Gestational diabetes mellitus (GDM) is a type of diabetes that affect one in five pregnant women in Singapore. In most cases, GDM develops in the middle or towards the end of one's pregnancy.
Should I be screened for GDM?
Generally, all pregnant women will be screened for GDM at 24 to 28 weeks of their pregnancy. You could be screened earlier if you have any of the following risk factors:
• Body mass index (BMI) > 25kg/m2
• Previous baby > 4 kg at birth
• History of GDM
• Known prediabetes
• Family history of diabetes
• 40 years old and above
How will I be tested?
GDM is diagnosed using an oral glucose tolerance test (OGTT). You are required to fast from the midnight before the test (only plain water is allowed). The next morning, you will do a fasting blood sugar test, following which you will be required to drink a glucose drink within 5 minutes. Your blood will then be taken at the 1-hour and 2-hour interval.
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How does GDM affect my baby and me?
Normal blood sugar level is essential for healthy pregnancies and babies.
Abnormal blood sugar level can result in the following:
• your baby growing bigger than average. A big baby increases the chance of injury during delivery as the baby’s shoulder may be stuck in the pelvis.
• your baby has a higher chance of a low blood sugar level or jaundice after birth.
• you having a higher chance of developing high blood pressure during pregnancy, preterm birth, needing induced labour or caesarean section, and stillbirth (death of baby in the womb).
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How is GDM treated?
Healthy eating and exercise can help you to manage GDM and optimise your blood sugar.
A dietitian will work with you on a personalised eating plan. You will learn to have well-balanced meals to support your pregnancy, and advice on carbohydrate amount and portion sizes.
Most pregnant women can exercise safely, such as walking or swimming 30 minutes on most days. You may wish to discuss with your doctor to see if such exercises are suitable for you.
Do I need medication for GDM?
You may need injectable insulin if your blood sugar levels are not within targets with diet and exercise.
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How do I monitor my blood sugar?
You will need to purchase a glucometer to monitor your blood sugar level. The diabetes care nurses will advise
you on:
• blood sugar monitoring
• frequency of blood sugar monitoring (typically 7 tests a day, 2 to 3 days a week or more if required)
• blood sugar targets
• recording and reporting of blood sugar readings and food intake
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What happens after delivery?
You are required to do an OGTT 6 to 12 weeks after delivery to determine if the abnormal blood sugar levels have resolved or persist after delivery.
Women with a history of GDM have a higher risk of diabetes later in life. You can prevent diabetes by adopting a healthy lifestyle, i.e. healthy diet, active lifestyle and healthy body weight. You are advised to go for diabetes screening once every 1 to 3 years.
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