Friday, October 5, 2012


            The World Health Organization's estimation of prevalence of diabetes in adults indicates an expected total tise of more than 120% from 135 million in 1995 to 300 million in 2025. This includes Gestational Diabetes Mellitus (GDM) which is defined as carbohydrate intolerance with first recognition or onset during pregnancy and pre GDM, a term that denotes known diabetic subjects who become pregnant.

          Women with GDM are at increased risk of future diabetes and their children are at risk of childhood obesity and diabetes later in life. This fact should warn the physicians and general public alike to the necessity to devote special attention to this problem. Uncontrolled diabetes in pregnancy leads to spontaneous abortions, birth defects, preterm labor, big baby, hypertension, sudden in-utero death, delayed and difficult labor. 


            A team approach is needed in management of pregnancy in diabetes with the obstetrician, diabetologist, dietitian and pediatrician working in concert. Intensive monitoring, diet and insulin therapy are cornerstones for management. The importance of educating pregnant women with diabetes about the condition and its management cannot be overemphasized. 

          All pregnant women must be aware of when to screen for GDM and GDM mothers must know about its implications for her and her baby. Fetal growth must be evaluated with ultrasound and fetal echo done to rule out cardiac problems.

          Prevention of adverse maternal and perinatal outcomes in GDM is based on achieving maternal blood glucose as close to normal as possible. Gestational diabetic women require follow up. Glucose tolerance test with 75g oral glucose is performed after 6 weeks of delivery and if necessary repeated after 6 months and every year to determine whether the glucose tolerance has returned to normal or progressed. Diabetes in pregnancy needs holistic care for good health of women and her child. 

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