Gestational diabetes mellitus - which occurs when a pregant woman who’s never had. diabetes before develops high blood sugar levels during pregnancy, affects about …
The Diabetes in Pregnancy Program At St Lukes-Roosevelt Hospital There are short-term and long-term complications, for both mother and child, of gestational diabetes mellitus GDM Although there is debate among the medical community about how to approach and treat GDM and a lack of resources and treatment programs in certain areas of the country, the ob/gyn department at Roosevelt Hospital is committed to addressing what they consider a disease and they are doing so through the Diabetes Pregnancy Program at the hospital Gestational diabetes mellitus - which occurs when a pregant woman whos never had diabetes before develops high blood sugar levels during pregnancy, affects about 4 percent of all pregnant women - about 135,000 cases in the US each year However, in New York City, the rate may be a little higher because GDM is a condition that is more common among Hispanic, African American and Asian women Although rarely lifethreatening, untreated or poorly controlled GDM can have major immediate and longterm health consequences for both mother and baby Its been long been recognized that the offspring of women with diabetes during pregnancy are more likely to be macrosomic translated
as: big babies, making birth trauma for mom more likely Several well-founded studies in the journal Diabetes and the Journal of Pediatric Endocrinology Metabolism found that the weight and height of these offspring are excessive during the latter stages of gestation and also during childhood and early adulthood Because of the extra insulin made by the babys pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes So, women who go through a pregnancy with uncontrolled diabetes are literally breeding a whole new generation of babies who are already genetically at a disadvantage and at risk of developing the condition Equally as troubling is that many women who have gestational diabetes mellitus go on to develop type 2 diabetes years later A well-known 1991 study published in the journal Diabetes and subsequent such studies have reported a link between the tendency to have GDM and type 2 diabetes The goal of the maternal fetal medicine MFM specialist high-risk obstetrician at most hospitals is to normalize
blood glucose levels during pregnancy to avoid these complications However, the Diabetes Pregnancy Program at Roosevelt Hospital in NYC is unique in their structure and in how they approach a GDM pregnancy Rather than simply normalizing blood glucose levels, the goal at Roosevelt Hospital is to recreate normal - meaning the MFMs attempt to normalize everything about the pregnancy, including, but not limited to, the blood glucose levels Unlike other hospitals where GD moms are often induced early and encouraged to have c-sections, we work with our moms to normalize them so they can carry their baby to term, avoid C-section and if low-risk enough, can even deliver in the hospitals Birthing Center where pain medication and fetal monitoring arent used When Oded Langer, MD, a world-renowned and published expert on diabetes pregnancy, joined Roosevelt Hospital as the Chairman of Ob/Gyn in 2000, he attracted a knowledgeable cluster of doctors who have expertise and interest in diabetes during pregnancy That same year, he published a paper in the NEJM December 2000 about the efficacy of oral anti-diabetic medications Glyburide rather than insulin injections and Roosevelt Hospital became
one of only 2
hospitals in the country to routinely employ this method of medication delivery Today, oral anti-diabetics are endorsed by all the major hospital centers and professional organizations These oral medications allow patients to more easily take part in the management of their condition The Diabetes Pregnancy Program experts collaborate on patient cases and care and have created a concentrated program that addresses all the needs of gestational diabetes patients The physicians - Louis Brustman, MD, Barak Rosenn, MD, and Oded Langer, MD, work side-by-side with a nutritionist and a specialized diabetes nurse educator who encourage moms-to-be to take an active role in their healthcare and diabetes monitoring Monitoring GDM is no easy feat - it involves adhering to a strict diet and scheduled eating, testing sugar levels up to 7x/day via finger pricking to draw blood, exercising moderately but regularly and sometimes taking daily medication either orally or through an injection Since gestational diabetes patients have to be monitored by their doctor on a regular basis every week or two depending on severity, the program is set up so that all GDM patients come in on the
same day for routine testing and monitoring In addition to the specialized medical attention they receive at these visits, theres a comraderie that often develops among these women, who have to deal with their pregnancy in a completely different way than most of their friends
Source:hispanichealth.org
