Sunday, November 21, 2021

How Soon Can Women Overcome Gestational Diabetes After Childbirth?

When a woman who has never had diabetes gets high blood sugar levels during pregnancy, she is said to have gestational diabetes. Insulin is a hormone that helps to maintain a healthy level of blood sugar. Higher amounts of other hormones can interfere with your body's ability to respond to insulin during pregnancy, resulting in high blood sugar. Gestational diabetes usually gets cured after the delivery as blood sugar level comes down. But it sometimes can turn into Type 2 diabetes. How pregnant women can reduce their chances of developing gestational diabetes? If I have gestational diabetes, what can be done to control/overcome the condition? A Consultant Obstetrician & Gynaecologist,  provided answers to some of the FAQs about gestational diabetes.

Q. How can gestational diabetes affect the baby?

Gestational diabetes during pregnancy can be a problem for the unborn baby as the high blood sugar level can bypass the placenta. It can also cause breathing issues, low levels of calcium, low blood sugar at the time of birth.

High blood sugar levels can also cause an excessive build-up of amniotic fluid, macrosomia, and in rare situations, stillbirth. Early birth, high blood pressure, and preeclampsia are among the other dangers.

Q. How gestational diabetes is diagnosed?

Gestational diabetes cannot be diagnosed very easily as some may show no signs or symptoms, while others feel severe hunger, thirst or tiredness.

An Oral Glucose Tolerance Test (OGTT) is used to determine gestational diabetes. It is done in a pathology lab. Fasting for at least 24 hours is required before taking this test. A sample of your blood will be collected to determine your fasting blood glucose level. You will then be given a sugary drink and your blood will be drawn one and two hours later. You have gestational diabetes if your blood glucose level is higher than usual after a fasting, one- or two-hour test.

Q. What can be done to manage this condition?

Keep yourself active unless you are advised not to do. It will help you and your baby to stay healthy while also limiting weight gain. Overweight or obese women are more prone to acquire gestational diabetes. Finding the right combination of protein, lipids, and carbs is key to controlling gestational diabetes. 

Q. Who is at risk of developing gestational diabetes?

During pregnancy, any woman can develop gestational diabetes, but you're at a higher risk if you:

  • History of PCOS
  • Family with history of diabetes
  • Hypertension
  • Dyslipidemia
  • Sedentary lifestyle
  • Obesity
  • Stressful lifestyle
  • History of Gestational Diabetes Mellitus in previous pregnancy

Q. What factors contribute to the cause of gestational diabetes?

All of the above and the placental hormones which work against insulin.

Q. Is gestational diabetes curable?

Gestational diabetes can be cured for majority of women but half of those who test positive for gestational diabetes have a higher risk of developing type 2 diabetes later in life.

Q. Is it possible to lower my chances of developing gestational diabetes?

Maintaining a healthy lifestyle prior to conception can help lower the risk of gestational diabetes. Try to maintain a healthy weight or keep it as near to it as possible, eat healthy foods, and  exercise everyday.

At 6 weeks after giving birth, all women with gestational diabetes should be tested to see if they have diabetes outside of pregnancy. A woman with gestational diabetes must be conscious of nutrition and exercise for the rest of her life.

Q. Will I have diabetes for the rest of my life if I develop gestational diabetes?

After the baby is born, most women's diabetes goes away. However, up to one out of every five mothers with gestational diabetes will have high blood glucose levels after their baby is born. As a result, a follow-up oral glucose tolerance test (OGTT) should be performed 6 -12 weeks after the baby is born to ensure that blood glucose levels have returned to normal.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

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Wednesday, July 10, 2019

For the prevention of excessive bleeding after childbirth heat stable carbetocin has been added to essential list t

  • Heat-stable carbetocin has been added to the WHO Essential Medicines List of uterotonics for the prevention of excessive bleeding after childbirth
  • Excessive bleeding after birth, also known as postpartum haemorrhage (PPH), is the leading direct cause of maternal mortality worldwide
  • WHO guidelines recommend heat-stable carbetocin for PPH prevention in settings where oxytocin is unavailable or its quality cannot be guaranteed, and where its cost is comparable to other effective uterotonics
  • Heat-stable carbetocin was developed to address limitations in refrigeration and cold-chain transport of medicines in low- and lower-middle income countries
Due to postpartum haemorrhage (PPH), a woman was rushed to have emergency blood transfusions after childbirth. Her husband felt helpless, but thankfully she recovered.

A Pharmaceutical company today welcomes the World Health Organization’s (WHO) addition of heat-stable carbetocin to the WHO Model List of Essential Medicines (EML) of uterotonics for the prevention of excessive bleeding after birth. The EML identifies medicines the WHO deems essential for addressing the most important public health needs globally. 
 
Every year, 14 million women are affected by excessive bleeding after birth, also known as postpartum haemorrhage (PPH). Although most deaths are preventable, PPH is the leading direct cause of maternal death worldwide, causing approximately 70,000 deaths per year, 99% of which occur in low- and lower-middle income countries.

“The WHO’s addition of heat-stable carbetocin to the Essential Medicines List brings us one step closer to tackling this life-threatening condition that impacts thousands of women and their families,” said a researcher. “This milestone is thanks to collaboration from stakeholders around the world, and demonstrates how work across both the public and private sectors can help achieve development goals in global health. As the manufacturer, is now seeking registrations for heat-stable carbetocin and, once approved, our priority is to make heat-stable carbetocin available at an affordable and sustainable price in public sector healthcare facilities in low- and lower-middle income countries where cold-chain transport and refrigeration of medicines is often difficult to achieve or maintain.” 

This addition to the EML follows the 2018 update to the WHO’s recommendations on uterotonics for the prevention of PPH. The guidelines recommend heat-stable carbetocin for the prevention of excessive bleeding after all births in settings where oxytocin is unavailable or its quality cannot be guaranteed, and where its cost is comparable to other effective uterotonics. The CHAMPION trial, the largest clinical trial in PPH prevention, showed that heat-stable carbetocin is non-inferior to current standard of care oxytocin, for the primary outcome of ≥500 ml blood loss or additional uterotonic use, after vaginal birth. Heat-stable carbetocin remains effective at high temperatures, addressing a significant limitation of oxytocin, which must be stored and transported at 2 – 8°C.
Carbetocin is currently registered in more than 80 countries worldwide for the prevention of PPH due to uterine atony following caesarean section.The Dr. is now seeking registrations for heat-stable carbetocin for the prevention of PPH following all births. Once approved, the heat-stable formulation of carbetocin will be available at an affordable and sustainable price to publicly controlled or publicly funded healthcare facilities and healthcare facilities operating on a social marketing basis in low- and lower-middle income countries. 

About the EML
The WHO Model List of Essential Medicines (EML) serves as a guide for the development of national and institutional essential medicine lists and is updated and revised every two years by the WHO Expert Committee on Selection and Use of Medicines.

 
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