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SCREENING AND MANAGEMENT OF GESTATIONAL DIABETES

Gestational Diabetes Mellitus (GDM) is a type of diabetes that some women develop during pregnancy. If not managed well, GDM can cause many complications to the baby including macrosomia (abnormally large babies) and its resulting consequence of difficult delivery like assisted delivery and caesarean section, birth injuries to the baby including fractured bones, low blood sugar in the newborn and, in the worst case scenario, intrauterine death.

Risk factors for GDM include:

  • Family history of Diabetes Mellitus,
  • History of GDM in previous pregnancies,
  • Maternal age of 35 years or more,
  • High body-mass index (BMI),
  • History of having delivered big babies,
  • Known history of having polycystic ovarian syndrome (PCOS) prior to pregnancy

Women at risk of developing GDM should be screened with an Oral Glucose Tolerance Test (OGTT) at 28 weeks of pregnancy. To do OGTT, the woman has to fast for 8 hours. Her fasting blood sugar will first be measured and she will be given a drink containing 75gm of glucose. Her blood sugar level will be tested again 2 hours after the drink.

If tested positive, women with GDM would be taught how to maintain a normal blood sugar level to reduce poor outcome for the pregnancy and her baby. In most cases, normal blood sugar control can be achieved with just dietary modifications. In the small minority of cases, the pregnant women may need insulin to maintain their blood sugar levels.