Home' Trinidad and Tobago Guardian : May 20th 2015 Contents A28
Guardian www.guardian.co.tt Wednesday, May 20, 2015
Be Healthy NOW!!!
Be Fit not Fat
have been in the uterus in an environment where there
was high insulin because the mother s glucose levels
were high, again, the baby would be producing insulin
right after birth. Which is why we need to check the
blood glucose levels in that baby, as they tend to drop.
Those children are more at risk to develop diabetes
and also more at risk to become obese and suffer heart
disease in their later life.
What are the symptoms?
This is one of the main problems. The majority of
women who are already gestational diabetics exhibit
no symptoms. So it s very difficult to tell without per-
forming the necessary tests.
Is there treatment?
Before we talk treatment, I want to go back a bit,
because I want to make a call to our population. As
a university professor I think it is important for edu-
cation. Women in this country and in many other
countries need to start planning their pregnancies.
In so doing, they can ensure that they are in the
best state of health before they embark on a pregnancy.
So if the woman is, say, obese, it would be a good
idea for her to start exercising and dieting to lose some
weight in order to improve her overall health prior to
Most of our pregnant population seek antenatal
care during their pregnancy, but we still lack a proper
system---a universal method of screening for diabetes
In the past, the common method was to test urine.
But this method is so inaccurate; in fact, it can be
dangerous. Because a woman might have very high
blood glucose in her pregnancy and may not spill any
glucose in her urine. On the contrary, another woman
might have normal blood glucose, she is not diabetic,
but she may pass glucose in her urine. So to use glucose
in the urine as a screening test for gestational diabetes,
one has to be extremely careful.
There are other methods of screening, like a random
blood glucose test and a sample is taken regardless of
when you had your last meal. That is very difficult
to interpret, except if the value is extremely high; then,
and only then, can you determine that the person is
What I recommend is the 50 gram glucose challenge
test. With this test, it doesn t matter when you had
your last meal. The steps are simple: you just go to
your doctor or clinic, you are given the glucose which
will be diluted in about 200ml of water. In my research,
I found because glucose in water is associated with
terrible nausea and vomiting, many women regurgitate
it on contact.
I did a study where it was decided to place a small
amount of lime juice in the water as well. This worked
and 99 per cent of our population accepted the test.
This test is recommended to be administered during
the period of 24-28 weeks for low risk women. But
for the woman who is very high risk, she must do
this test earlier.
Currently the gold standard test is the glucose 12-
hour fasting test, which requires the patient to fast
overnight. They are given a 75 gram glucose drink in
the morning and a test is done in one hour after the
drink, and another the following two hours. But this
requires a fair amount of patient preparation, as well
as having three blood tests taken. And if you have to
do it privately, obviously there is a cost. And in the
lab, it means it s more labour intensive. It is easy, less
hassling and still effective to do the 50 gram glucose
test. However, when I do those tests, if they come
back abnormal, I will then send that patient off for
that oral glucose tolerance test or OGTT.
Now when we diagnose diabetes, of course, many
woman become quite anxious about how they devel-
oped it and the risks involved. And I think our pop-
ulation needs to be very much aware that we are very
high-risk for diabetes---not just diabetes in pregnancy,
but diabetes generally.
From my studies, I would think at least 20 per cent
of our population would have gestational diabetes.
Which means one in every five women. If you don t
screen these women, you would not pick it up, and
hence we are going to have problems.
It is also important for the population to be aware,
once diabetes is diagnosed in pregnancy early enough,
that there is good treatment and the outcome could
be excellent, provided, of course, there is good patient
• In tomorrow's conclusion, Dr Bassaw speaks
more about treatment and long-term care for moth-
What are the symptoms
Most women who have gestational
diabetes never suffered with
diabetes before getting pregnant.
From Page A27
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