Im­por­tance of reg­u­lar screen­ing

The Star Malaysia - Star2 - - World Diabetes Day -

HIGH blood glu­cose level that oc­curs dur­ing preg­nancy is known as ges­ta­tional di­a­betes. Although it usu­ally re­solves af­ter child­birth, ges­ta­tional di­a­betes can in­crease the mother’s and baby’s risk of de­vel­op­ing type 2 di­a­betes in fu­ture.

The body nat­u­rally be­comes a lit­tle in­sulin-re­sis­tant dur­ing preg­nancy so that more sugar stays in the blood­stream to be car­ried to the foe­tus. How­ever, when this in­sulin re­sis­tance be­comes stronger than nec­es­sary, it can lead to ges­ta­tional di­a­betes.

What makes this type of di­a­betes dan­ger­ous is how it can cause birth-re­lated com­pli­ca­tions. Thank­fully, th­ese com­pli­ca­tions can be pre­vented with early de­tec­tion and proper man­age­ment.

Min­imis­ing risks

Ges­ta­tional di­a­betes does not have clear, tell­tale symp­toms but can be eas­ily de­tected with a sim­ple blood test. It usu­ally de­vel­ops dur­ing the later stages of preg­nancy, so a di­ag­nos­tic glu­cose screen­ing test is done dur­ing this pe­riod, specif­i­cally from week 24 to 28 of preg­nancy.

In Malaysian pub­lic hospi­tals, a mod­i­fied glu­cose tol­er­ance test (MGTT) is per­formed to screen for ges­ta­tional di­a­betes. If the con­di­tion is de­tected, fur­ther check-ups and man­age­ment meth­ods are ad­vised, and the mother is kept un­der care­ful ob­ser­va­tion un­til de­liv­ery.

Done twice dur­ing the preg­nancy, MGTT con­sists of a fast­ing blood glu­cose test in the morn­ing, af­ter which the mother drinks a so­lu­tion of wa­ter mixed with 75mg of glu­cose. An­other blood glu­cose test is done af­ter two hours to de­ter­mine how much sugar has been ab­sorbed by the body.

Apart from reg­u­lar blood test, MGTT is a pre­cau­tion­ary test ini­tia­tive taken by the Gov­ern­ment to curb the preva­lence of

Ges­ta­tional di­a­betes does not have clear, tell­tale symp­toms but can be eas­ily de­tected with a sim­ple blood test. It usu­ally de­vel­ops dur­ing the later stages of preg­nancy, so a di­ag­nos­tic glu­cose screen­ing test is done dur­ing this pe­riod, specif­i­cally from week 24 to 28 of preg­nancy.

ges­ta­tional di­a­betes and re­duce di­a­betes­re­lated birth com­pli­ca­tions.

When blood glu­cose level is high, an ex­pect­ing mother may ex­pe­ri­ence symp­toms such as fre­quent need to uri­nate as well as in­creased thirst and fa­tigue, but as th­ese are com­mon oc­cur­rences dur­ing preg­nancy, they are of­ten over­looked.

This is the rea­son ev­ery preg­nant woman in Malaysia, re­gard­less of symp­toms of di­a­betes or risk fac­tors, must un­dergo reg­u­lar blood glu­cose level mon­i­tor­ing and MGTT screen­ing.

The com­pli­ca­tions

Hav­ing ges­ta­tional di­a­betes does not nec­es­sar­ily in­di­cate the pos­si­bil­ity of

prob­lems aris­ing dur­ing child­birth be­cause most women with this con­di­tion have per­fectly nor­mal preg­nan­cies and child­births.

How­ever, the risk of cer­tain com­pli­ca­tions oc­cur­ring dur­ing child­birth is higher for mothers with ges­ta­tional di­a­betes. Some of th­ese com­pli­ca­tions are:

Pre­ma­ture birth – The baby is born be­fore the nor­mal stip­u­lated time. Pre­ma­ture birth is as­so­ci­ated with sev­eral fu­ture health com­pli­ca­tions for the baby.

Still­birth – Though rare, it is a pos­si­bil­ity.

High birth weight – Ges­ta­tional

Who is at risk?

Although any­one can de­velop ges­ta­tional di­a­betes, some women are more at risk than oth­ers and should be ex­tra vig­i­lant dur­ing their preg­nancy. Com­mon risk fac­tors are listed be­low. A his­tory of hy­per­ten­sion

A fam­ily his­tory of di­a­betes

A body mass in­dex of more than 30 Ex­ces­sive weight gain dur­ing preg­nancy

Mul­ti­foetal preg­nancy

Had ges­ta­tional di­a­betes in pre­vi­ous preg­nancy

Pre­vi­ously given birth to a baby weigh­ing more than 4.5kg

Of His­panic, Asian, African or Mid­dle Eastern ances­try

If you have any of the above risk fac­tors, you will need to un­dergo reg­u­lar blood glu­cose level tests and fol­low a life­style con­ducive to man­ag­ing blood glu­cose level through­out your preg­nancy. di­a­betes causes the weight of the foe­tus to in­crease rapidly, which can cause prob­lems dur­ing de­liv­ery. The need for sur­gi­cal in­ter­ven­tion is higher with heav­ier ba­bies.

Pre-eclamp­sia – A con­di­tion that oc­curs specif­i­cally in preg­nant women, preeclamp­sia is when the mother’s blood pres­sure rises and po­ten­tially dam­ages or­gans, specif­i­cally the liver and kid­neys.

It can be life-threat­en­ing for both mother and child if left un­treated.

Poly­hy­dram­nios – Char­ac­terised by too much am­ni­otic fluid sur­round­ing the baby, this con­di­tion can cause pre­ma­ture labour and de­liv­ery com­pli­ca­tions.

Low blood glu­cose level in baby – The mother’s ges­ta­tional di­a­betes may cause the new­born to have low blood glu­cose level and de­velop jaun­dice, lead­ing to the need for im­me­di­ate med­i­cal treat­ment af­ter birth.

Treat­ment pro­ce­dures

The usual treat­ment for ges­ta­tional di­a­betes is usu­ally life­style al­ter­ation, which in­cludes reg­u­lar blood glu­cose level mon­i­tor­ing, proper diet and light ex­er­cise. How­ever, if the mother’s blood glu­cose level is high, in­sulin in­jec­tions will be pre­scribed by doc­tors.

Di­a­betes is not fa­tal, but it is as­so­ci­ated with other con­di­tions that are lifethreat­en­ing. Ges­ta­tional di­a­betes is no dif­fer­ent since it causes many birth-re­lated com­pli­ca­tions.

It is thus im­per­a­tive for us to be vig­i­lant and keep our mothers-to-be and their un­born ba­bies safe from the grips of this deadly dis­ease.

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