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FACTS
DIABETES IN
PREGNANCY
Diabetes is the most common
complication of pregnancy affecting
1% of all pregnant women. Pregnant
diabetic patients can be separated into
two categories.
1
Overt diabetes - Patients are
known to have diabetes before
pregnancy.
2
Gestational diabetes - Patients
are diagnosed as diabetic for the
first time only during pregnancy.
Gestational diabetes (GD) or
Pregnancy induced glucose
intolerance; means that diabetes was
induced due to pregnancy and it
persists with remissions after delivery
usually within six weeks. Quite a
few pregnant women may have had
diabetes but it was never recognised.
Gestational diabetes is typically a
disorder of late pregnancy so an
increase blood sugar rate during the
first trimester usually means diabetes
was present even before conception.
By Ruqya Khan, freelance writer
Patients are usually detected when
their random blood sugar is more than
200mg/dl, with fasting blood sugar
exceeding 110 mg/dl.
Women more prone to it
• Family history of diabetes in parents,
siblings, and grand parents.
• Previous birth weight more than 4kgs
• Previous stillbirths.
• Previous unexplained foetal loss.
• Persistent glycosuria.
• Age more than 30yrs.
• Obese.
Causes
Pregnancy is said to be diabetogenic
that is pregnancy induces glucose
intolerance because of the exaggerated
physiological changes in carbohydrate
metabolism. As a result of complex
endocrinal changes occurring during
pregnancy there is an increased
absorption of glucose from the intestinal
tract but a delay in exchange of glucose
between the blood and tissues.
Due to impaired insulin affect the
blood sugar levels remain relatively
high for nearly two hours following
carbohydrate ingestion as compared
to a non-pregnant state. Infact this
facilitates the transfer of glucose from
the maternal to foetal circulation.
But when this mechanism becomes
exaggerated it results in GD. As the
pregnancy progresses and due to
the various body changes there is
increased filtration of glucose into the
urine but decreased re-absorption of
glucose.
Sugar tests during
pregnancy
Investigations thus start at the
first antenatal visit itself. Urine
is examined as a routine for the
presence of sugar. Positive test
for glucose in urine is a common
occurrence in random samples but it
may be also due to presence of lactose
or other such reducing substances.
The commercially available dipstick
Diabetes means there is an increase in blood sugar levels i.e. hyperglycemia either due to
lack of insulin or a diminished effectiveness of insulin, which is produced by the pancreas.
Lack of insulin prevents the smooth uptake of glucose by the cells for the energy production,
thus the glucose gets more and more accumulated in blood instead of going into the cells.
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Apr/May 2014