A 41-year-old woman who had no previous history of diabetes was diagnosed with high blood sugar level by the glucose challenge test during the antenatal care and then transferred to the Department of Metabolism and Endocrinology. After discussing with her physician, the patient was advised to adjust her diet and control her blood sugar level by means of insulin injection. Her blood glucose level returned to normal after the delivery. Now the patient is still under continuous follow-up care. Guo Ya-wen, attending physician of the Metabolism and Endocrinology in the Zhongxing Branch of Taipei City Hospital, points out that gestational diabetes refers to those patients who have no previous diabetes history before pregnancy and are first diagnosed with high blood sugar level during pregnancy. The incidence rate in Taiwan is about 5 - 10%. Once diagnosed with gestational diabetes, the patients will become the high-risk group of Type II diabetes in the future. Dr. Guo says that the maternal hormones change during pregnancy and some hormones secreted from the placenta will increase insulin resistance. If the maternal insulin secretion can’t be compensated, expecting moms may suffer from gestational diabetes and develop complications, such as gestational hypertension, poly-hydramnios, infection and obstructed labor. And newborns may suffer from congenital malformation, oversize, neonatal hypoglycemia, respiratory distress syndrome, hypocalcemia, hypercythemia, jaundice and even death. When patients are diagnosed with gestational diabetes, their fasting blood glucose shall be controlled below 95mg/dL, 1-hour postprandial blood glucose below 140mg/dL and 2-hour postprandial blood glucose below 120mg/dL. Patients are advised to receive insulin injection in case of failure in achieving the required level. Usually the blood glucose level will go back to normal after the delivery, but patients shall still be subject to 75-g oral glucose tolerance test 6-12 weeks after the delivery, to confirm whether the blood glucose level is still abnormal. Dr. Guo reminds the public that more and more women suffer from gestational diabetes owing to the lifestyle changes and delayed age of pregnancy. The patients are advised to control the blood glucose well during pregnancy and monitor the blood glucose level continuously after the delivery, so as to discover Type II diabetes as early as possible.
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