This document discusses diabetes in pregnancy. It defines gestational diabetes as high blood sugar that develops during pregnancy and usually disappears after giving birth. The document outlines risks of gestational diabetes to both mother and baby, including difficulties during labor, risks of obesity and type 2 diabetes later in life for the baby. It also discusses screening, diagnosis via glucose tolerance tests, and management of gestational diabetes through diet, exercise and possibly medication.

2. Diabetes in Pregnancy
Diabetes is a condition in which the amount of glucose
in the blood is too high (hyperglycemia) as a result of
limited or no insulin production.
About (2 to 10 %) of pregnant get gestational diabetes.
The ideal range of glucose for pregnant should be:
- 70 to 100 mg/dL before meals.
- Less than 120 mg/dL two hours after eating.

3. On Mother:
• Eye and kidneys problems.
• Difficult labor and cesarean delivery due to large baby.
• Having a miscarriage (The end of pregnancy before the
24th week).
• The gestational type; increase the mother risk for
developing type 2 diabetes later.
Diabetes Effects:

4. On Baby:
• Large baby over 4 kg (macrosomia).
• Fetus congenital abnormalities (specially heart and nervous
system abnormalities).
• Stillbirth baby or dying soon after birth.
• The baby become at risk for obesity and type 2 diabetes later in
life.
• Low blood sugar (hypoglycemia).
• Newborn with health problems shortly after birth (such as heart
and breathing problems) and needing hospital care.
• Asphyxia (Lack of oxygen in the body).
• Polycythemia (Elevation in red blood cell count).
• Birth injury related to macrosomia.
Diabetes Effects:

5. Large weight newborn (right)
Comparing to normal newborn (left)

6. 1. Type 1 diabetes
2. Type 2 diabetes
3. Gestational diabetes.
Classification
Pre-gestational diabetes

7. • Type 1 diabetes develops when the body
can't produce any insulin.
• It usually begins in childhood, and most
women with type 1 diabetes will be aware of
their condition before they become
pregnant.
• People with type 1 diabetes need to take
insulin to control their blood glucose.
1- Type 1 diabetes:

8. • Type 2 diabetes develops when the body can't
produce enough insulin, or when the insulin that
is produced doesn't work properly.
• It often occurs in obesity people and is usually
diagnosed in women aged 40 or over. But it can
happen at a younger age, too.
2- Type 2 diabetes:

9. Type 1 diabetes controlled by insulin.
Type 2 diabetes can usually be treated with:
• Sugar tablets to lower blood glucose
• Well planned diet
• Regular exercising
• Some pregnant women require insulin injections.
Pre-gestational Diabetes Management:

10. • Gestational diabetes only occurs in pregnancy
and goes away after the baby is born.
• It can occur at any stage of pregnancy, but is
more common in the second 20 weeks.
• It occurs when the pregnant body can't produce
enough extra insulin to meet the extra needs of
pregnancy.
• Gestational diabetes usually has no symptoms.
3- Gestational diabetes mellitus (GDM):

11. • Overweight mother
• Family history of diabetes
• Woman who had given birth to a large baby, weighing more
than 4.5kg before.
• Woman who had gestational diabetes before
• Ethnic group of diabetes; (South Asian, black Caribbean,
Hispanic or African)
• Woman who had unexplained stillbirth
• Over 35 years mother
• Mother with high blood pressure.
Risk factor of Gestational Diabetes

12. • The diabetes screening and tests are ideal in
second trimester.
• It is important because symptoms of gestational
diabetes are uncommon.
• Women with high risk should start the tests earlier in
first trimester.
• If the blood screen is abnormal; we do (glucose
tolerance test) between 24 and 28 weeks of
pregnancy to check for gestational diabetes.
Gestational Diabetes Screening

13. A normal result for the glucose screening test is a blood sugar
that is ≤140mg/dL 1 hour after drinking the glucose solution. If
the result is not normal; we do Oral Glucose Tolerance Test
(OGTT):
1. Do the test first before the pregnant eat or take any thing.
2. Give a pregnant a liquid that contains (100 gram) of
glucose.
3. Test the blood after 1 hour, then 2 hours, then 3 hours.
4. If more than 1 of the blood glucose results is higher than
normal, this mean the pregnant have gestational diabetes.
Glucose Tolerance Test (GTT)

14. Abnormal readingInterval
95 mg/dl or higherFasting (for 8 hours)
180 mg/dl or higher1 hour
155 mg/dl or higher2 hours
140 mg/dl or higher3 hours
Abnormal blood values for 100 gram oral glucose
tolerance test (OGTT)

15. Often gestational diabetes can be controlled through:
• Eating a healthy diet:
− Reduce sugar, salt, fat, simple carbohydrate
− Increase fibers, minerals, vitamins, omega 3
• Exercising regularly.
• Insulin injection and diabetes pills (Glyburide and
Metformin) in some cases
Gestational Diabetes Management:

16. • Most women with gestational diabetes; the
diabetes goes away soon after delivery. If it
does not go; that is mean the mother
developed diabetes type 2.
• All women with diabetes in pregnancy should
be offered an appointment with a doctor at the
postnatal check, around six weeks after the
baby is born.