What is Gestational Diabetes?

If your blood sugar level first becomes too high when you are pregnant, you have gestational diabetes. It usually goes away after the baby is born.

High blood sugar can cause problems for you and your baby. Your baby may grow too large, which can cause problems during delivery.
Your baby may also be born with low blood sugar. But with treatment, most women with gestational diabetes are able to control their blood sugar and give birth to healthy babies.

Risk Factors
In gestational diabetes, blood sugar levels return to normal after delivery. However, the woman faces a higher lifelong risk of developing type 2 diabetes, and her baby is also more likely to develop the disease later in life. Gestational diabetes is believed
to be associated with:

·    larger babies, and thus an increased chance of delivery by caesarean section
·    infant respiratory distress syndrome,
·    low blood sugar levels at birth, and
·    prolonged newborn jaundice.

What causes gestational diabetes?
As the pregnancy progresses, the mother's energy needs increase. Coupled with this, the placenta produces hormones that help the baby grow and develop. These hormones also block the action of the mother's insulin. This is called insulin resistance. The pregnant woman needs extra insulin so the glucose can get from the blood into the cells where it is used for energy. From about 24 weeks, insulin needs in pregnancy can be two or three times higher than normally required.

If the body is unable to meet this requirement, then diabetes develops Ante-natal Care
·    Ante-natal care should be hospital-based, from a multi-disciplinary team
·    Individualise insulin regimens and recommend 4-times daily glucose monitoring.
·    Aim to maintain glucose 4-7 mmol/L and HbA1c within the normal non-diabetic range.
·    Remember insulin requirements increase progressively from the 2nd trimester until the last month of gestation, when a slight fall-off may be noted

Why there is a need to take care of gestational diabetes

Gestational diabetes can harm you and your baby, so you need to consider about it seriously and start caring at once. The main aim of gestational diabetes treatment is to keep blood glucose levels equal to those of normal pregnant women. It needs a planned meal and scheduled physical activity, even blood glucose testing and insulin injections if required. If gestational diabetes is taken care off properly, reduces the risk of a cesarean section birth that high weight babies may require.

Diagnosis
The guidelines for diagnosing GDM in Australia are essentially unchanged from those recommended for use in Australasia in 1991.22

Although there are no uniform international criteria for the diagnosis of GDM, commonly used criteria are those of O'Sullivan and Mahan23 and the World Health Organization (WHO).24 One problem with the development of absolute diagnostic criteria is the lack of evidence that perinatal mortality is increased in pregnancies associated with mild degrees of hyperglycaemia.

New drug for gestational diabetes
Doctors have proven the safety of anti-diabetic drug Metformin, and found the tablet has no adverse affects for mother or child.
Gestational diabetes affects five per cent of pregnancies, but that number is several times higher for indigenous women.