Posted on 14th April, 2023 at 6:29:12 AM
Effect of High Blood Sugar on the Fetus.
If a woman’s blood sugar is high it will have an effect on the fetus. There can be a short-term effect during pregnancy. The baby puts on much more weight than normal. There can be much more fluid around the baby which can lead to pregnancy complications. This baby when born can have problems maintaining blood sugar after birth and may require NICU and special care.
The most dreaded complication is genetic programming happening in the fetus. A concept named “fetal origin of adult disease” means fetuses exposed to the high sugar levels in the uterus, ultimately their pancreas gets programmed and these babies then cannot produce enough amount of insulin in their adult life and later become diabetic. We are basically passing on the disease of diabetes to the next generation if the pregnant woman doesn’t control her abnormal sugar level.
Tests & treatment for high blood sugar during pregnancy.
Out of 100 pregnant women, 12%-15% will turn out to be gestational diabetes. This can be tested in the first trimester i.e. first 3 months. But it is very important to test for them again even if they are negative between 24-28 weeks. Because 6-7 months is the time when the pregnancy hormones change a women’s metabolism and these women can become diabetic in that particular stage. There are two types of tests recommended in pregnancy. One in the first contact and another at 24 to 26 weeks.
There are multiple treatments available the world over. Generally, the test which is done is the Glucose Challenge Test. But in Indian conditions what suits us best is known as the Dipsi test. In this test, the woman is given 75 gms of glucose in half a glass of water and after 2 hours the blood is tested for blood sugar. A blood sugar level of 140 is labeled as diabetic in such cases. We do not insist that the woman should be fasting, she can come in a non-fasting state. We give them a glucose packet to drink and after two hours the blood can be tested by a glucometer even in a rural area where there is no laboratory.
Tests & treatment for high blood sugar during pregnancy at Thanawala Maternity Home.
The way we do it in our clinic is we have an anhydrous glucose packet available which is given in the previous visit say at 20-22 weeks. When you come next, drink this glucose packet irrespective of the last meal, after drinking don’t eat or drink anything and after 2 hours give it to the laboratory for the glucose test. If the level comes above 140 that means they cannot metabolize the sugar to the required level and they have got glucose intolerance or gestational diabetes. Once you pick up gestational diabetes and you know the sugar levels are going high and remaining high after every meal then it is important to control it so that the effects are not passed on to the baby.
Control is not difficult. In 90% of gestational diabetes women, it is controlled by only diet and exercise. You have to go to a dietician, get a diet chart made, eat sensibly, be aware of the sugar, and do some exercise to get it under control. If that doesn’t work and if your fasting levels are not down to 90 and post-meal i.e. 2 hours every meal if the level is not down to 120, then you may require drugs. Today we have oral drugs available namely Metformin, well tolerated and can bring down the sugar level very safely. In case the levels are still not under control then one will have to be on Insulin and visit a physician for the same. All in all, it is important to get the sugar under control in gestational diabetes to avoid passing the effects on to the baby.
Today young thing looking women too have abnormal sugar. The scenario has changed as every pregnant woman has to get tests done for abnormal sugar levels. Getting a good screening in pregnancy done, getting sugar tested twice first at the first contact and second one at around 6-7 months to make sure one doesn’t have gestational diabetes. If you have gestational diabetes then it is a must to maintain the blood sugar levels to 90 at fasting and 120 posts. So that one can get a good pregnancy and if sugar levels are maintained rest assured nothing can interfere with a good pregnancy.
“Pass on all the good karma to the baby and not diabetes”
