Date
18 August 2018
Gestational diabetes mellitus (GDM) refers to the condition in which a woman develops high blood sugar levels during pregnancy. Photo: Reuters
Gestational diabetes mellitus (GDM) refers to the condition in which a woman develops high blood sugar levels during pregnancy. Photo: Reuters

What exactly is Gestational Diabetes Mellitus, or GDM?

“Doctor, will my gestational diabetes affect my baby?” “Do I have to take insulin?” These are some of the familiar questions that I received from my patients who were diagnosed with gestational diabetes mellitus (GDM).

According to the latest local data, one in five pregnant mothers commonly suffers from the condition.

A few years ago, the definition of GDM was narrowed down due to more new medical discoveries. And nowadays most women delay childbearing, and the diagnosis of GDM has been increasing.

GDM refers to the condition in which a woman develops high blood sugar levels during pregnancy. Because of the hormonal change caused by the placenta, the ability of pregnant women to handle high blood sugar (especially postprandial blood glucose) is weakened, therefore resulting in GDM.

Like general diabetes, gestational diabetes is more common in women with a family history of diabetes, excess body weight, and/or polycystic ovarian symptom (PCOS).

I would recommend such women have an oral glucose tolerance test (OGTT) during their first prenatal visit while others should take the test during the 24th to 28th week of pregnancy.

After giving birth, their blood sugar level should return to normal without the placenta hormones affecting them. However, some women will still have higher blood sugar level and their risk of diabetes in the future will also increase. They should test their blood sugar level a month after giving birth and retest every two to three years.

If GDM is not handled properly, the risks of premature birth and pre-eclampsia will be greater and the weight of the fetus will increase, leading to a higher birth risk. Due to high blood sugar level in mothers, the pancreas islet cells of the fetus will likely proliferate and they may have excess insulin several days after birth, resulting in low blood sugar.

The majority of the GDM patients would have a normal blood sugar level on an empty stomach, which means diet is adequate for controlling their condition.

If diet cannot manage the sugar level, using insulin injections is the most effective and safest diabetes medicine for both the mother and the child. Insulin injections can be done painless using a short and thin needle.

The new model of monitoring blood sugar level has also minimized the pain, while with a blood sugar level scanning device, you do not even need to prick your finger.

Many pregnant women worry that the next generation will inherit GDM. I personally think that heredity defects can be redressed through proper care. Children should develop healthy eating habits, with low-salt, low-sugar, and ensure low-fat diet. Do not often use sweets as rewards. Also, don’t be helicopter parents. Give children enough time to “recharge” and exercise even when academic studies are heavy. It will benefit their whole life if they fall in love with exercising.

This article appeared in the Hong Kong Economic Journal on May 2

Translation by John Chui

[Chinese version 中文版]

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JC/BN/RC

Specialist in Endocrinology, Diabetes & Metabolism

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