For pregnant mothers, gestational diabetes is one of the complications that they should be worried about during the pregnancy as it would affect both the mother and the baby. Here we have Dr Muhammad Azrai Abu, Obstetrician and Gynaecologist from UKM Medical Centre to help us understand more about gestational diabetes in this episode of AskMeDoctor! Season 2. Q1: What is gestational diabetes? Photo Credit: Freepik Dr. Azrai: Gestational diabetes means diabetes during pregnancy. So, what happens to every pregnant woman; there are hormonal changes. The changes will lead to insulin resistance, whereby this insulin is needed for the turning of your diabetes, your hormones in your body and in order for the glucose to be stable in your body or any woman's body.\u00a0 Whenever you are pregnant, there will be a high risk of developing diabetes. National Data provided us in the year of 2014, around 10%-15% of women are at higher risk of diabetes mellitus when they go into pregnancy. Q2: What are the causes of gestational diabetes? Dr Azrai: It is just hormonal changes. Because the main hormone that majority of the pregnant women will discrete is human placental lactogen. So this hormone will create an environment that is suitable for any woman to be diabetic during pregnancy. You just need some monitoring for you to be diagnosed. Once the diagnosis is already made, then we will give you some medication to control the problems.\u00a0 The occurrence of this gestational diabetes is during the 2nd and 3rd trimester. Around 24 weeks to 28 weeks. That is why the process is called 'minum air gula' or the glucose test screening.\u00a0 Q3: Who is at risk for diabetes during pregnancy? Photo Credit: Freepik Dr Azrai: This glucose testing will be indicated for a certain lady, which are:\u00a0 \tOver 25 years of age \tPre-pregnancy obesity \tHigh levels of glucose in the urine \tMaternally inherited diabetes \tDiabetes during a previous pregnancy \tPreviously delivered a baby weighing 4kg\u00a0 These are all risk factors which we can actually need for an early screening programme for this diabetes. So we can actually intervene before any problems like macrosomia, baby weight or your glucose is incontrollable or else, a lot more complications is going to happen.\u00a0 So, is it important to diagnose early and be prepared for it? Yes! And we have a proper plan for you in order for any complications to arise to the mother or to the baby itself. Q4: What are the complications that may affect the mother? Photo Credit: Freepik Dr Azrai: The first thing is to the mother. The mother is at a higher risk to develop hypertension; especially because these two come together. These diseases always come in a package, and therefore, we need to do some screening.\u00a0 That is why nowadays, for any diabetic mother, we are more prone to give some kind of medication we call Aspirin or Antiplatelets to prevent the occurrence of hypertension.\u00a0 This is also to ensure that the disease is not to be earlier in terms of the occurrence. This is one of the prophylaxis measurements that the majority of clinicians and doctors give to current women when they have diabetes. And then, the other thing is they are prone to have a preterm birth. Because when you have diabetes, you are prone to get infections; a\u00a0majority of women get urinary tract infections, vaginal infection and they are prone to get preterm birth. Risk and Effects of Gestational Diabetes include: \tProne to get an infection, \tUTI (Urinary Tract Infection), \tVaginal Infections,\u00a0 \tPreterm birth When the baby is actually bigger, the mother is more prone to get cesarean section operative delivery. Of course, later on in the future, what will force these women whenever they have already gone through the postpartum or subsequently, in the long term, they will get diabetes type two or other kinds of diabetes subsequently and also cardiovascular disease. Q5: What can one do to prevent this health issue? Dr Azrai: There is no exact mechanism that can prevent gestational diabetes mellitus. But, we totally know that obesity in pregnancy is one of the risk factors.\u00a0 So, for the majority of pregnant women who are at risk of gestational diabetes mellitus, they will need to have individualized medical nutritional therapy by a nutritionist which includes close monitoring of gestational weight gain. Initiatives Pregnant Women Can Do To Prevent GDM: \tPractice healthy eating habits \tConsume the appropriate amount of calories \tManage sugar intake \tExercise regularly\u00a0 \tAround 20-30min daily\u00a0 First of all, the diet recommended by the nutritionist is already a nutritional diet, and we will advise on regular exercise too.\u00a0 Whenever you are pregnant, it is normal that you are encouraged to do exercises for at least 20 to 30 minutes every day. So, these are some of the ways that you can try to make sure that you are not in the obese group, which will lead you to all kinds of abnormal changes during your pregnancy.\u00a0 \tUnderweight - 13-15kg \tIdeal Weight - 11-16kg \tOverweight - 7-11kg \tObese - \u22647kg\u00a0 There is a certain limit of weight gain that needs to be achieved. If you are obese, then you will need to only gain a maximum of seven kilos throughout your pregnancy journey.\u00a0 So, whenever you exceed the limits of the weight gain, it can lead to a higher risk of developing a lot of complications.\u00a0 One of the complications is diabetes mellitus or hypertension itself. So, these are the ways that we can actually help any pregnant woman.\u00a0 Q7: If one is already diagnosed with diabetes even before getting pregnant, what should she do? Photo Credit: Freepik Dr. Azrai: For this category, the majority of them are under a proper follow-up. Before you embark on pregnancy, someone who is known as an Endocrinologist will need to monitor you.\u00a0 So, you will be on certain medications. They will have optimum numbers like control of their glucose level need to be adjusted accordingly with the medications. Then we can allow you to embark on the pregnancy. You should have this pre-pregnancy counselling so that we can have good control before anything happens.\u00a0 If the endocrinologist or the doctors from your medical side approve that you can embark on the pregnancy, only then you can continue with it. A lot of complications would happen because of the glucose overload during the early phase, where the development of the baby brain, baby spine, and cardiovascular. You are ending up with a lot of complications to the babies. You might also have a baby with birth defects. The easiest way is just to control the diabetes beforehand.\u00a0 Photo Credit: Freepik Another main problem with the majority of pregnant women diagnosed with diabetes beforehand is that they would always stop their medications because they said the medications will make the baby abnormal. This is totally a wrong thing to do. Because the uncontrolled glucose load is the main problem, not because of the medication that you take. So, please continue to take the prescribed medications that you have been taking and please have proper pre-pregnancy counselling.\u00a0 And do not stop any medications on your own just because you want to save your baby from getting any problems. Always seek doctor\u2019s advice before you stop any medications or even start any new medications. Again, I will always advise every pregnant woman to enjoy every moment of her pregnancy journey. Do not stress yourself so much.\u00a0 Do not make yourself anxious unnecessarily. Just enjoy the moment. As advised by Dr Muhammad Azrai, one of the many ways to have a healthy pregnancy is by practising healthy eating habit. https:\/\/www.youtube.com\/watch?v06bYfn_a4v8 For pregnant mothers, it is good for you to supplement yourself with a good maternal milk like Similac\u00ae Mom to support your pregnancy. Certain nutrients, particularly during the early stages of pregnancy, provide a strong foundation for better growth and brain development. Why Similac\u00ae Mom? Similac\u00ae Mom is a low-fat maternal supplement designed for mothers who are pregnant or breastfeeding. It is made with Eye-Q\u00ae Nutrition System, Natural Vitamin E, and Lutein to keep DHA from oxidising while supporting your little one's growth and brain development before birth. \tContains 23 vitamins & minerals to help meet increased nutritional needs. \tSupports better sugar management during pregnancy. \tHas the lowest fat content to support better weight management during pregnancy, and post-delivery weight loss for breastfeeding moms. Similac\u00ae Mom meets your daily calcium and folic acid requirements with only two servings! It also gives your child the nutrients he or she needs to grow and develop properly. Stay tuned for our next episode of Ask Me Doctor! regarding your pregnancy with Similac\u00ae Mom. Meanwhile, don't forget to visit Similac\u00ae Mom's official website and Facebook.