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Gestational Diabities
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 Frequently Asked Questions

Q: I am a 32 year old woman diagnosed as a gestational diabetes. Blood sugar successfully controlled on insulin and a mild polyhydramnios on treatment with indomethacin. I am in my 26 weeks pregnant. The USG showed placenta as grade 0 but within 20 days the USG showed it as grade 2. This rapidly increasing placental maturity worries me as I have read that it affects the baby and it may progress to grade 3 placenta in the third trimester. What is to be done? What can be the reason and what are the repercussions? I lost my last baby 31 week due to polyhydramnios. This is a precious pregnancy, 9 years after marriage. Thanks in advance for your time and valuable guidance.

Lalitha (Calcutta, India)

A: The frequency of scans will be determined by how much monitoring will be required. Continue to do USG at the same place every time. One cannot give an opinion about the reason and repercussions with only this much information. You must talk to your gynecologist and get these doubts cleared.

Dr. Asha Paranjpe

Q: I am 8 months pregnant. I was recently diagnosed with gestational diabetes and have been on insulin since then. My total weight gain has been 40 pounds so far, but this week I lost 3 pounds. I have been on a no-sugar diet since a month now. How is the baby going to gain weight?

Kajal (San Jose, USA)

A: Gestational diabetes makes your pregnancy a high risk one as if this is uncontrolled it can lead to complications in both the mother and the foetus. Usually gestational diabetes manifests in the second trimester of pregnancy but can manifest at anytime. You must be exceptionally careful and have your sugars and foetal well being thoroughly monitored. Gestational diabetes controlled on insulin has a high morbidity rate close to term. According to me weight loss at this gestation, especially if your sugars are controlled on insulin, is not a good sign. A stability in weight is what should be achieved and maintained. I advise you to consult your gynaecologist immediately, have your sugar profile rechecked and insulin levels adjusted. Maybe it is being caused by abnormal glycemic (sugar) control. Once your weight has stabilised and your sugar levels are well under control, the baby will gain adequate weight.

Dr. Sahni

Q: I am 27 weeks pregnant. My blood sugar had shot up and the doctor put me on a diet. The following are my blood sugar results after 12 days of dieting: Fasting 4.2 mmol/L 2 hrs. after breakfast 4.1 mmol/L 2hrs after lunch 5.3 mmol/L 2hrs after dinner 5.9 mmol/L Prior to dieting my blood sugar figures were 7.4 mmol/L and 7.8 mmol/L ( 2hrs after lunch & dinner respectively ). How is my blood sugar level now? What should the blood sugar level be in a normal person at any given time? How does one convert mmol /L to mg?

Pritha (Brampton, Canada)

A: Your blood sugar levels at present are within normal limits, but remember these have been achieved by following a diabetic diet so you must continue with it. As regards giving you the figures in mmol---all you need to do is to multiple the number in mmols by 18 to get the value in mg, and to convert mg to mmol just divide by 18. In your case as long as the fasting blood sugar remains below 105mg% and the post meal values stay below 120mg% there should be little to worry about. You must however repeat these values every 2 weeks. For more information on these topics, you can revisit the section on Pregnancy and look up Common Concerns during Pregnancy.

Q: I am in the 39th week of my first pregnancy. My B.P. is normal. My doctor says that my cervix has come down. I urinate often and I have a constant pain in the joints of my thigh bone, hip bones and backbone. I also have pregnancy induced diabetes so, am on insulin and am following a strict diet. My doctor has advised full bed rest. What risks does my child face in delivery? What all precautions should I take? What should I do? What is foetal distress and what are the symptoms?

Canchan (Chennai, India)

A: Pain in the joints occurs in a large number of women in the third trimester of pregnancy due to calcium deficiency and also due to relaxation of ligaments caused by hormonal influences in order to facilitate child birth. Frequency of urination can increase in the 3rd trimester due to the head descending into the pelvis. Diabetics on insulin must be very careful during the last few weeks of pregnancy as there is always a risk. Preterm labour in a diabetic is risky as we cannot give steroids to the mother to enhance foetal lung maturity because it may accelerate the diabetic process.

Dr. Sahni

Q: Is blood sugar a mandatory test during pregnancy? My baby was born unusually big and his breathing was rather erratic. My doctor said that my blood sugar went unnoticed during pregnancy. He said that a urine test was not a very accurate indicator of blood sugar. Then why is this test used to determine sugar?

Falguni (Mumbai, India)

A: Yes, blood sugar test is a mandatory test during pregnancy. Estimation of urine sugar in not very accurate during pregnancy because a pregnant woman's renal threshold decreases and sugar is present in the urine at lower concentrations also. However, we still conduct these urine sugar estimation so as to pick up any LARGE values of sugar, which may be an indication of gestational diabetes. GCT is done as a screening test for all pregnant women in modern obstetrics. As long the blood sugar level of the child was normal at birth and he is subsequently achieving age-appropriate milestones, there should be little cause for concern.

Dr. Sahni

Q: I am 23 years old and 7 months pregnant. I got to know that I had diabetes when I was in my 3rd month. I read in this website that this is normal, and I have stopped sugar. Now the FBS is showing 152 and I have started getting pelvic pains. Even though I have stopped sugar, the FBS is not going down I am taking 5 units of insulin 4 times a day.

Gargi (Norwalk, USA)

A: It is unclear why you need to take Insulin four times a day in dose of 5 units Insulin. Without all your reports, I am afraid that I cannot say anything.

Dr. Asha Paranjpe

Q: I am 5 months pregnant and have found out that I have Gestational Diabetes. I am very concerned about my baby. What should I do?

Mahira (Jeddah, Saudi Arabia )

A: Gestational Diabetes can affect the baby if it is not under control during pregnancy. Your baby may be relatively large in size.

Dr. Asha Paranjpe

Q: I am 6 months pregnant. Last week it was discovered that I have sugar in my blood. How will this affect the baby? What should I be eating?

Durdana (Boston, USA)

A: Kindly mail us your blood sugar values as everyone has sugar in their blood. It is the amount which matters. Once we have your blood sugar reports we can help and advise you better.

Dr. Sahni

Q: I am 5 months pregnant and had my blood glucose test done. The level is 141. The nurse mentioned that the level should be between 60 - 140. She asked me to retake the test after a month. Do you think I have gestational diabetes? What measures should I take to control it? I am very concerned.

Illika (Paris, France )

A: Do repeat the blood sugar test again. A level of 141 cannot be labelled as diabetes so there is no need to worry.

Dr. Asha Paranjpe

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