Gestational Diabetes (GDM)

During pregnancy, the placenta produces hormones that naturally help the baby grow. However, these hormones also make the mother's cells more resistant to insulin. Normally, the mother's pancreas produces extra insulin to compensate, but if it cannot keep up, blood sugar levels rise. This 'extra' sugar crosses the placenta to the baby, who then produces their own insulin. Since insulin is a growth-promoting hormone, the baby grows faster and larger than normal.

You are more likely to develop GDM if you have:

• Higher BMI: Being overweight before pregnancy.
• PCOS: Polycystic Ovary Syndrome.
• Family History: A parent or sibling with Type 2 Diabetes.
• Previous GDM: Having had diabetes in a prior pregnancy.
• Ethnicity: Certain groups, including those from the Middle East and South Asia, have a naturally higher risk.
• History of Large Babies: Having previously given birth to a baby weighing more than 4.5kg.

The Oral Glucose Tolerance Test (OGTT) is performed between 24 and 28 weeks:

1. Fasting: A blood sample is taken after you haven't eaten for 8-12 hours.
2. The Drink: You drink a syrupy glucose solution (75g).
3. Follow-up: Your blood sugar is tested again 1 hour and 2 hours after the drink. If any of these readings are above specific thresholds, GDM is diagnosed.

We follow a step-by-step management plan:

• Glucose Monitoring: You will be taught to prick your finger 4 times a day (fasting and 1 hour after meals) to track your patterns.
• Medical Nutrition Therapy: Working with a dietitian to balance complex carbohydrates, proteins, and healthy fats.
• Exercise: Regular moderate activity like walking helps your body use insulin more effectively.
• Medication: If diet alone doesn't meet the target levels, we may prescribe Metformin or Insulin injections. These are safe for the baby and essential for preventing complications.

Well-managed GDM results in excellent outcomes:

• Healthy Birth Weight: Control prevents the baby from becoming too large, reducing the risk of 'shoulder dystocia' (the baby's shoulder getting stuck during birth).
• Neonatal Health: Prevents the baby from having dangerously low blood sugar (hypoglycemia) immediately after birth.
• Postpartum Check: GDM usually disappears after birth, but you must have a follow-up test at 6-12 weeks postpartum to ensure your sugars have returned to normal and to screen for future Type 2 Diabetes risk.

If you have multiple risk factors, you should be screened early (at your first booking) rather than waiting until 24 weeks.

Led by Dr. Maria Haji Liga, our Unit provides a direct link between fetal specialists and endocrinologists. We focus on empowering you with the tools and knowledge to manage your blood sugar, ensuring a smooth pregnancy and a healthy start for your baby.