Carefully Navigating Diabetes in Pregnancy at Silver Nest Clinic

Risk Factors for Gestational Diabetes

Several factors increase the likelihood of developing gestational diabetes, including:

• Being over the age of 30 when pregnant.
• Having a body mass index (BMI) over 30.
• Having a history of gestational diabetes in a previous pregnancy.
• Having a short interval between pregnancies.
• Experiencing an unexplained stillbirth in the past.
• Giving birth to a previous baby weighing 5 kg or more.
• Having a close family member with diabetes.
• Belonging to certain ethnic groups, such as South Asian, Black Caribbean, or Middle Eastern.

Diagnosis

Gestational diabetes is diagnosed using a glucose tolerance test (GTT). The National Institute for Health and Care Excellence (NICE) guidelines recommend the following:

• Women who had gestational diabetes in a previous pregnancy should be tested early during their first antenatal visit.
• Women with risk factors should undergo a GTT between 24-28 weeks of pregnancy.

Treatment for Gestational Diabetes

While gestational diabetes can have serious consequences for both the mother and the baby, these risks can be significantly reduced through proper treatment. The key to managing gestational diabetes lies in controlling blood sugar levels, which involves:

1. Diet and physical activity: A well-balanced diet and regular physical activity help in maintaining healthy blood sugar levels.
2. Medication: If diet and exercise are insufficient, medications like metformin or insulin may be prescribed to regulate blood sugar levels.

After the baby is born, most women with gestational diabetes no longer require medication, and their blood sugar levels return to normal. However, women with a history of gestational diabetes are advised to:

• Maintain a healthy weight.
• Engage in regular physical activity.
• Avoid smoking.
• Get their blood sugar levels checked regularly, including six weeks postpartum and annually.

What is the Advice for Women with Diabetes Before Pregnancy?

For women with pre-existing diabetes (Type 1 or Type 2), careful planning is essential before starting a family. Proper management of diabetes before pregnancy significantly reduces the risks for both mother and baby. Key recommendations include:

1. Pre-conception care: Avoiding unplanned pregnancies is crucial, and effective contraception is necessary until blood sugar levels are under control.
2. Blood sugar control: Tight control of blood sugar levels before and during pregnancy helps prevent stillbirth, miscarriage, congenital malformations, and neonatal death.
3. Regular check-ups: Women with diabetes should undergo regular assessments to check for complications, including eye and kidney problems.
4. Folic acid supplementation: Women planning to conceive should take 5 mg of folic acid daily until 12 weeks into the pregnancy to reduce the risk of birth defects.
5. Lifestyle modifications: Quitting smoking, reducing alcohol intake, and maintaining a healthy weight are essential to ensure a successful pregnancy.

Glucose Monitoring During Pregnancy

Women with Type 1 diabetes should be offered continuous glucose monitoring (CGM) throughout their pregnancy. For those using insulin but not diagnosed with Type 1 diabetes, CGM may be considered if they experience problematic hypoglycemia or unstable blood glucose levels.

Risks of Diabetes During Pregnancy

Having diabetes during pregnancy can lead to complications for both the mother and the baby. Proper management, including pre-conception care and tight blood sugar control, can significantly reduce these risks.

Risks for the Baby:

• Premature birth: Babies born to mothers with diabetes are more likely to be born before 37
• High birth weight: This increases the risk of complications during
• Congenital abnormalities: These are more common in babies born to mothers with poorly controlled diabetes.
• Hypoglycemia: Low blood sugar after birth is common in babies of diabetic
• Respiratory distress syndrome and jaundice: These conditions are also more likely in such

Risks for the Mother:

• Infections: Women with diabetes are more prone to infections, which can become
• High blood pressure and blood clots: The risks of these complications are
• Ketoacidosis and hypoglycemia: Uncontrolled blood sugar can lead to severe complications for the

Read more: Obstetric Cholestasis in Pregnancy | Diet in Pregnancy

Treatment During Pregnancy

Women with diabetes during pregnancy require frequent check-ups and monitoring. This includes regular blood sugar checks, specialized care from a diabetes specialist, and close monitoring of the baby. It is advised that women with diabetes give birth in a hospital, where specialized care is available if needed.

Diabetes in pregnancy, whether pre-existing or gestational, requires careful monitoring and management to ensure a healthy outcome for both the mother and the baby. By following medical advice, managing blood sugar levels, and attending regular check-ups, women with diabetes can have successful pregnancies and healthy babies. As a gynecologist, I recommend that women with diabetes work closely with their healthcare team to reduce risks and ensure a smooth pregnancy journey.

We look forward to welcoming you to our clinic and supporting you on your journey to optimal health. Contact Us Tel: +91 84481 28007 Email:ask@drshwetawazir.com | Location:  Eros City Square Mall Silver Nest Clinic Shop no.198ff Opposite Rosewood Apartments Sector 49-50 Gurgaon, 122018