"This is the commonest question asked by all the patients, the answer is no, gestational diabetes is the diabetes appearing the first time in pregnancy and most of them will disappear after pregnancy. It disappears so fast that the day after delivery their sugars crash back to normal. After the delivery what we do is we allow the patients to have a normal diet and we check their sugars 6 weeks after delivery by doing the oral glucose challenge test and if the oral glucose challenge test is abnormal that is the value is more than 140 mg per decilitre then we tell them that they remain diabetes, but the chances of gestational diabetes turning not diabetes immediately after delivery, the chances are very low, having said this there are occasional where the gestational diabetes who have been out in high dose of insulin or oral hypoglycaemic agents they have the chance to remain diabetic even after delivery but their requirement of insulin or oral hypoglycaemic agents will come down. For patients who have not been found to be diabetic about 6 weeks after delivery, however we advise that they may turn diabetic later in their life, maybe about 5 to 10 years later. So to prevent that do lifestyle modification, as in follow the diet. Go for regular exercises, watch their weight and that way they can avoid becoming diabetic for the rest of their life or they can postpone the onset of diabetes or if they get diabetes atleast they can avoid taking medications like insulin oral hypoglycaemic agents and if at all they require insulin or oral hypoglycaemic agents the dose would be very small"

"Gestational diabetes will not have to be delivered early. It mainly depends upon the control of the sugars. If the sugars are well controlled and the sugar control does not require any oral hypoglycaemic agents and they are well controlled by just diet and exercises s the delivery can be done as late as 40 weeks. But if the gestational diabetes needs insulin or oral hypoglycaemic agents and the sugars are well under control then we can still wait up till about 38 or 39 weeks of gestation. On the other hand if gestational diabetes requiring insulin and oral hypoglycaemic agents and the sugar levels are not at all under control, then we may have to deliver them about 37 to 38 weeks of gestation and there is another particular segment of gestational diabetes we call as brittle diabetes, where irrespective of adequate exercises and adequate diet and maximum doses o f insulin or very high doses of insulin, sometimes patients requiring upto 100 to 120 units of insulin and still the sugars is not getting controlled at all, then these diabetic swill have to be delivered before 3 weeks, maybe 34 to 37 weeks. If macrosomia has set in. If baby’s weight is more than 4 kg and macrosimia has set in, it is an indication that diabetes is not under control, then we may have to deliver by 39 weeks, but macrosomia is along not an indication for induction of labor"

"Gestational diabetes is usually screened using a test called as oral glucose challenge test between 6th and the 7th month that is about 24 to 26 weeks and when the patient books with us about 6 to 8 weeks the screening tests would be fasting blood sugars and HbA1c, that is glycosylated haemoglobin. This HbA1c indicates that her blood sugars for the past 3 months. So FBS combined with HbA1c will screen her for overt diabetes , that is if the diabetes was present in her before even she fell pregnant. Any fasting blood sugar below 90 and HbA1c below 6 indicates she was not diabetic before she fell pregnant. When we come to oral glucose challenge test that is done between 6th and the 7 th month that is about 24 to 26 weeks, the upper limit for the cut off is about 140 mg per decilitre. So any level above 140 mg per decilitre, indicates that she is having gestational diabetes"

""Sugars during pregnancy can be lowered naturally that is without even medications, are by exercise or diabetic diet. Exercise consist of walking, the main thing is walking about 2 times a day, one in the morning, and one after dinner just before you sleep and walking and the speed of walking depends on the comfort level of the patients. Some patients who don’t have too much of pain, they usually manage some amount of brisk walking, whereas patients who gain lot of weight they would usually like to have a light stroll. There are some exercises called as isometric exercises, wherein 1 kg weight is grasped on both the hands, that is dumbbells and if dumbbells are not available what she could do is fill the 1 litre water bottle and fill water in that and keep water in each hand and start flexing her upper limb at the elbow up and down, about 3 to 4 sets in a day and each set will be stopped when the patient has got shortness of breath and she feels tired and these type of exercises will bring the sugar down, the second type of way how she can lower her sugars is the diabetic diet. In the diabetic diet the whole meal has to be divided into 6 portions, that is 3 major meals, that is breakfast lunch and dinner and snacks in between that and may be a midnight snack because gestational diabetes patient generally feel a little more hungry than the rest of the population mainly because they are exercising and following some kind of a diet. Direct sugars like sugars and bakery items and pastries, cakes and ice-cream, milkshakes, in fruits, fruits like pineapple, chikoo, big banana will have to be avoided, brown bread has to be taken, rice has to be avoided, wheat and ragi to be encouraged, raw vegetables and ofcourse they can have light non-vegetarian food"

"The medications are given for gestational diabetes are two, one is insulin and the other is oral hypoglycaemic agents that is oral medications. Before insulin was the and stay of treatment for gestational diabetes, there was no other options apart from exercise and diet, we used to give insulin. But now plenty of studies have been conducted and they have proved that there are about 2 to 3 oral hypoglycaemic agents that are used for gestational diabetes. Infact this is a welcome studies for the patient because they can avoid taking injections everyday and the different medications that are available for treating gestational diabetes metformin that is commonly used and the other or glipizide"

"The word dangerous is not an apt term to be used for gestational diabetes because gestational diabetes is one which starts first time in the pregnancy and it doesn’t cause any major abnormalities or chromosomal abnormalities or birth defects in the baby. So if you consider that it is not a very dangerous condition for the fetus. The only two problems mostly that are caused by gestational diabetes that is macrosomia where the weight of the baby is more and polyhydramnios where the liqor around the baby is more. If the gestational diabetes is well controlled, without requiring oral hypoglycaemic agents or insulin, usually the outcome is very good. But even if the gestational diabetes requires insulin or oral hypoglycaemic agents, and the sugars are well under control, even then the outcome is very good the problem arises when the sugars are not under control, even if the dose of the insulin or whether the patient is following proper diet and exercises and the sugars do not come under control then there is a small chances of stillbirth. Stillbirth is a term we use where the baby is suddenly dies, in utero maybe 39 to 40 weeks. This is the only problem, but a rare problem, but generally gestational diabetes are well controlled"