Maternal risks of GDM include- polyhydramnios, pre-eclampsia, prolonged labour, obstructed labour, cesarean section, uterine atony, postpartum hemorrhage, infection and progression of retinopathy which are the leading global causes of maternal morbidity and mortality.
Fetal risks include – spontaneous abortion, intra-uterine death, stillbirth, congenital malformation, shoulder dystocia, birth injuries, neonatal hypoglycemia, and infant respiratory distress syndrome. Long-term clinical effects of GDM are important contributors to the burden of non-communicable diseases in many countries.
Can GDM be controlled ?
With early diagnosis and management, Gestational diabetes mellitus and the complications associated with it can be prevented and controlled.
How can I manage gestational diabetes
- Physical exercise- Keeps you active, fit and controls sugar level.
- Medical nutritional therapy (MNT) – Healthy eating practice
- Eating small meals, but frequently throughout the day
- Fasting or missing meals should be avoided.
- Selecting carbohydrates carefully – Complex carbohydrates ( like whole-grain cereals like oats, bajra, jowar, ragi, whole pulses, vegetables, and fruits with skins ) should be preferred over simple carbohydrates like food with lots of added sugar or honey, or foods that are made from refined white flour. Some examples of simple carbohydrates include sweets, cakes, puddings, sweet biscuits, pastry, juice, soft drinks, chips, white bread, naan, pizza, etc.
- Follow a low-fat diet – reduce the intake of saturated fats (sources – ghee, butter, coconut oil, palm oil, red meat, organ meat, full cream milk, etc).
Ways to trim the fat from your diet
- Use less fat in cooking and avoid frying of foods.
- Using low-fat dairy products in place of whole milk or full cream products.
- Choosing low-fat snacks like substituting fresh fruit, salads, baked and steamed food items for high-fat snacks such as cakes, biscuits, chocolates, pastries, samosas, and pakoras, etc.
- Using lean meat in place of red meat.
- Intake of high fibre diet – High fibre foods especially soluble fibre may help control blood sugar by delaying gastric emptying, retarding the entry of glucose into the bloodstream and lessening the postprandial rise in blood sugar. Soluble fibre in flax seed, psyllium husk, oat bran, legumes (dried beans of all kinds, peas and lentils), and pectin (from fruit, such as apples) and forms in root vegetables (such as carrots) are helpful.
- Taking at least 3 serving of proteins foods everyday to meet the increased demands. Sources of protein are milk and milk products, egg, fish, chicken, pulses (dal), nuts etc.
GDM is managed initially with MNT and physical exercise and if it is not controlled with MNT (lifestyle changes), Metformin or Insulin therapy is added to the MNT.