What is diabetes?
Diabetes is a disease characterized by the inability to produce or use sufficient endogenous insulin to metabolize glucose properly.
Is a type of Diabetes that develops for the first time during pregnancy. Metabolism of glucose fats and protein is altered during pregnancy. 1% of pregnant women are diagnosed with Pregestational diabetes. Expecting mothers are diagnosed with either gestational or pregestational diabetes.
Symptoms of Gestational diabetes
– Glycosuria on 2 successive office visits.
– Recurrent monilial (vaginal) infection.
– Macrosomia (High fetal weight).
– Polyhydramnios (Excessive amount of amniotic fluid).
Gestational diabetes is diagnosed through a two-step process that begins with an oral glucose challenge test performed at 24 to 28 weeks. If results are abnormal a confirmatory 3- hour 100-g glucose tolerance test is done. Once diagnosed, the mother needs to undergo certain screening tests to ensure her health and her baby’s health.
– Necessary testing for the mother
A pregnant woman with pregestational diabetes should undergo the following testing:
1- Comprehensive eye examination
2-Baseline renal function.
4- Thyroid check-up.
due to the higher risk of thyroid disease
Necessary testing for the baby
– Fetal anatomy survey at 20 weeks and fetal cardiac evaluation.
– Serial ultrasound examinations to monitor fetal growth
Possible complications for the mother
– Increase the rates of gestational hypertension.
– Increase in the chance of developing overt diabetes later in life.
– Macrosomia (Excessive fetal weight at birth).
– Neonatal hypoglycemia.
– Shoulder dystocia.
– Birth trauma.
– The diet should consist of 33to 40% carbohydrates, with the remaining 20% protein and 40% fat.
– Complex carbohydrates are preferred.
– A daily intake of 3 meals and 2 snacks
– Moderate exercise is also recommended.
Gestational diabetes is treated either with insulin or oral medications.
Women with good glycemic control can wait until 39 to 40 weeks to start the treatment.
Postpartum follow up
After delivery woman should be screened for diabetes 6 to 12 weeks postpartum.