Gestational Diabetes Millitus(GDM)
Gestational Diabetes Mellitus is a kind of diabetes associated with high levels of blood glucose in pregnant women who is not known to have diabetes before pregnancy.
The mother develops insulin resistance, it starts when the body is not able to use insulin because the hormones that are produced by the placenta to support the pregnancy also block the action of mother’s insulin. As a result, glucose builds up in the bloodstream causing hyperglycemia.
- Being older than 35 years
- Personal history of GDM in previous pregnancies
- Family history of diabetes
- Mother being overweight or obese
- Previous birth of baby weighing more than 4 kg
- Using medications, e.g.: corticosteroids, ventolin
For every pregnant woman, screening test will be preformed, which is checking the blood sugar two hours after a regular main meal.
If it is high or one of the mentioned risk factors exists, Oral Glucose tolerance Test is preformed to confirm diagnosis. It starts with testing fasting blood sugar (10-12 hours), and then testing blood sugar 2 hours after gluco-cola drink containing 75 gm of sugar to test the body’s ability to digest sugar.
- Following a healthy diet is crucial for the well being of an expecting mother and her baby. The goal is to avoid peaks in blood sugar levels.
- Quality and quantity of food need to be adjusted so that it is low in fat and sugar. Also, care should be given to cooking methods. It is preferable to have boiled, steamed or grilled food than fried food.
Exercise is one of the cornerstones of GDM treatment as it causes blood sugar levels to drop by burning sugar and improving insulin resistance in the body.
Third: Insulin Therapy
- Insulin therapy may become necessary if a GDM diet and exercise are inadequate to control glucose levels.
- The most common therapeutic regimen involves Regular insulin combined with NPH insulin, ranging from two to four doses per day.
First: For the baby
- Macrosomia (Fat baby) and difficult delivery.
- Hypoglycemia after birth.
- Respiratory distress.
- Intrauterine fetal death.
Second: For the mother
- Risk of delivery by caesarian section is increased.
- Urinary tract infection due to excess glucose in the urine.