Gestational Diabetes Mellitus is defined as Carbohydrate intolerance during Pregnancy. It is difficult to stabilize the blood sugar during pregnancy due to altered Carbohydrate metabolism and impaired insulin action. The insulin antagonism is probably due to the combined effect of human placental lactogen, oestrogen, progesterone, free Cortisol and degradation of the insulin by the placenta. Nausea and vomiting in early pregnancy and infection if not promptly and effectively treated may lead to Ketosis.
Uncontrolled Diabetes during the first three months of Pregnancy increases the risk of abortions and congenital malformations in the foetus. Elevated blood sugar should therefore be adequately controlled by dietary means and treatment with insulin even before conception.
Elevated maternal blood glucose level has a direct effect on the increased susceptibility of the foetus developing diabetes later. Monitoring Blood glucose level especially during the 20 to 24 weeks (2nd Trimester) and staggering the meal plan or medication if required. Pregnant women or insulin therapy need individualized carbohydrate-controlled recommendations.