Your risk for gestational diabetes

Your risk for gestational diabetes


Wednesday, February 03, 2016

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It is often said that when you become pregnant everything changes — your body, your health, and your outlook on life. However, not all these changes are positive and you may develop certain conditions that you never had before pregnancy.

One such condition is gestational diabetes, which, according to Dr Michelle Bailey, obstetrician-gynaecologist (ObGyn) at Seymour Park, is abnormally high blood sugar diagnosed for the first time in pregnancy.

"Pregnant women, because of an increase in the levels of some circulating hormones, are at an increased risk for diabetes especially if they have risk factors. As many as 10 per cent of all pregnant women will develop gestational diabetes," she said.

There are certain details about gestational diabetes that you should know if you’re pregnant or thinking of becoming pregnant.

These include:

1. Its risk factors

Dr Bailey said one of the risk factors for gestational diabetes is obesity — having a body mass index greater than 30. She added that a family history of diabetes, excessive weight gain in pregnancy, history of previously large babies — bigger than nine pounds, and having had gestational diabetes in a previous pregnancy all put you at risk.

2. How it’s diagnosed

"This consists of a screening test, and if it is abnormal then a confirmatory test is done," the ObGyn said. "The screening test is carried out between 24 to 28 weeks of pregnancy (six to seven months), or it may be done earlier if there are overt signs of elevated blood sugar levels. The screening test involves drinking a special, sweet drink and then your blood is taken one hour later."

3. Its effects on the pregnancy and the mother

Dr Bailey said gestational diabetes can affect both mother and baby as the pregnancy progresses. "High blood pressure; infections, especially urinary tract infections; increased risk for Caesarean sections due to large babies; foetal distress in labour; increased risk of an early delivery; and an increased risk of vaginal lacerations secondary to delivery of a large baby are some of the effects gestational diabetes has on the pregnancy and mother," she said.

4. Its effect on the baby

Dr Bailey said gestational diabetes can result in a large baby, slow development of the baby’s lungs, birth trauma, low blood sugar after birth, and rarely, congenital anomalies or birth defects, especially with those mothers who are undiagnosed or have uncontrolled diabetes. She said if the blood sugar remains uncontrolled, then the baby is at an increased risk for foetal death.

5. How treatment is administered

Treatment involves a strict diabetic diet that is monitored by a dietician. "Blood sugar levels are checked daily. If diet and exercise alone are not enough to control the blood sugar, then the patient is started on medication to further lower the blood sugar levels. These medications usually include metformin or insulin depending on the severity. Because of the risks associated with gestational diabetes, you will need to be seen by your health care provider more often than you would in a normal pregnancy," she said.

Dr Bailey further explained that after delivery, your blood sugar levels usually return to normal; however, at your six-week visit, it is important that you are retested for diabetes, as a small percentage of women will remain diabetic, necessitating lifelong treatment.

6. Your long-term risk

Dr Bailey said in the long run there is an increased risk of developing type 1 and type 2 diabetes, especially if you become overweight and do not exercise. "Therefore, follow-up testing every few years is beneficial. There is also an increased risk of high cholesterol, hypertension and heart disease being diagnosed at an earlier age than with women who had no prior history of gestational diabetes," she said.

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