Pregnancy & DM

 

What is GDM ( Gestational Diabetes Mellitus)?

Defined as diabetes that begins or is first recognized during pregnancy

Important because it impacts maternal health care both during and after pregnancy

 

Potential risks for foetus

 

  • The baby may be born big or overweight leading to difficulty in normal delivery
  • Nerve injury
  • Spinal defects
  • Low sugar may occur in the baby after birth
  • More chances of abortion or malform
 

Risk for the mother

  • 3rd/4th degree vaginal tears during delivery
  • Instrument deliveries
  • Cesarean delivery
  • Preeclampsia
  • Future diabetes mellitus

 

Diagnostic criteria

2 step approach:

1st step: 50 gm glucose load

              1 hour post value > 140mg/dl, then

2nd step: 100 gm glucose load

 

Treatment Options

Insulin is the only safe mecinie to be given for diabetes during pregnancy (a few oral medications are now being approved for use too). insulin dosage may increase as the pregnancy progresses.

In GDM patients, the diabetes usually disappears after delivery of the child.

These patients are however, at risk of getting Type 2 Diabetes in future, hence, they should periodically check their blood glucose levels.