Dr Sharwari MD internal medicine
Gestational diabetes is a type of diabetes diagnosed during pregnancy in or after 28 weeks of gestation. It can occur due to multiple factors like, advanced age pregnancy, PCOD, obesity, insulin resistance, or family history of diabetes. People with these risk factors need to get the sugar test done before conception, immediately after conceiving and at 28 weeks of pregnancy, depending on the foetal condition.
The gold standard test for diagnosis is oral glucose tolerance test (OGTT), wherein a patient’s blood sugar levels are tested at fasting, and 1 and 2 hours after ingestion of 75gms of glucose, respectively.
Gestational diabetes has several implications on the growing foetus and hence it requires immediate attention and appropriate treatment.
Some common complications related to diabetes in pregnancy include macrosomia (increase in fetal head size), increase in amniotic fluid (polyhydramnios), growth impairment in foetus, pre term delivery.
Strict glucose monitoring is needed during the course of pregnancy in order to avoid complications and for better foetal well being. Glucose monitoring needs to be done using a glucometer at home, and the sugar levels need to be monitored before and after each meal throughout the day.
It needs to be closely monitored especially until 36 weeks of pregnancy as the foetus attains maximum growth during this period.
A stricter sugar control is indicated in cases where the mode of delivery is through Caesar or C-section, or with pregnancy induced hypertension, or other complications.
After delivery, most patients need not require insulin/oral hypoglycemic drugs, and only a healthy diet can help control the sugar level. However, patients with gestational diabetes are at a higher risk of developing type 2 diabetes mellitus, and this risk is higher in the first few years of delivery.
Hence a periodic check of sugar levels (OGTT) beginning from 6 weeks post delivery and every 3 months thereafter helps to track the progression of disease.
A healthy diet and regular exercise can help prevent the onset of type 2 diabetes in patients with gestational diabetes.