Diabetes in Pregnancy

Diabetes in a pregnant mother can be either pre- existing diabetes (Type 1 DM or 2 DM) or can be diagnosed for first time during pregnancy (GDM Gestational diabetes mellitus)

• Single step test
• No fasting is required or 75 gms of glucose in 200 ml water.
• Blood sugar checked after 2 hrs of oral glucose load
• If plasma glucose is
  < 120 mg/dl: Normal
  121-140 mg/dl: IGT (Impaired Glucose Tolerance)
  >140 mg/dl: GDM (Gestational Diabetes Mellitus)

Whom to Screen?

• Ethnic group with high prevalence of Diabetes (e.g. in Indian women etc.)
• Strong family history of diabetes
• Woman who have given birth to a large infants
• History of recurrent foetal loss
• Persistent glycoruria (presence of glucose/ sugar in urine)
• Age >25 yrs
• Past history of glucose intolerance/ diabetes in previous pragancy
• Obese/overweight women
• Chronic hypertension (high blood pressure)
• Recurrent urinary tract infections

When to Screen?

It is important to carry out an early screening for DM in the 1st Trimeter in Indian pregnant woman. (On first ante-natal visit & if normal, then, re-test during 24-28

What Are Complications Of Diabetes In Pregnancy?

Maternal complications:

• Repeated abortions
• High blood pressure
• Worsening of diabetic nephropathy (kidney damage)
• Progression of Diabetic Retinopathy
• Risk of death due to cardiac event
• Increased chances of caesarean section
• Post delivery bleeding

Foetal complications::

• Intra uterine growth retardation
• Risk of birth – defects
• Pre- mature birth
• Big baby (weight > 4 kg)
• Sudden falling of blood sugar levels in new born
• Difficulty in breathing
• Jaundice