Introduction:- Everybody has heard someone saying ” I have blood sugar” . everybody has sugar in their blood and nobody can survive without sugar blood in their blood. Sugar levels in blood can give rise to problems when sugar level rise above the normal level. Blood sugar is also called blood glucose. When the blood sugar levels go above normal, that condition is called diabetes mellitus. Therefore the body needs more and more insulin to control the level of the sugar in the blood. someone’s body is not always ready to produce enough amount of the insulin. If the insulin is not produce required amount the level of the sugar in the blood would be increased. When sugar is sufficiently high, glucose can pass through to the kidneys and presence in urine.
Some women get diabetes only when they are pregnant. It is called “gestational diabetes” it effects only 2-3% of pregnant women. It is figured in the world where majority of meals composed of carbohydrates or starch. If it controlled it may be effect mothers as well as the babies in the future. it develops in the women during pregnancy because an increase of some certain hormones, which can effect the blood sugar ( glucose) levels. In the words, in the pregnancy the placenta produces some hormones. Which block or act against the action of the hormone in the blood sugar control ( insulin).
Who are effected mostly:- it is more common in women who are over weight, older, have a family history of diabetes. However we can list given
Gestational diabetes in a previous pregnancy
A large baby in a previous pregnancy ( over 3.5kg)
An unexplained still birth ( like dead baby delivery)
Being over 35 years old
Family history of diabetes ( Mother, father etc…)
High blood pressure and pressure
Having previous history of cardiovascular system.
Symptoms:- Increasing thirsty or need to pass out are common in pregnancy however it is very difficult to find out in pregnant women as soon as they having it. This is found in pregnancy in any time but usually begins after 24 to 28 weeks as the hormones that block the action of insulin start to increase at stage of the pregnancy and almost disappears once the baby has been born.
Importance and Causes:- Raised blood glucose level in pregnancy are passed through the placenta to the developing baby causing an increased risk of complication during pregnancy, labour and delivery. If the mother body can not produce enough extra insulin to counteract this blocking effect the pancreas produce the hormone insulin.
Tests – Screening and diagnosis Screening test screening is the method of finding out those who are at a high risk of getting a particular condition. Screening test ‘positive’ does not mean that she is having the condition screening for. A further test has to be done to conform the condition that we are going to diagnose. Screening is mostly done when it is health problem which can asymptomatic. Because gestational may be asymptomatic but have serious consequences that can be reduced by treatment, it is a candidate for screening. The screening test for diabetes is a test of urine to check for sugar which is each and every clinic visit. Presence of sugar in urine doesn’t mean that you are having diabetes. Due to hormonal change in the pregnancy’s blood and supply of the blood to kidney is increased, therefore more sugar will be filtered into blood. This condition is called ‘Renal Glycosurea’ it is commonly normal not to worry.
Oral glucose tolerance test (OGTT) Which describes around 75g of glucose is given to pregnancy orally to how coping with this load. In this process the mothers let to keep fast overnight and taken sample of urine to test fasting sugar in blood, then glucose is given after blood is taken hourly twice, if the system is working normally the level sugar in the blood returns normally within two hours.
After completing test, if gestational diabetes is diagnosed the pregnancy will be admitted to hospital for controlling sugar in blood. If sugar is controlled in hospital you will be asked to go to antenatal clinic. Then you have to check your level of blood frequently which could be in a normal lab by glucose meter.
Treatment In some case food habit of pregnancy has to be changed, this is called ‘diabetic diet’ An information of leaflet will be given to pregnancy which includes what meals she should take. It is important to reduce sugary food like cake, biscuit, soft drink and tea etc. gentle exercise may also prevent excessive weight of the body, it is also helps to control the level of the sugar in the blood. Insulin given as an injection pregnant could be trained how to inject her own.
Baby most of women who have diabetes can have healthy babies, but they a higher risk of getting complications than non-diabetic pregnancy. Having high blood sugar levels can effect the baby’s growth in the womb. This can cause the baby to grow larger ( knows as macrosomia). Which can make the delivery difficult, and high pressure in the blood. If there is excessive water around the baby ( known as polyhydramnios ) which is seen commonly in diabetic pregnancies, it can lead to premature delivery giving rise to breathing problems of the baby. Inside the womb the fetus produce extra amount of insulin to cope up with the high blood sugar levels which it receives through the umbilical cord, a short after birth, the baby may continue to make extra insulin even though high levels of blood sugar are no longer present. This may cause the baby to have low blood sugar. ( known as hypoglycemia) which can be harmful to baby. If the level of sugar in the blood is lower than normal amount sometime baby might need a glucose drip. It more likely that that your new born baby will develop jaundice ( yellow color skin) it is normally fades out without any medical treatmen, but sometimes phototherapy has to be done for few days. If born early baby will feel to breath difficulty because of lungs are premature, some extra oxygen is needed for a few days. but rarely, sudden death may occur inside the womb.
After delivery after delivery your level of the sugar in the blood returns to normal. This happen basically due to expulsion of the of the placenta following delivery, which is is the cause for onset of diabetes. The drip will be stopped your usual diet can be resumed, and the insulin will be discontinue. A glucose tolerance test will be arranged for you 6 to 8 weeks after your baby is born to ensure your blood glucose has returned to normal.
Breast feeding breast feeding is strongly encouraged and it also helps to bring down the blood sugar levels back to normal.
Conclusion if you are pregnancy, if you suspect that you having diabetes go to your doctor and take the test of the OGTT sure you don’t have gestational diabetes it is the way to make a strong baby.