Diabetes mellitus in pregnancy

Abstract

Pregnancy is a diabetogenic state due to rise of anti insulin hormones like human placental lactogen, steroids, progesterone and glucagon. In pregnancy normal values for fasting blood sugar level and post meal blood sugar level are less than normal population by approximately 10-20 mg/dl. Universal screening is advocated for all women at 24/28 weeks. Those with high risks should be screened at initial visit and then at 24/28 weeks. Diagnostic values have changed over period of time. Pregestational diabetic patients should ideally be on insulin therapy before planning pregnancy. Long term follow up of gestational diabetes mellitus patients is must. This patient should undergo glucose tolerance test after 6 weeks of delivery and once in a year thereafter. Management of diabetes mellitus in pregnancy is a team approach.