Pregnancy & Diabetes
pregnant mother with a flower

Pregnancy is one of the most cherished periods in the life of every woman, Its the time when the long nurtured dreams of motherhood become a reality.

Blood Sugar levels play a very important role in life of both the mother and the baby during pregnancy. High Blood Sugar levels may cause deformities in the baby while predisposing the baby to development of Diabetes during adulthood. In the mother it may lead to abortions, Caeserian deliveries and cause many other complications during like high blood pressure, Pre-eclampsia, kidney disease etc.

 There are two aspects to Diabetes during pregnancy

Pre-existing Diabetes

Gestational Diabetes 

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Pregnancy & Diabetes PDF Print E-mail
Pregnancy & Diabetes - Diabetes & Pregnancy
Written by Dr Rajesh Kesari MD   
Wednesday, 06 May 2009 16:30

Pregnancy and Diabetes

 

Diabetes is a Cause of concern both in women who are known to have Diabetes before 

pregnancy as well as those who develop Diabetes after getting pregnant. High blood Sugar levels at the time of conception or during pregnancy may cause birth defects, large sized baby, complicate delivery in the mother or may even cause abortions. Diabetes or tendency to become diabetic may be present in many mothers during pregnancy. Pregnancy in pre-existing diabetics requires rigorous and special care, its discussed in more detail in Pregnancy in pre-existing Diabetics.

The need for insulin is greatly increased during pregnancy, hence even mild abnornamilities in the functioning of pancreas may cause the so called ' unmasking of Diabetes' which may have otherwise gone unnoticed for many years. Such development of Diabetes is called Gestational Diabetes Mellitus and elaborately discussed in Gesational Diabetes Mellitus. 

Symptoms of High Blood Sugar during Pregnancy: ( Diabetes may be absolutely asymptomatic)

 


  • Frequent urination and dryness of mouth 
  • Frequent Urinary Tract infections, Burning while passing urine 
  • Frequent vaginal fungal or bacterial infections 
  • Excessive nausea, vommitting 
  • Unusual weight gain or weight loss 
  • Blurring of vision 

 

Please also visit

BLOOD TESTS FOR DIABETES IN PREGNANCY

DIET & EXERCISE IN DIABETES 

 

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Last Updated on Friday, 15 May 2009 17:30
 
Pre-existing Diabetes and Pregnancy PDF Print E-mail
Pregnancy & Diabetes - Preexisting Diabetes & Pregnancy
Written by Dr Rajesh Kesari MD   
Thursday, 07 May 2009 08:14

Pregnancy in known Diabetics

(Patients on Insulin or oral tablets)

 

High blood glucose levels at the time of conception and initial development of the baby may have serious detrimental effect on development of its vital  organs. Such a Baby may be born with birth defects and deformities. Sustained levels of blood glucose during pregnancy may be prone to abortions or large size babies.

 


  • The risk of congenital anomalies in babies born to mothers with uncontrolled diabetes is 2-5 times higher than the normal population. 
  • Spontaneous miscarriages occur in 30-60% of  mothers with high blood sugar at the time of conception. 
  • Such mothers are prone to develop other complications of pregnancy like Hypertension and Pre-eclampsia. 
  • Women who are Diabetic and on any treatment of diabetes either oral tablets, insulin or exenatide injections should be very careful while conceiving 
  • Plan your pregnancy atleast six months before conception 
  • Glycosylated Hemoglobin ( this blood test show average blood glucose levels of past 3 months) should be between 6.5% and 7% before conception. 

  •  Frequently monitor Blood Glucose, First 10 weeks are critical to the normal development of the baby.

  •  Blood Glucose levels should be Fasting between 60-95, 1 hr after meals less than 155 and 2 hrs after meals less than 130 always

 

A number of trials have proven that keeping proper control of Blood sugar and maintaining the right HbA1C levels drastically decreases the chances of congenital malformations.

 

Plan your pregnancy in advance

 

            Important points to remember for Diabetic women planning pregnancy

 

  •  Plan your pregnancy, use effective contraception if pregnancy is not being planned.
  •  Stop your anti Diabetic drugs well before conceiving; switch over to insulin if Blood glucose levels are not controlled
  •  Consult your doctor about requirement of insulin and doses.
  •  Exercise regularly, take the diet as advised by your doctor or dietician.

 

 

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Last Updated on Wednesday, 27 May 2009 14:53
 
Gestational Diabetes Mellitus PDF Print E-mail
Pregnancy & Diabetes - Gestational Diabetes ( newly Diagnosed Diabetes in
Written by Dr Rajesh Kesari MD   
Thursday, 07 May 2009 08:15
  • The babies who are exposed to high levels of insulin, grow bigger in size (medically called macrosomia), on average weighing more than 4 Kgs. This may complicate their their normal  delivery and even require Caesarian delivery. Such mothers are prone to infections, they may also develop other complications like High Blood Pressure, Pre-eclampsia, and run the risk of a premature delivery. 
  • After birth, babies of mothers who develop Diabetes during pregnancy may develop hypoglycemia- low blood glucose ( symptoms- irritation, weakness, abnormal crying, bluish coloration). Treatment of this may require admission to Neonatal ICU ( Intensive care Unit) 
  • Such babies may also develop Hypocalcaemia- deficiency of calcium in blood and other electrolyte disturbance, Respiratory Distress Syndrome (difficulty in breathing), Hyperbilirubinemia- Jaundice. Treatment of this may require admission to Neonatal ICU ( Intensive care Unit) 
  • Such babies are themselves prone to develop Diabetes, High Cholesterol, High Blood Pressure and Heart Diseases during their adulthood. The chances are 3-4 times more than as compared to otherwise normal babies. 
  • Mothers who develop GDM have much more likelihood of developing Diabetes than other women, They should have their Blood Glucose checked 3 months after the delivery , and if normal check every 6 months after that to rule out development of Diabetes. 

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Last Updated on Friday, 29 January 2010 07:06
 
Testing for Diabetes during pregnancy PDF Print E-mail
Pregnancy & Diabetes - Gestational Diabetes ( newly Diagnosed Diabetes in
Written by Dr Rajesh Kesari MD   
Friday, 08 May 2009 17:00

Tests to determine GDM

 

All mothers who may be prone to develop Gestational Diabetes would be asked to do some blood tests by their doctors.

Different tests may be used by different doctors depending on the history and condition of the would be mothers and also the prevailing local practices and professional guidelines.

This Test is called Glucose Tolerance test. It may be done in two steps or in one step as your doctor would consider better. Some doctors also use the standard glucose tolerance test which may require only two tests of Blood glucose .

WHO guidelines 

WHO recommends  Testing blood glucose while fasting (after 10 hrs of fast) and 2 hrs after taking 75 gms of glucose.

Normal values are 

Fasting - less than 90 mg/dl

2 hrs post 75 gms of glucose - less than 140

ADA guidelines

The criteria set by the American Diabetes Association to Diagnose GDM are as follows

Step One 

First you have to give a fasting blood glucose sample, after which you would be given a a sweet liquid or juice containing 50 gms of glucose. Blood is again tested for glucose after 1 hour. 

If the Blood glucose after 1 hour is less than 140 mg/dl no further testing would be required.

Step Two 

If the Blood glucose levels were more than 140mg/dl after 1 hour then an Oral Glucose Tolerance (OGTT) test is done.

In this test blood is tested four times.

 

At the time of fasting

1 hour after taking 100 gms of glucose powder or drink,

at two hrs and three hours.

 

Normal values should be

 

Fasting - less than  95

 

After taking 100 gm glucose - at:

 

1 hour less than 180

2 hour less than 155

3 hour less than 140

 

If more than 2 values are abnormal, the mother may be considered to be having Gestational Diabetes.

( Please consult your doctor for specific details)

 

Latest News 

Latest research done on more than 12000 pregnant mothers have shown that blood glucose levels after 2 hrs of taking 75 gms of glucose should be less than 120 mg/dl

 

 Glycosylated Hemoglobin ( HbA1C or just A1C)

 

 This test shows the average blood glucose values prevailing over past three months, sometimes this test may also be ordered by your doctor to asess the glucose levels in past few months. Normal levels should be less than 6.5 % during pregnancy.

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Last Updated on Friday, 15 May 2009 16:11