Onm-2: Gestational Diabetes

Background: Gestational diabetes mellitus (GDM), a common medical complication of pregnancy, is defined as “any degree of glucose intolerance with onset or first recognition during pregnancy. Risk factors for GDM: a previous GDM or prediabetes, a family history revealing a first degree relative with type 2 diabetes, maternal age(>35 y), ethnic background, being overweight, a previous pregnancy which resulted in a child with a high birth weight and PCOS. Scientific evidence is beginning to show that controlling glucose levels can result in less serious fetal complications (such as macrosomia) and increased maternal quality of life.GDM can be managed through healthy dietary steps, regular exercise and, in some cases, medication. The amount of calories, carbohydrate and other nutrients that patient need depends on several factors: weight before pregnancy, current weight gain, current physical activity level and blood glucose level. The aim of this study is investigation of risk factors of GDM and assay the number of patient who controlled with diet. Materials and Methods: Our study subjects were 60 patients who offered to Nutrition Clinic in Royan Institute during 12 months, diagnosis of GDM based on glucose challenge test (GCT) (with 50 g Glucose) and then confirmed with glucose tolerance test (GTT) (with 100 g Glucose) in 24-28 weeks of pregnancy. Colorie diet calculated based on the weight of the patient in pregnancy and patients followed up for controlling diet with phone call after 1week . The combination of each diet: 45 to 65 percent of daily calories from carbohydrates, including vegetables, fruit and grains,15 to 25 percent of daily calories from protein and 20 to 35 percent from fat for improved blood sugar management. Results: Among 60 patients with GDM visited in Nutrition Clinic. The cause of infertility were: 36.7% PCOS, 31.66% male factor,5% Tubal factor, 13.33% recurrent abortion,1.6% hypo-hypo, 10% unexplain, 1.6% POF. Approximately 70% of patients with GDM controlled with diet only & 30% controlled with diet along with insulin injection. It should be considered that 68%0f patient with GDM were obese. From PCOS patients with GDM, about 63.7% patients had BMI over 25. 72.8% PCOS patients with GDM controlled with diet. The most of patients who controlled with diet, were PCOS patients. Conclusion: PCOS and obesity are most important risk factors for GDM and many of patients with a good diet, self monitoring of blood Glucose can controlled in 2/3 of patients. We recommend overweight and obese patients who want to be pregnant should be reached the appropriate weight before pregnancy.