Expert Explains The Effect Of Gestational Diabetes On The Mother And Her Baby

India is known as the diabetes capital of the world. Diabetes during pregnancy known as gestational diabetes can affect even healthy women during pregnancy which can also lead to different other health issues such as diabetes and cardiovascular disease. However, the change of Gestational diabetes mellitus (GDM) as a major public health issue is because it may play a crucial role in the growing prevalence of diabetes and obesity. In fact, GDM is believed to be a stage in the development of type-2 diabetes mellitus.

Due to gestational diabetes approximately 7% of all pregnancies are complicated, resulting in more than 200,000 cases annually. Gestational diabetes mellitus is also a known risk factor for type-2 diabetes besides its known adverse impact on pregnancy outcome. Women with GDM have a seven fold higher risk of developing type-2 diabetes. This risk increases steeply 5 years after delivery. Women with a history of GDM also have a higher prevalence of metabolic syndrome and increased risk of cardiovascular disease (CVD).

In India, gestational diabetes mellitus (GDM) is a public health priority due to its high prevalence as well as its immense potential for diabetes prevention. The understanding that diabetes in pregnancy is a significant contributor to the rising epidemic of type-2 diabetes mellitus has also helped focus on the pregnant woman as a major target for diabetes prevention strategies.

Though there are might be chances that women with a history of gestational diabetes are at a significantly greater risk of heart artery calcification, even if they maintain normal blood sugar levels after pregnancy but direct signs of the benefits of interventions in the prevention of future of type-2 diabetes in the context of GDM also exists. Postpartum lifestyle intervention aids to prevent type-2 diabetes and cardiovascular disease in women with gestational diabetes. Intensive lifestyle and metformin are highly effective in delaying or preventing diabetes in women with impaired glucose tolerance and a history of gestational diabetes.

Infants born to mothers with glucose intolerance are at an increased risk of morbidity and mortality due to respiratory distress, growth abnormalities (large for gestational age, small for gestational age), hyper viscosity secondary to polycythemia, hypocalcemia, hypoglycemia, congenital malformations, hypomagnesemia, and iron abnormalities. These newborns are likely to be born by caesarean delivery for many reasons, among which complications are such as shoulder dystocia with potential brachial plexus injury related to the infant's large size.

Early detection and optimizing treatment in GDM is the best way to deal with this condition. Once identified, all patients should receive extensive diet and exercise counseling. Estimated that 70-85% of cases can be measured only with the help of lifestyle modifications. If treatment targets are not met, typically within 1-2 weeks, one should underway pharmacotherapy.

(Dr. Kiran Coelho, Consultant, Gynecology & Obstetrics at Hinduja Hospital Khar)

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