Diabetes and Pregnancy

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Diabetes and Pregnancy

  1. 1. Diabetes and Pregnancy
  2. 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. 3. How diabetes happen in pregnant woman?
  4. 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. 5. What does it mean for the mother and baby? Mother BabyDifficult normal delivery Macrosomia (birth weight > 4 kg)Birth canal trauma Congenital abnormalitiesIncreased risk of pregnancy-related Stillbornhypertension (pre-eclampsia)Increased risk of cesarean delivery Premature delivery Trauma related to difficult labor
  6. 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. 7. • Macrosomia is the most common complication of gestational diabetes, especially because of lipid metabolism disorder.
  8. 8. Is early detection for gestational diabetes possible? Low risk Medium risk High risk Check blood sugar level at Check blood sugar level asCheck blood sugar level 24th to 28th weeks of described for medium riskonly 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. 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 ofabnormal glucosemetabolism• Good obstetrichistory
  10. 10. Diagnosis of gestational diabetes
  11. 11. Blood 100 grams glucose Fasting < 95 mg/dL 1 hour < 180 mg/dL 2 hour <155 mg/dL 3 hour < 140 mg/dLNormal glucose level after the 100 grams glucose challenge
  12. 12. Management
  13. 13. Diet• A non-obese pregnant woman needs calorie intake as much as 30 kcal/kg body weight/day.
  14. 14. Glucose level monitoring• Daily glucose level monitoring reduces the incidence of macrosomia
  15. 15. ~End of Slide~

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