Gestational Diabetes melliatus

GESTATIONAL DIABETES MELLITUS
(GDM):

It is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy (especially during third trimester). In other word, glucose intolerance that is first recognized during pregnancy is classified as GDM.

Pathophysiology of GDM:

•       Pregnancy hormones and other factors are thought to interfere with the action of insulin

•       Insulin resistance prevents glucose from entering the cells properly.

•       As a result, glucose remains in the bloodstream, where glucose levels rise.

•       More insulin is needed to overcome this resistance; about 1.5-2.5 times more insulin is produced than in a normal pregnancy.

Classification:

•       According to White classification, GDM(type A) can be distinguished from diabetes that existed prior to pregnancy (pregestational diabetes).

These two groups are further subdivided according to their associated risks and therapy.

The two subtypes of gestational diabetes (diabetes which began during pregnancy) are:

•       Type A1:

                Oral glucose tolerance test (OGTT)-Abnormal

                2-hour Postprandial Glucose-Normal

                Therapy-Diet modification

•       Type A2:

                OGTT –Abnormal

                2-hour Postprandial Glucose level- Abnormal

                Therapy- Insulin