Pregnancy is optimal when the mother is biologically mature. A biologically mature female is a young women who is at least 5 years post menarchial and this has greater impact on pregnancy than her chronological age.
Gestational diabetes mellitus (Diabetes comes out from Greek word “SIPHON” and Mellitus meaning honey comes out from Latin word “SWEETNESS OF URINE”) Gestational Diabetes mellitus is defined as carbohydrate intolerance during pregnancy. It is difficult to stabilize the blood sugar during pregnancy due to the alternations of carbohydrate metabolism and an impaired insulin action.
There is a term “INSULIN ANTAGONISM” it is probably due to the combined effect of human placental lactogen, Oestrogen, Preogesterone, Free cortisol (hormones releasing during pregnancy) and degradation of the insulin by the placenta.
An insulin requirement goes up one to three times in pregnancy. In the first trimester, the total daily insulin requirement is 0.7 units/kg/day, in the second trimester it is 0.8 units/kg/day, and in the third trimester it is 0.9 – 1.0 units/kg/day.
GLUCOSE INTOLERANCE TEST VALUES
More than 140 mg/dl after (2 hours)
NORMAL RANGE: 75 g of glucose is a definite indicator of gestational diabetes mellitus
a) During pregnancy: Abortion Preterm labour (20%) Urinary tract infections (UTI) Increased incidence of preeclampsia (25%) Polyhydraminos Maternal distress Diabetic retinopathy, hemorrhages and proliferative retinopathy Diabetic nephropathy Ketoacidosis
b) During labour: Prolongation of labour due to big baby Perineal injuries Postpartum hemorrhages Operative interferences
c) Peurperium : Puerperal sepsis Lactation failure
d) Fetal hazards: The incidence of fetal macarosomnia is 30-40 percent in Indian pregnant women. The results are Maternal hyperglycemia – hypertrophy and hyperplasia of fetal islets of langerhans – increased secretion of fetal insulin – stimulates carbohydrates utilization and accumulation action of fat, Elevation of maternal free fatty acids (FFA) and diabetes leads to increase transfers to the fetus acceleration of triglycerides synthesis adiposity, Congential (6-10%) due to severity of diabetes affecting organogenesis, Birth injuries (BRANCHIAL PLASMA), Growth restriction (less common) And Unexplained fetal death.
There are some other complications of gestational diabetes on newborn are given below in following points: Low blood glucose levels Respiratory distress syndrome Presence of high albumin levels in blood Polycynthemia (means i.e. volume percentage of red blood cells (RBCs) is elevated are termed as hematocrit) Presence of low levels of calcium and magnesium in blood Cardiomyopathy: this condition makes it hard for the heart to deliver blood to the body, and it can lead to heart failure, stroke and cardiac rest.
PERINATAL MORTALITY: Increased 2- 3 times due to hypoglycemia , respiratory distress syndrome, polycynthemia ( the volume percentage of red blood cells is elevated are termed as hematocrit) and jaundice.
Create a healthy life with healthy carb strategy: swap out refined carbohydrates such as white bread, candy and soda for the fiber – filled alternatives like whole grain bread, fruits and vegetables so, stay in contact with your recommended dietitian / nutritionists.
Eat small meals throughout the day: make an option for small meals or low carb snacks every two to four hours instead of having three large meals a day.
Stay active throughout pregnancy: exercise regularly. Even a short 10 minute walk after every meal can make a huge impact.
Keep an eye on your glucose levels: check with your doctor on how frequently you should measure your blood sugar levels.
Useful herbs for diabetes management: jambhul (powder from jamun core is useful, gurmar, bitter gourd/bitter melon, bel, fenugreek, turmeric, neem, triphala, and shilajit.
Share your diagnosis with your primary care doctor: women with gestational diabetes have higher chances of developing type 2 diabetes later in life, so stay in contact with your primary care doctor.