Sunday, July 1, 2012

Pregnancy with Diabetes

It is estimated that 3- 5 % of pregnancies are complicated by Diabetes mellitus.With increasing prevalence of Diabetes in young women, it is important to understand  the common symptoms that a pregnant lady may suffer, to diagnose it early.

Some important features to be understood…
*Gestational Diabetes refers to the condition where in high blood glucose levels are monitored for the first time during pregnancy.
*Diabetes diagnosed before pregnancy may be insulin dependent (IDDM), or non- insulin dependent (NIDDM).
* During pregnancy, there is a physiological increase in insulin resistance, to satisfy the nutritional demands of foetus.
* High levels of maternal blood glucose levels, may lead to high levels of glucose in foetal blood.
* Patients who are already diagnosed with Diabetes, before getting pregnant, may develop high blood pressure during pregnancy, and increased susceptibility to infection; may increase the likelihood of caesarean section; large baby size (Macrosomia); shoulder dystocia etc.
*Increased risk of congenital abnormalities in the foetus, miscarriage, still birth, premature delivery.
Intensive control  of glucose levels around the time of conception, can reduce the incidence of congenital abnormalities. In non diabetic subjects fasting glucose should be 70mg/dl- 126mg/dl .Diabetic subjects tend to have higher post prandial  & sustained minor elevations of glucose,


A higher fasting, postprandial sugar levels

An abnormal glucose challenge test

An abnormal Glycosylated Hemoglobin

Repeated infections especially urinary infections

Polyhydraminos (increased liquor )

H/o previous stillbirths, large babies, premature delivery, traumatic delivery

For any queries, pl consult your doctor

Dr Deepika Tiwari, Gynecologist, Gurgaon 9911821669

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