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What Is Gestational Diabetes Mellitus (GDM) ?

WHAT IS GESTATIONAL DIABETES MELLITUS (GDM)?

Diabetes Mellitus is a disorder which prevents the body from effectively using glucose we consumed (from simple as well as complex carbohydrate). Gestational diabetes mellitus (GDM) is diabetes that developed only in pregnancy. GDM occurred when several hormones produced by the placenta prevents the body from using the insulin effectively. This condition is known as insulin resistance. Insulin resistance causes glucose/ sugar to build up in the blood instead of being absorbed by the body.

GDM is a serious condition affecting pregnant mothers, however will usually recover following childbirth. But do bear in mind that mothers with history of GDM remains at high risk of developing diabetes later on in life.

 

IS GDM COMMON?

GDM is usually detected after the 24th week of pregnancy. It occurs in about 1-14% of pregnancies each year. If left undetected and untreated, GDM can cause many serious health issues for pregnant mother including the foetus/ baby.

 

WHO IS AT RISK?

Although any woman can develop GDM during pregnancy, some of the factors that may increase the risk include the following:

  • Overweight or obesity prior to pregnancy
  • Family history of diabetes
  • History of GDM, prediabetes
  • History of big baby (macrosomia) (>4kg)
  • Age of >25 years old
  • Current obstetric problems eg: high blood pressure in pregnancy, excessive accumulation of amniotic fluid (polyhydramnios)

 

SIGNS & SYMPTOMS

Most mothers with GDM do not possess any risk factors. To identify whether you are diagnosed with GDM, a test called Modified Oral Glucose Tolerance Test (MOGTT) should be conducted by your doctor between week 24th to 28th of pregnancy, or during your antenatal check- up if mother has any risk factors.

 

WHAT IS THE TREATMENT FOR GDM?

Treatment focuses on keeping blood glucose levels in the normal range. Treatment may include:

  • Special diet
  • Exercise
  • Daily blood glucose monitoring (ideally 4 to 6 times a day)
  • Insulin injections

 

ANY SPECIFIC DIET & EXERCISE RECOMMENDATION?

A balanced and nutritious diet is important to maintain good health in the pregnant mother. Avoid excessive daily calorie intake and good choice of food consumed to ensure good blood sugar control. Cut down intake of sweets and food with high sugar content like baked goods, pastry, sweetened beverages, canned fruits, jams etc. Instead, include more complex carbohydrate including fiber like whole grains, vegetables, legumes, and fruits in diet.  High saturated fat diet (fast food, butter, cream, baked goods, fatty meat, deep fried food) should be minimized too.

As for exercise, frequent physical activity such as walking, stretching, hydro- exercise of moderate intensity can reduce the risk caused by GDM. Start slow, then gradually increase the frequency and duration at your own pace and comfort. Avoid exercises that can cause abdominal trauma, such as contact sports, fall- prone and bouncing exercises. It is very important for mothers to seek advice from your doctor, midwife and dietitian for more details on diet and exercises.

 

REFERENCES

  1.  Johns Hopkins Medicine (n.d). Gestational Diabetes Mellitus (GDM). Retreived from https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/gestational-diabetes
  2. MyHealth Kementerian Kesihatan Malaysia (2019). Diabetes in Pregnancy, Retrieved from http://www.myhealth.gov.my/en/diabetes-in-pregnancy/

 

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