Gestational diabetes mellitus is carbohydrate intolerance with onset or first recognition during pregnancy. In affects up to 14 of the pregnant population. The main pathogenic factor is insulin resistance , which occurs to same degree in all pregnancies, but those who are unable to compensate develop gestational diabetes mellitus. Diabetes mellitus: Diabetes mellitus is a clinical syndrome characterized by hypoglycemia due to absolute or relative deficiency of insulin. Gestational diabetes mellitus: Gestational diabetes mellitus can be defined as diabetes that appears in pregnancy for the first time in a previously non – diabetic patient and disappears after delivery. Causes: 1. Hormonal imbalance 2. High blood sugar 3. The pancreas produce less effective insulin It is a presentation on GDM 2023.

1. Gestational Diabetes Mellitus
A presentation on
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Contents
 Introduction
 Definition
 Causes
 Clinical feature
 Diagnosis
 Risk factors
 Management
 Complication

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Gestational diabetes mellitus is carbohydrate intolerance
with onset or first recognition during pregnancy. In affects
up to 14 of the pregnant population. The main pathogenic
factor is insulin resistance , which occurs to same degree in
all pregnancies, but those who are unable to compensate
develop gestational diabetes mellitus.
Introduction

4. Gestational diabetes mellitus:
Gestational diabetes mellitus can be defined as diabetes
that appears in pregnancy for the first time in a
previously non – diabetic patient and disappears after
delivery.
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Diabetes mellitus:
Diabetes mellitus is a clinical syndrome
characterized by hypoglycemia due to absolute or
relative deficiency of insulin.
Definitions

5. Causes 5
1. Hormonal imbalance
2. High blood sugar
3. The pancreas produce less effective insulin

6. Clinical features
Symptoms:
1. Asymptomatic
2. Polyuria, Polydepsia,
Polyphagia
3. Fatigue and weight loss
4. Women with established
diabetes may have
retinopathy or neuropathy.
Sign:
1. Elevated serum glucose
2. Ketonuria
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7. Diagnosis
A. Screening by 1 hour 50g OGTT
Irrespective of food intake, 50g glucose is given orally
and at the end of 1 hour blood glucose is measured.
If blood glucose is >7.8mmol/l (140 mgl dl) ; Patient is
suspected for GDM and subjected to 100g OGTT
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8. B. Diagnosis of GDM by 100g OGTT
After 12 hours overnight fasting patient FBS is measured
and then 100g glucose with 300 ml of water is given
orally. The blood glucose is measured 1,2 and 3 hours
after glucose load.
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Diagnosis

9. Risk factor of GDM
1. Family history of DM
2. Age 30 years
3. Obesity
4. Ethnic group
5. Previous birth of baby weighing 4 kg
6. Unexplained fetal death
7. Presence of polyhydraminos
8. Persistent glycosuria
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10. Management of
gestational diabetes in pregnancy
1. Careful antenatal supervision
2. Control of diabetes mellitus
3. Obstetric management
4. Follow up
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1. Antenatal supervision should be monthly upto 20 weeks
and there after at 2 weeks interval.
2. The diet pattern should be same as other diabetic patient.
3. Frequent blood sugar both fasting and 2 hours after breakfast
4. HbA1C level 5 – 6 is desirable.
5. Assessment of fetal wellbeing including anomaly;
by ultrasonography.
 Careful antenatal supervision

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 Obstetric management
 Women with good glycaemic control and who do not require insulin therapy
wait for spontaneous onset of labour.
 Effective delivery is considered in patients requiring insulin or with complication
at around 38 weeks.
 Control of diabetes mellitus
 Insulin is used always oral hypoglycemic drugs are contraindicated.
 Follow up
 To see development of overt diabetes mellitus.
 Nearly 50 percentage of women with GDM would develop overt diabetes over
a follow up period of 5 – 20 years.

13. Effects / Complications of gestational
diabetes mellitus in pregnancy
Effects on the mother:
* pre- eclampsia
* pre – term labour
* recurrent infection
* maternal distress
* Diabetic ketoacidosis
*prolongation of labour
* shoulder dystocia
* perineal injury
* post- partum haemorrhage
* Lactation failure
* Increased incidence of
puerperal sepsis.
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14. Effects on the fetus:
Overall perinatal mortality is increased 2 – 3 times .
1. Fetal macrosomia 30-40 example ; big baby
2. Fetal congenital anomalies
* neural tube defect
* anencephaly
3. Birth injury
4. Unexplained fetal death
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Effects / Complications of gestational
diabetes mellitus in pregnancy

15. Conclusion
Gestational diabetes is a condition that can impact both the mother and the fetus,
which is why adequate glycemic control is important in helping prevent
complications. Non pharmacologic measures such as diet and exercise are often
sufficient for many women to maintain appropriate blood glucose concentrations.
However, some women may require additional pharmacologic therapy, in which
case insulin is typically the first-line choice, followed by metformin or glyburide.
To ensure that patients with gestational diabetes are achieving adequate glycemic
control, self-monitoring of blood glucose concentrations 1 or 2 hours
postprandially is most often recommended. Additionally, these women should be
screened postpartum, as they are at increased risk for developing overt diabetes.
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