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Tamil Nadu
Diabetes is increasing throughout the world at an alarming rate. More and more young people are diagnosed to have diabetes. Consequently, number of pregnancies complicated by high blood sugar is also increasing. Diabetes during pregnancy is a very serious health problem affecting both the mother and the baby.. It requires lot of effort from the doctors and the pregnant wom en to cope with it. CLASSIFICATION : Diabetes in pregnancy can be of two types 1. Pre-gestational Diabetes – Diabetes is present even before the patient becomes pregnant. 2.Gestational Diabetes – Development of diabetes for the first time during pregnancy. It usually resolves after delivery. PROBLEMS OF DIABETIC PREGNANCY: In Pre-gestational diabetic, recurrent abortions, still birth, cardiac and neurological malformations, macrosomia (large baby) can happen to the baby. In both pre-gestational and gestational diabetes, after delivery, baby may develop hypoglycemia, respiratory distress syndrome, jaundice, hypocalcemia ( low calcium). For the mother, chances of caesarean section are high and she is at high risk for PIH (Pregnancy Induced Hypertension) and Birth canal injuries during delivery. Gestational Diabetes(GDM) Pregnancy induces a state of insulin resistance and susceptible persons develop GDM. Risk factors for GDM: 1. Obesity 2. Age more than 25 years 3. Family history of diabetes 4. Previous history of large baby(>4kg) 5. Bad obstetric history(recurrent abortions still birth etc.,) 6. Presence of hypertension/ dyslipidemia. Whom do you screen for GDM? Because ,India is having maximum number of diabetic population,all pregnant women irrespective of the presence of risk factors, should be screened for GDM using 75g or 100g “Glucose Tolerance Test” (GTT) around 5th month of pregnancy. Management: Management of diabetic pregnancy requires multidisciplinary approach involving diabetologist, Gynecologist and paediatrician. Strict sugar control is very important. It requires lot of motivation,education& counselling to the pregnant mother & their family members. Blood sugar should be monitored using glucometer at home by the patient & they should aim for near normal blood sugar (fasting sugar should be less than 100mgs/dl and 2hrs post prandial should be less than 120mgs/dl. Regular consultation with diabetologist, Periodical ultrasonogram of abdomen to assess foetal well being one vital for successful completion of pregnancy. For More Details Contact:- Dr K Krishna Moorthy, MD DNB Consultant Diabetologist. M.V.Diabetes Clinic 139,North Cross 3rd Street, Annanagar, Opp.Shenbagam Hospital, Madurai – 625020 Ph:4210700-701 Email: mvdmadurai@airtelmail.in
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