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GDM- Diagnosis and treatment

Gestational diabetes is caused by issues that arise as part of a normal pregnancy, i.e. hormonal changes and weight gain. Gestational diabetes usually appears roughly halfway through the pregnancy, as the placenta puts out large amounts of "anti-insulin" hormones.

Women without known diabetes should be screened for gestational diabetes 24 to 28 weeks into their pregnancies. (If high blood glucose levels are detected earlier in pregnancy, the mother-to-be may actually have type 2 diabetes, rather than gestational.)Before the gestational diabetes test, pregnant women should fast overnight for at least eight hours.

The next morning, doctors will check fasting blood glucose, and then give an oral glucose tolerance test (OGTT). This involves drinking a glucose solution and testing blood glucose one and two hours later.

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Gestational diabetes is diagnosed if any of these three criteria are met:

  • Fasting glucose is 92 mg/dl or higher.
  • One-hour OGTT is 180 mg/dl or higher.
  • Two-hour OGTT is 153 mg/dl or higher.
  •  
    ADA 100-g OGTT
    ADA 75-g OGTT
    WHO 75-g OGTT
  • Fasting (mg/dl)
    95
    95
    126
  • 1-hour (mg/dl)
    180
    180
  • 2-hour (mg/dl)
    155
    155
    140
  • 3-hour (mg/dl)
    140

For the ADA criteria, two or more of the values from either the 100- or 75-g OGTT must be met or exceeded to make the diagnosis of GDM. For the WHO criteria, one of the two values from the 75-g OGTT must be met or exceeded to make the diagnosis of GDM.

You Would Also Like To Read: Risk Factors, Symptoms And Complications Of Gestational Diabetes

Is it Treatable?

Yes! Many women with gestational diabetes are able to achieve blood glucose targets through diet and exercise.

  • Include plenty of foods with low Glycemic index-

The glycemic index, or GI, measures how a carbohydrate-containing food raises blood glucose. Foods are ranked based on how they compare to a reference food — either glucose or white bread. A food with a high GI raises blood glucose more than a food with a medium or low GI.

  • Moderate-intensity exercise

is encouraged for women with gestational diabetes during pregnancy unless a medical condition makes physical activity dangerous. If you have gestational diabetes, you'll want to talk with a doctor about whether exercise is appropriate and, if so, ask for a recommended workout routine.

If changes in diet and exercise aren't enough to keep blood glucose at safe levels, medication may be required.

What if it is left untreated?

Women with unmanaged gestational diabetes are at increased risk of developing type 2 diabetes mellitus after pregnancy, as well as having a higher incidence of pre-eclampsia, pre-term labour and Caesarean section. Their offspring is prone to developing childhood obesity, with type 2 diabetes later in life.

Most women are able to manage their blood glucose levels with a modified diet and the introduction of moderate exercise, but some require antidiabetic drugs, including insulin.

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Superfoods for you!

Eating well is a great way to stay healthy during pregnancy. If you have gestational diabetes, choosing the right food is especially important.

Gestational diabetes treatment becomes very important when a pregnant lady is detected with GDM. This helps both the mother and the baby to stay healthy. By controlling the blood glucose levels with exercise and diet at the right time, protects the baby and the mother.

If you are pregnant and detected with GDM; take your doctor’s advice on diet and exercise to enjoy a healthy pregnancy.

Happy Pregnancy!

Must Read: Gestational Diabetes Decoded

Contributed by -

Dr Sana Khalid,

Cloudnine Hospital

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