Pregnancy & Diabetes

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Pregnancy & Diabetes

Gestational Diabetes Mellitus:

 

We will walk with you with dedication, compassion intensive caring through your valuable months concluding in elated bliss of joy with your precious baby.

Carbohydrate intolerance with onset or first recognition during pregnancy is known as Gestational Diabetes mellitus.

It occurs in approximately 2 to 26 % of all pregnancy marked world-wide, this is assossciated with foetal & maternal complications. And also associated with future level diabetes post pregnancy.

Risk factors for GDM:

  • Age > 35 years of age
  • BMI > 25 kg/m2
  • Multipara > 3
  • Family history of DM
  • Ethnic
  • Previous Macrosomia
  • Previous pregnancy weight gain by 9 – 15 kg
  • H/o foetal death and abortion
  • Migration to westernized country
  • Short stature

Management

  • Screening to assess prediabetes and risk for future diabetes with an informal assessment of risk factors or validated tools should be considered in asymptomatic adults.
  • To test regularly test prediabetes, FPG, OGTT, and A1C.
  • Pre- pregnancy counselling
  • Diet and insulin therapy
  • Self-monitoring of blood glucose
  • CGMS and Insulin pump
  • Management during delivery
  • Post-partum care of diabetic patients

Pre-existing Diabetes Mellitus:

Management

  • Starting at puberty, preconception counselling along with a female family member is incorporated into routine diabetes care for all girls of childbearing potential.
  • To test regularly test FPG, OGTT, and A1C.
  • Screen for thyroid dysfunction/ autoimmunity with TSH and thyroid peroxidase antibodies (TPOAb) in all diabetic women before or during early pregnancy.
  • Preconception counselling should address the importance of glycaemic control as close to normal as is safely possible, ideally A1C < 6.5% (48 mmol/mol), to reduce the risk of congenital anomalies.
  • Women with pre-existing type 1 or type 2 diabetes who are planning pregnancy or who have become pregnant should be counselled on the risk of development and/or progression of diabetic retinopathy.
  • Screen diabetic pregnant women for depression, anxiety/stress, and disordered eating& diabetes distress using validated and appropriate measures.