Gestational Diabetes
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