This document discusses gestational diabetes, which occurs when a woman without a previous history of diabetes develops high blood sugar levels during pregnancy. The placenta produces hormones that can cause diabetes and make it difficult to control blood sugar levels. This puts both the mother and baby at risk. For the mother it increases the risks of issues like pre-eclampsia and needing a c-section. For the baby it increases the risks of being large for gestational age, trauma during delivery, premature birth, and stillbirth. Early testing and monitoring blood sugar levels can help manage the condition and reduce complications.

1. Diabetes and Pregnancy

2. Definition
• Gestational diabetes is a condition which a
woman with no history of diabetes is
diagnosed with diabetes mellitus during her
pregnancy.
• Diabetes is one of the most common
complication of pregnancy.

3. How diabetes happen in pregnant woman?

4. • In every pregnancy, the placenta generates
several hormones:
– Growth hormone
– Corticotropine releasing hormone
– Placental lactogen
– Progesterone
• These hormones are diabetogenic; meaning,
they can cause diabetes.

5. What does it mean for the mother and
baby?
Mother Baby
Difficult normal delivery Macrosomia (birth weight > 4 kg)
Birth canal trauma Congenital abnormalities
Increased risk of pregnancy-related
Stillborn
hypertension (pre-eclampsia)
Increased risk of cesarean delivery Premature delivery
Trauma related to difficult labor

6. • In diabetic mother, the chance of a stillborn is
4 to 6 times higher than non-diabetic mother.
• This is caused by the high blood sugar level
and high insulin level in the mother’s blood
which in turn caused hypoxia (lack of oxygen)
in the baby.

7. • Macrosomia is the most common
complication of gestational diabetes,
especially because of lipid metabolism
disorder.

8. Is early detection for gestational diabetes
possible?
Low risk Medium risk High risk
Check blood sugar level at Check blood sugar level as
Check blood sugar level
24th to 28th weeks of described for medium risk
only when:
pregnancy women when:
• Two steps test:
• Belongs to an ethic
50 grams glucose
group with low • The pregnant
challenge followed by
incidence of woman is obese
100 grams glucose
gestational diabetes
challenge
• No family history of • 1 step test: • Family history of
diabetes (especially in 100 grams glucose type 2 diabetes
parents) challenge mellitus

9. Low risk Medium risk High risk
• History of
gestational diabetes,
• Age < 25 years old glucose in urine or
glucose metabolism
disorder
• Normal birth weight
• No history of
abnormal glucose
metabolism
• Good obstetric
history

11. Diagnosis of gestational diabetes

12. Blood 100 grams glucose
Fasting < 95 mg/dL
1 hour < 180 mg/dL
2 hour <155 mg/dL
3 hour < 140 mg/dL
Normal glucose level after the 100 grams glucose challenge

13. Management

14. Diet
• A non-obese pregnant woman needs calorie
intake as much as 30 kcal/kg body weight/day.

15. Glucose level monitoring
• Daily glucose level monitoring reduces the
incidence of macrosomia

16. ~End of Slide~