Gestational Diabetes Teachers: amerah and hana done by: rasha ,khoulod,anood,anwar,areeg,shouq &dalia Outline • Introduction • Definition • Risk factor • Diabetes diagnosis criteria • Classification • Complication • Treatment introduction • Diabetes occurs in 2-5%of all UK pregnancies and its prevalence is raising • 40 years ago the majority of women with DM attending antenatal clinic had type 1 but today the majority of women have type 2 or gestational DM • The prevalence of type 2 DM is predicted to increase due to current trends in obesity and physical inactivity Definition Is the state of high blood sugar during pregnancy (especially in the third trimester) in women who have never been diagnosed with diabetes The risk factors PCOS. Previous diagnosis of gestational diabetes, diabetes predisposition, impaired glucose tolerance, or fasting glucose imbalance. Family history shows a first-degree relative injury with type 2 diabetes. Mother's age - A risk factor for women increases with age (especially for women over 35). Ethnicity Overweight, obesity or obesity increase risk Diabetes diagnosis criteria According to the National Diabetic Data Team: • On the vacuum 105 mg / dL • After one hour 190 mg / deciliter • After two hours 165 mg / deciliter • After three hours 145 mg / deciliter Classification Type A1:The glucose tolerance test in this pattern is abnormal but blood glucose levels are normal during fasting and after two hours of eating; adjusting the diet is sufficient to control glucose levels in this pattern.. Type A2: The glucose tolerance test result in this pattern is abnormal and blood glucose levels are also abnormal during fasting and / or two hours after a meal. Additional treatment with insulin or other drugs is necessary to control glucose levels in this pattern Complication • pre-eclampsia - a condition that causes high blood pressure in pregnant women • placental abruption - the placenta (the organ that links the pregnant woman's blood supply to her unborn baby's) starts to come away from the wall of the womb (uterus) • needing to induce labour - when medication is used to start labour artificially • premature birth macrosomia • trauma during the birth - to yourself and your baby • neonatal hypoglycaemia - your newborn baby has low blood glucose, which can cause poor feeding, blue-tinged skin and irritability • perinatal death - the death of your baby around the time of the birth Treatment • Monitoring blood glucose. • Diet You may be advised to change your diet to control your gestational diabetes. In some cases, you may be referred to a dietitian (a healthcare professional who specializes in nutrition) to advise you about a special diet Cont.. • Lean protein You may be advised to choose lean (not fatty) proteins, such as fish. Eat two portions of fish a week, one of which should be oily fish, such as sardines or mackerel. There are some type of fish you should avoid, for example, eating too much tuna. • Unsaturated fats Aim to eat a balance of polyunsaturated fats and monounsaturated fats. Small amounts of unsaturated fat will keep your immune system (the body's defense system) healthy and can reduce cholesterol levels. Foods that contain unsaturated fat include: nuts and seeds avocados sunflower, olive and vegetable oil spreads that are made from sunflower, olive and vegetable oils • Low GI carbohydrates. Examples of low GI carbohydrates include: pasta made from durum wheat sweet potatoes Cont… • Calories If your body mass index (BMI) was more than 27 before you became pregnant, you may be advised to reduce the amount of calories in your diet.. • Exercise.. . • Medication. • Insulin • These are safe to use during pregnancy. However, you will need to monitor your blood glucose closely. If you are being treated with insulin, you will need to check your: blood glucose before going to bed at night Cont.. • Monitoring your unborn baby If you have gestational diabetes, your unborn baby may be at risk of complications, such as being large for their age. Because of this, you may be offered extra antenatal appointments so that your baby can be closely monitored during your pregnancy.. • During labour and the birth, your blood glucose will be measured every hour and kept at 4 to 7 mmol/l. Around two to four hours after the birth, your newborn baby's blood glucose will also be measured. • After Birth You should have the oral glucose tolerance test repeated 6 to 12 weeks after delivery of your baby. You are at a long term risk of developing diabetes and so you should continue to follow a healthy lifestyle with regular testing for diabetes • After pregnancy After you have given birth, any medication you were on to control your blood glucose will be stopped. Your blood glucose level will be tested to make sure that it has returned to normal. You should be aware of the symptoms of high blood glucose (hyperglycemia), which could be a sign your diabetes has returned Thanks for attention