Diabetes rise in pregnant women causes concern over birth defects

All pregnant women who attend the Corniche Hospital are to be screened for gestational diabetes because the disease is becoming more prevalent. Although there are no figures for the prevalence of the blood sugar disorder, which occurs only in pregnant women, doctors say patient numbers are on the increase. "I'm surprised by the number of pregnant ladies who come to me with diabetes," said Dr Prakash Pania, a specialist endocrinologist at Aster Medical Centre in Dubai. "I'm almost running a parallel antenatal clinic in the morning for pregnancies with gestational diabetes." Dr Pania follows strict screening guidelines issued by the International Association of the Diabetes and Pregnancy Study Groups. "The more stringent you are in the diagnostic criteria, the more patients you pick up," he said. The Corniche Hospital plans to introduce screening for all pregnant women - whether they are at risk or not - as a means of controlling the condition from an early stage. Dr Gowri Ramanathan, a foetal medicine specialist and consultant obstetric gynaecologist, said: "We're moving towards having universal screening for all our pregnant women only because diabetes is very prevalent." The symptoms of gestational diabetes - frequent urination, lethargy, and excessive thirst - are also symptomatic of a normal pregnancy, making the condition difficult to diagnose. However, left untreated, it can lead to severe birth defects. "If diabetes goes undiagnosed, or if a diabetic lady conceives with uncontrolled blood sugar, then we can expect some congenital anomalies in the baby such as birth defects, spinal cord defects, and certain organs may not be well developed," said Dr Pania. Women with high blood sugar levels may also have larger babies, which can complicate delivery. "Most of the time gynaecologists don't wait for the full 40 weeks; they deliver at maybe 38 weeks by c-section," Dr Pania added. Dr Ramanathan said every pregnant woman was at risk of contracting gestational diabetes, but factors that increased the risk included being overweight, having a history of diabetes in the family, and having previously given birth to a large baby. The condition can be managed, predominately through diet. The dietician Lubna Surya said that, contrary to the popular saying, pregnant woman should not be eating for two. Women participating in an average amount of activity require about 1,800 calories a day. This amount is also sufficient for women in their first trimester, she said. Women in their second and third trimester needed to add 300 and 450 calories per day, respectively. While the blood sugar levels of most women return to normal immediately after delivery, further monitoring is required. Patients should be checked six weeks after the birth of their child, and then on an annual basis thereafter, said Dr Pania. "They could be potential diabetics in the future."