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Managing Diabetes In Pregnancy

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                                                   By: Dr Fatema Jawad

The International Hyperglycemia and Adverse Pregnancy Outcome(HAPO) study lately announced its results, states a recent issue of the journal of American Medical Association. It was observed that pregnant non-diabetic women having blood glucose in the upper normal range can have increased risks for their newborns similar to diabetic mothers.

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The HAPO study included 23,000 non-diabetic mothers at 28 weeks gestation who underwent a 75 gram 2 hours Oral Glucose Tolerance Test. It was found that fasting blood glucose between 95mg and 100mg/dl, was a high risk for heavy babies four to six times compared to those with a lower blood glucose. Also the newborns had 2.7 times greater chances of developing low blood sugar at birth. These babies also had blood insulin levels. This proved the strong association between maternal glucose metabolism and the babies development and outcome.

The treatment for this condition cannot be advised at this stage because the level of normal blood glucose which can cause complications is still not determined. No clear cut-off point has been identified above which risks are high and below which risks are minimal. More studies are ongoing and one has recruited non-diabetic pregnant women who will be guided on healthy life styles and the effect of this on the health of the newborn will be observed.

It is to be marked that Gestational Diabetes Mellitus is treated with an appropriate diet and physical activity. Some women may require insulin. Self Blood Glucose Monitoring is an important tool for managing diabetes in pregnancy. This condition is characterized by insulin resistance and high blood sugar levels. If not treated, then excess glucose enters the baby via the placenta and can cause delayed lung maturity and breathing problems at birth. Also there is a high risk for obesity and diabetes mellitus in later life.

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