physician
City Clinic Khaitan
Every year on April 7, the world observes World Health Day, which is a day marked by the World Health Organization to highlight important global health problems. This year, the focus is on maternal and newborn health with the campaign of HEALTHY BEGINNINGS, HOPEFUL FUTURES.
Under this theme, let’s discuss Gestational Diabetes.
Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. It is more common in the second or third trimester, and occurs due to demands of the growing fetus on the mother’s body.
It can lead to complications like: premature birth of baby, or birth of a large baby that may develop Diabetes in the future. And for the mother, it can cause a serious condition called Pre-eclampsia.
Who's at risk of gestational diabetes?
Any woman can develop gestational diabetes during pregnancy, but the risk increases if:
Age > 40 years
body mass index (BMI) is above 30
Previous baby who weighed 4.5kg (10lb) or more at birth
gestational diabetes in a previous pregnancy
Diabetes in the parents of siblings of the mother
From the Indian subcontinent or African or arab origin
Screening for gestational diabetes is offered in any of the above conditions.
Symptoms of gestational diabetes
Gestational diabetes does not usually cause any symptoms. Most cases are only discovered when blood sugar levels are tested during screening for gestational diabetes.Some women may develop symptoms if their blood sugar levels gets too high (hyperglycaemia), such as:
increased thirst
urinating more often than usual
dry mouth
tiredness
blurred eyesight
genital itching or thrush
How does gestational diabetes affect pregnancy?
Most women with gestational diabetes have otherwise normal pregnancies with healthy babies.
However, gestational diabetes can cause problems such as:
The baby growing larger than usual – this may lead to difficulties during the delivery and increases the likelihood of needing induced labour or a caesarean section
polyhydramnios – too much amniotic fluid (the fluid that surrounds the baby) in the womb, which can cause premature labour or problems at delivery
premature birth – giving birth before the 37th week of pregnancy
pre-eclampsia – a condition that causes high blood pressure during pregnancy and can lead to pregnancy complications if not treated
loss of the baby (stillbirth) – though this is rare
Gestational diabetes also causes an increased risk of developing type 2 diabetes in the future.
Screening for gestational diabetes
During the first antenatal appointment at around week 8 to 12 of pregnancy, the doctor will ask some questions to determine whether you're at an increased risk of gestational diabetes.
If there are 1 or more risk factors for gestational diabetes a screening test will be offered.
The screening test is called an oral glucose tolerance test (OGTT), which takes about 2 hours.
It involves checking fasting blood sugar, followed by a glucose drink.
After resting for 2 hours, another blood sample is taken to see how the body is dealing with the glucose.
The OGTT is done between 24 and 28 weeks of pregnancy. If a pregnant lady has had gestational diabetes before, she will be offered an OGTT earlier in her pregnancy, soon after the first antenatal appointment, then another OGTT at 24 to 28 weeks if the first test is normal.
Although gestational diabetes can cause complications for both mother and the baby, but these complications can be avoided if the condition is detected early by your doctor and treated on time.
So, this World Health Day, let’s all strive for HEALTHY BEGINNINGS AND HOPEFUL FUTURES!
