Gestational diabetes has long-term effects in mother and baby

Pregnant women should be alerted to be on the lookout for gestational diabetes, which occurs when the body cannot make enough insulin during pregnancy.
The risk is higher if one is overweight with a Body Mass Index of over 30, has already had a baby weighing more than 4.5kgs, was diabetic in a previous pregnancy, or has parents whose siblings are diabetic. Asians, Middle Easterners, Africans or people from the Caribbean are also more pre-disposed to this diabetes. Diagnosis is done by checking blood sugar levels during pregnancy. If the woman have the identified risk factors, it's done early in pregnancy, and routinely in the later months.
If blood glucose levels are too high, the risk to the foetus could be the baby growing too big, increasing the risk of long labour, C-section, birth injuries and still-birth. The baby produces more insulin and can have low glucose levels after birth. Its future risks include obesity and diabetes.
Pregnant women are instructed to monitor blood sugar levels at home. During delivery, if sugar levels are well-controlled, labour will be induced between 39 and 40 weeks. If sugar control is poor, the baby is large and water around the baby is increased, labour will need to be induced after 38 weeks. Normal delivery is possible if the baby's weight is average, while large babies have to be delivered by C-section. Women with gestational diabetes also have a 1 in 3 chance of developing Type 2 diabetes within 5 years.
(Dr Josephine Jose is consultant obstetrics, head of the Gynaecology Department at International Modern Hospital in Dubai)