Dr Sharwari Dabhade, consultant Internal medicine Fortis la Femme GK 2
In recent years, diabetes prevalence has increased multiple folds at a young age. The reason can be an increase in obesity, unhealthy lifestyle, family history of diabetes and early onset of insulin resistance. Gestational Diabetes Mellitus (GDM) that is diabetes in pregnancy is seen more nowadays as compared to the last decades, due to the same reasons.
Screening for gestational diabetes starts between 24-28 weeks of pregnancy, except in patients with preexisting diabetes mellitus, insulin resistance, PCOD, obesity, where the screening may have to be done in early pregnancy.
The oral glucose tolerance test (OGTT) is the confirmatory diagnostic test, against the random blood sugar and HbA1C checkup. A few complications associated with GDM include increased fetal weight, macrosomia (large head of fetus), preterm labor, polyhydramnios (increased liquor).
Diet and exercise remain the initial and most important part of the treatment. Diet which contains more proteins, complex carbohydrates and fibre and moderate-intensity exercise, including aerobic activity for 30 minutes a day.
Treatment options in oral medications include Metformin and Glyburide, however, they do not stand as the mainstay of treatment. Insulin which includes short-acting lispro, mix insulin and/or long-acting NPH or detemir, are the most effective way of treatment and is considered safe for the fetus.
Regular sugar monitoring with a glucometer and appropriate patient education can help avoid complications in pregnancy-related to diabetes
