Tackling gestational diabetes in the womb

Gestational Diabetes Mellitus ( GDM) is high blood sugar levels diagnosed during pregnancy,

Pregnancy imposes biological stress on the body. A certain hormone secreted during pregnancy ( Human Placenta Lactogen), interferes in the way insulin normally functions in the body, leading to elevated blood sugar levels for the mother. On an average 3 million women suffer from this problem. Blood sugar level is measured on fasting & 2 hours after consuming 75 mg of glucose solution.

It is estimated that about 10 per cent of women who get pregnant every year develop diabetes during their gestation period, usually in the last trimester. Even with 10 per cent, the numbers in this country are damning: it works out to about three million women every year, counting the total number of annual deliveries at 27 million.

Of these three million women, in 5-10 years after pregnancy, 30 per cent go on to develop Type 2 Diabetes, according to a Dr., adds that in women followed up for 20 years, it was clear that up to 70 per cent of them who had gestational diabetes mellitus (GDM) went on to develop diabetes.

And there are clear factors that facilitate this: enormous weight gain after pregnancy, following a sedentary lifestyle and not eating healthy. “When women are pregnant, they listen to everything the doctor says, but once the baby is born, they don’t even return for follow-up checks,”  adds the Dr.

In a sense, we are entering an environment where the family is most willing to do something about the mother’s condition during her pregnancy. This is an opportunity to enable the whole family alter its lifestyle,” according to a Dr.

No wonder then that the diabetes federation has been agitated enough to reach out to these people, by organising training programmes on gestational diabetes for members. Dr.  explains, “This is an effort to address the tsunami of diabetes in this country. The woman who develops diabetes in pregnancy has an increased risk of developing Type 2 Diabetes later in life. In addition, there is a high risk for the baby born to such mothers too.”

While that sounds scary, it is possible, with simple techniques, to ensure that both the mother and foetus remain diabetes free. “Focus on the foetus for the future,” says a Dr.

“The intra-uterine environment is very precious, how a baby shapes out is decided here. It is important to not let the baby in the womb know that the mother has diabetes. It is possible, even with following a recommended meal plan, he says.

Dr.  indicates the accepted protocol to test pregnant women: One dose, 75 mg of glucose solution is used to check the post-prandial sugar levels. Anything in excess of 120 means a need to investigate further. “If we assume that a doctor can do this test just once, then let it be done at 20 weeks.

However, with the more awareness we manage to get out, it will be ideal to test at 12 weeks of pregnancy.” FOGSI and DIPSI together will train 100 master trainers to then train 1000 others in 25 regions across the country.

“We hope to map and tap every single case of GDM in the country. Intervention with follow-up over several years is the only way to prevent mothers moving into diabetes,” says a Dr.