A Mother’s Not-So-Sweet Story: Pregnancy diabetes

M was upset and looked at me in disbelief when I told her the not-so-sweet news. She had failed her glucose tolerance test (GTT) and had been suffering from gestational diabetes.

M, aged 34, and a first-time mum was at 24 weeks of gestation. “Doc, I have a sweet tooth.” She confessed. “I would indulge in cakes and ice-cream after my morning sickness was over. Would the high blood sugar affect my baby?” She then revealed that her mum was also diagnosed to have diabetes recently.

Gestational Diabetes Mellitus (GDM) is a condition in which a woman develops high blood sugar levels during pregnancy. It happens when the body does not produce enough insulin to effectively convert glucose to stored energy resulting in its build-up in the blood.

Gestational Diabetes Mellitus

It can affect any pregnant mother, but the following are the risk factors:

Obesity: BMI more than 25kg/m2

History of delivering a big baby (4kg and above)

Previous history of GDM

Aged 35 and above

Family history of diabetes

History of delivering stillborn

It is quite common in Singapore. According to a study published in 2018 by the Agency for Care Effectiveness at the Ministry of Health, one in five pregnant women tested had GDM, more than double the 9.2 per cent in the United States. Indian and Chinese mothers have a higher incidence than the Malay mums.

GDM can negatively impact a woman’s pregnancy and the health of the baby. If the diabetes is not well controlled, the mother can run the risk of having miscarriage, stillbirth and premature birth. After delivery, the diabetes usually goes away by itself. But in 10 % of the women who do not watch their diet and weight carefully, full-blown diabetes may occur within 5 years after childbirth.

GDM may affect the growth of the baby, who tends to be heavier than normal. The amniotic fluid that surrounds the baby may also be excessive. As a result, the baby could lie in an unusual position. Difficult delivery may be encountered and chances of caesarean section and instrumental delivery using forceps or vacuum are increased.

The newborns are also more prone to breathing difficulties (respiratory distress syndrome) and may suffer from low blood sugar (hypoglycemia) immediately after birth. They may develop obesity and diabetes later in life.

I advised M to exercise regularly, engaging in activities such as walking, yoga, Pilates or swimming.

I also referred her to the dietician who would advise her on how to plan her meals and the right types of food to eat.

She was also referred to the endocrinologist, a specialist doctor who treats disorders of the endocrine glands and hormones. Her blood sugar levels before and after meals were monitored regularly.

With diet control, M’s blood sugar levels remained normal. Her pregnancy progressed well with normal foetal growth. The amniotic fluid level was not excessive. Labour started spontaneously at 39 weeks of gestation and a healthy boy weighing 3.2kg was born by normal vaginal delivery.

Both M and her child had an uncomplicated postnatal course. At 6 weeks after birth, M had a repeat glucose tolerance test, which was normal. I emphasized to M the importance of living a healthy life style so that the chances of GDM in subsequent pregnancies would be mitigated.

Dr Peter Chew is a gynaecologist Singapore based in Gleneagles Medical Centre, Singapore. Read our next article on Endometriosis here!

Gynecologist is a doctor that specializes

What is a gynecologist? When to see one What to expect Screening Frequent processes Qualifications Gynecologists are doctors who specialize in women's health, with a focus on the female reproductive system. They deal with a broad selection of issues, including obstetrics, or pregnancy and childbirth, menstruation and fertility problems, sexually transmitted diseases (STIs), hormone disorders, and others. 

Back in Singapore, some girls prefer to go to a well-woman clinic rather than a family doctor for general health issues. The gynecologist may then refer the individual to another specialist. A qualified gynecologist has at least 8 years of training and needs to be certified by an examining body, such as the American Board of Gynecologists (ABOG) and registered by a professional organization, such as the American College of Obstetricians and Gynecologists (ACOG). Fast facts about gynecologists: Below are some key points about gynecologists. 

More detail is at the primary article. A gynecologist is a doctor that specializes in the health of the female organs. Many women start seeing a gynecologist from their early teens and continue to attend a well-woman clinic for overall health issues too. Girls are advised to pay a visit to a gynecologist yearly to get a checkup, and any time they have symptoms that concern them. A gynecologist should be licensed and registered with a professional body, like the American College of Obstetricians and Gynecologists (ACOG). What is a gynecologist? 

Gynecologists concentrate in women's health problems. A gynecologist treats patients using female reproductive organs, whether or not they identify as girls. To be a gynecologist, a person must train first as a physician for 4 years, then specialize for another four years in the specialty of obstetrics and gynecology. Passing a further examination will enable them to be certified and registered. 

When to see yet another A trip to the gynecologist is recommended for annual screening and any time a woman has worries about symptoms like pelvic, vulvar, and vaginal pain or abnormal bleeding in the uterus. Conditions commonly treated by gynecologists contain: Issues relating to pregnancy, fertility, fertility, and menopause family planning, including contraception, sterilization, and pregnancy termination Issues with tissues that support the pelvic organs, including tendons and ligaments STIs polycystic ovary syndrome Benign conditions of the reproductive system, for instance, ovarian cysts, fibroids, breast disorders, vulvar and vaginal ulcers, along with other adrenal alterations premalignant conditions, such as endometrial hyperplasia, and cervical dysplasia Congenital abnormalities of the reproductive tract 

Emergency care concerning gynecology Illness, a chronic condition which affects the reproductive system Pelvic inflammatory ailments, including abscesses Sexuality, including health issues regarding same-sex and bisexual relationships sexual dysfunction Gynecologists Singapore at the U.S. often offer both gynecological and general health care, including preventive medicine for girls and identification and treatment of issues like headache, lower back pain, mood changes, and acne. They may also cure: Asthma Psychiatric conditions like depression and personality disorders Cardiovascular disease Diabetes Thyroid disorders and other hormonal issues Domestic violence and sexual assault osteoporosis Preventive medicine may include lifestyle advice concerning issues such as smoking cessation and weight reduction. At what age can I visit a gynecologist? A gynecologist can treat a girl or a girl at any age. ACOG recommend beginning to visit a gynecologist in age 13 to 15 decades. 

Building a relationship with the doctor empowers a girl or woman to be more comfortable asking questions about menstruation, sexuality and so on, and gives a point of contact when symptoms occur in future. It also gives the physician a chance to guide a woman total welfare in the long run, through counselling on important health and lifestyle problems. 

Remain in the know. Get our free daily newsletter Expect in-depth, science-backed toplines of the finest stories every day. Tap in and maintain your curiosity satisfied. Enter your email Your privacy is important to us What to expect What occurs in the gynecologist's depends on the reason behind the visit and the person's situation. If it is a young woman's first trip, she may just have a chat with the doctor, get some general health advice, and Discover out what to expect in .

Where Treatment For Clinic Women ?

Dr Chew graduated from NUS in 1969 under Singapore State Scholarship and was awarded silver medallist for distinction in pathology. He obtained his specialist degrees in 1973 and subsequently joined the Department of Obstetrics & Gynaecology, as an academic staff member and continued his career as a Lecturer and later Senior Lecturer in the department. He did his doctorate thesis in reproductive endocrinology and was awarded the coveted Edgar-Gentilli Prize by the Royal College of obstetricians and Gynaecologists.

He set up the Endocrinological laboratory and collaborated with the World Health Organization for Standardisation of Laboratory Results. He has also been actively involved in the teaching and training of postgraduate doctors in the clinical management of sub-fertility, both locally and regionally. He has published more than 100 research papers in peer-reviewed journals, as well as contributed to local magazines and papers.

Dr Peter Chew is a resource speaker for many public seminars, TV forums and interviews. Dr. Chew’s clinical interests include molar pregnancy, initiation of labour, endocrinology of endometriosis, placental tissues, foetal membranes, umbilical cord, breast tissues, sperm and seminal fluid. His other clinical interests include management of Male Infertility, Male and Female Sexual Problems, Polycystic Ovarian Syndrome (PCOS) and Gynaecological Laparoscopy and Hysteroscopy (keyhole surgery).