Testing Pregnant Women for Gestational Diabetes

Gestational Diabetes refers to high blood sugar level that develops during pregnancy and usually disappears after giving birth. Even though it can occur at any stage of pregnancy, but is more common in the second half.

Gestational diabetes occurs when the body cannot produce enough insulin which helps control blood sugar levels for meeting the extra needs in pregnancy.

Guidelines of the Ministry of Health

The guidelines by the Ministry of Health and Family Welfare calls for testing, diagnosis and management of hyperglycaemia in early stages of pregnancy (during the first trimester) and if the test is negative, yet another test should be done between 24-28 weeks.

Study by the Diabetes in Pregnancy Study Group India

• It has become a necessity to test every pregnant woman be for high blood glucose even if no symptoms are exhibited.
• Primordial prevention at the earliest stage of development of the foetus is essential to prevent children from becoming predisposed to diabetes or other non-communicable diseases (NCD).
• Higher transfer of glucose to the foetus since the mother has high blood sugar results in the foetal pancreatic cells secreting insulin earlier and in higher quantities. Once initiated it becomes self-perpetuating
• If the maternal glucose reading is over 110 mg/dl, the amniotic fluid becomes glucose enriched. Hence after 20 weeks, when the foetus begins to swallow the amniotic fluid which further stimulates the production of insulin.

Oral glucose tolerance test (OGTT) is the most common test to ascertain gestational diabetes. A value of 140 mg/dl or more from the single reading of blood sugar two hours after the ingestion of 75 gm oral glucose solution is taken indicates GDM.