Sunday, January 24, 2010

Gestational Diabetes

I have a patient who was just diagnosed with gestational diabetes. Many pregnant woman are diagnosed with the disease and every pregnant woman should be tested. Testing is accomplished with a one-hour glucose challenge generally done in conjunction with a routine prenatal office visit. If a woman has a history of insulin resistance or a previous diagnosis of gestational diabetes, she may be tested earlier in the pregnancy and then again at 28 weeks, if she hasn't already been diagnosed. The test do not require any preparation. The patient is given 50 grams of a sugary drink ( very sweet ) and then her blood is taken for glucose metabolism after one hour.

If the value on the blood test is under 130, no further testing is required. If it is above 130, a three hour test with 100grams of the sugary drink is administered. Preparation for the three hour test is fasting after midnight the night before the test. A fasting blood sample is taken and then after the drink, three consecutive blood tests to come up with four values and if two or more are outside the acceptable window, the diagnosis is made: Gestational Diabetes Mellitis.

Gestational Diabetes is defined as a carbohydrate intolerance. It is due to the alteration of maternal metabolism caused by the hormones of pregnancy. It happens only in pregnancy but it does increase a woman's risk factor for developing Diabetes Type II or Adult Onset Diabetes. Younger woman, obese women, women who don't engage in exercise and some ethnic groups are at greater risk for developing the diabetes.

Much is published about the risks associated with Gestational Diabetes. The important thing to remember is that it isn't the diabetes, per se. If if it diagnosed and managed, all the "bad" things you hear about it shouldn't necessarily be a problem. So don't be afraid of the tests and DO be COMPLIANT, if you are diagnosed.

If you are diagnosed with Gestational Diabetes you will be taught how to monitor your blood sugar and you will be taught how to manage the disease with diet and exercise. Insulin is usually not needed. The baby will be carefully monitored as well.

So please don't dread the test and welcome the results, whatever it is. It means that you are being proactive about your baby's and your health. A woman with Gestational Diabetes can have a very healthy pregnancy and a wonderfully healthy labor, delivery and newborn.