Dr. Poornima Murthy

"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"

"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"

"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"

"Basically gestational diabetes does not cause any kind of congenital abnormalities or anomalies of the fetus because gestational diabetes is the diabetes that is occurring in the pregnancy for the first time. It is entirely different from a woman who is having diabetes for many number of years before she has actually fallen pregnant. Overt diabetes means diabetes in a woman for a long time before she has fallen pregnant cases a lot of congenital abnormalities in the developing fetus. As far as gestational diabetes is concerned, the two main things that it causes is macrosomia, that is increased weight of the fetus, that is the babies weight goes up more than above 4 kgs and the water around the baby it increases, a condition called as polyhydramnios. As a consequence of polyhydraminios or macrosomia, there is overdistension of uterus, that is the diameter of the uterus increases and the placental size increases and because of this there is an early onset of preeclampsia that is hypertension in pregnancy and polyhydramnios can cause preterm labor, that is the patient going in for preterm labor much before 34 or 35 weeks of gestation. So the bottom line is since the diabetes has occurred after the conception, that is after the fertilisation, the problems that occur at the time of fertilisation are usually absent in gestational diabetes. It basically occurs in overt diabetes"

Cloudnine expert, Dr. Poornima confirms Gestational Diabetes doesn't have any major impact on fetus growth or development. To know more, visit www.cloudninecare.com. #C9HealthTalk #CloudnineHospitals

Cloudnine expert, Dr. Poornima shares easy ways to control diabetes during pregnancy. To know more, visit www.cloudninecare.com. #C9HealthTalk #CloudnineHospitals