Dear Mala Hope this artical be of use to you The article has been provided by Dr. Shalini Jaggi, Consultant, Action Diabetic Centre, Sri Balaji Action Medical Institute Pregnancy is an exciting time in a woman’s life- a time of expectations and preparations. Taking care of the mother’s health during the gestation period is of utmost importance for the baby to grow normally and enter this world hale and hearty. Sometimes, especially around the 24th week of pregnancy, many women are diagnosed with high blood sugar- a term called Gestational Diabetes, even when they have had no history of diabetes. The diagnosis of gestational diabetes does not mean that the mother will remain a diabetic after delivery, although a susceptibility to develop diabetes in the future is certainly present. We are all aware that during pregnancy, placenta supports the baby as it grows. Placental hormones are necessary for the baby to grow to and sustain the pregnancy, but these hormones also block the action of insulin in the mother’s body- a term called insulin resistance. So, although the mother’s body continues to produce insulin, it is not allowed to work properly and as a result her blood glucose levels start rising. Gestational diabetes develops when the mother’s blood glucose levels rise above normal, thus, causing hyperglycaemia. Gestational diabetes occurs at a later stage in pregnancy- when the baby has already formed but is still growing. As a result, though the baby may not have developmental birth defects but if it is left untreated, the baby might be harmed. Rising blood sugar levels in the mother’s body send the pancreas into overdrive to produce more insulin, causing hyperinsulinemia, yet this is not able to reduce the blood glucose due to increasing insulin resistance caused by placental hormones. The insulin cannot cross the placenta but the extra glucose can easily enter the baby’s circulation through placenta along with other nutrients. As a result, the blood glucose levels of the baby also start rising, sending the developing pancreas in the baby’s body into an overdrive to produce extra insulin to control them. As the baby receives more glucose, i.e., more energy than it normally needs for growth, this excess energy gets stored as fat in the baby’s body, thus, leading to ‘macrosomia’ or a ‘fat baby’. Treatment for gestational diabetes should start immediately when the mother is diagnosed with high blood sugar levels after undergoing an Oral Glucose Tolerance Test. A good treatment regime aims at keeping the blood glucose levels at normal throughout one’s pregnancy. It starts with special customized meal plans for the expecting mother as well as scheduled physical activity. The blood glucose level needs to be monitored on a daily basis as well as insulin injections need to be taken if dietary and lifestyle measures alone are not able to normalize the blood sugar level. During pregnancy, doctors prescribe insulin injections and not oral tablets because in pregnancy all oral tablets cross the placenta and can harm the baby but insulin does not cross the placental barrier and, therefore, is very safe. Gestational diabetes usually goes away after pregnancy, but there are chances that in 2 out of 3 cases, it might return in future pregnancies too. In fact, in a small section of women it may unmask type 1 or type 2 diabetes! Such women may need to continue their diabetes treatment even after pregnancy. Losing a few kilos of weight, adopting healthy eating habits, exercising regularly and staying fit; go a long way in preventing future diabetes.
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