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Diabetes during pregnancy on the rise in UAE
Gestational diabetes is usually asymptomatic
In the UAE, that number is unfortunately higher, with studies showing that one in three women will develop gestational diabetes.
One in three women in the UAE will develop diabetes during pregnancy, said experts ahead of World Diabetes Day being marked today. This year, the day has been dedicated to 'Women and Diabetes: Our right to a healthy future'.
According to the International Diabetes Federation (IDF), one in seven births worldwide is affected by gestational diabetes, or diabetes during pregnancy.
In the UAE, that number is unfortunately higher, with studies showing that one in three women will develop gestational diabetes. So, it is imperative that women be educated on the risks of developing the condition during the most sensitive period of their life, said Dr Mariam Georgette Awatai, consultant, obstetrics and gynecology at Burjeel Hospital, Abu Dhabi.
Gestational diabetes is usually asymptomatic. "The symptoms may be very similar to normal pregnancy signs like excessive urination, food cravings, thirst, or weight gain, among others," she said. It is therefore important to universally screen all pregnant women for gestational diabetes, at 24 to 28 weeks of pregnancy, irrespective of symptoms and signs, she added.
According to Dr Mariam, obesity before conception or excessive weight gain during pregnancy are two of the key risk factors for gestational diabetes. "Other risk factors include previous delivery of an infant with a high birth weight (over nine pounds) and a history of polycystic ovary syndrome (PCOS)."
Gestational diabetes can also lead to complications for both the mother and the baby, along with increasing the child's chances of type 2 diabetes later in life. "It also increases chances of the mother delivering via a caesarean section and the probability of the infant being born large for its gestational age," she added.
Depending on the condition of the mother, the child too has a higher chance of having type 2 diabetes in later life. Thus, gestational diabetes can have severe consequences for the mother and the child. But if the mother is treated throughout the pregnancy period, those risks are reduced.
"Excessive weight gain in early pregnancy can be a key indicator too, and looking after the weight, blood pressure, and cholesterol levels before and during pregnancy is key to preventing gestational diabetes," said Dr Mariam.
"If the mother is obese, reducing her weight before conceiving is very important."
But regardless of risk factors, every pregnant woman must be screened between 24 to 28 weeks of pregnancy for gestational diabetes. For women who do develop diabetes during pregnancy, chances are that their diabetic condition may last even after delivery or in their next pregnancy.
"Therefore, women should start controlling their weight soon after giving birth, as this will help reduce the risk later in life and even reduce the risk of developing gestational diabetes in the next pregnancy."
The incidence of gestational diabetes worldwide is estimated to be 9.2 per cent, according to Dr Rita Nawar Tobias, endocrinologist at the Weight Care Clinic, Dubai HealthCare City.
"In the UAE, however, it is estimated that between 28 to 37 per cent women, both locals and expatriates, get it. Untreated or poorly controlled gestational diabetes or sugar levels that stay too high for too long, can hurt the baby and the mother," she said.
With gestational medicines, the pancreas works overtime to produce insulin, but the insulin does not lower the blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do and affect the baby growing in the womb.
"Extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to produce extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat," added Dr Rita.
This can lead to macrosomia, or a 'fat or big' baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth, jaundice, and pre-term birth.
Because of the extra insulin made by the baby's pancreas, many 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," she added.
UAE to launch device to fight type II diabetes
The UAE will be the first country in the world after the US Food and Drug Administration (FDA) to introduce a device to treat high blood sugar type II.
Dr Amin Hussein Al Amiri, assistant undersecretary for public policy and licensing at the Ministry of Health and Prevention (MOHAP), said that the move comes under the ministry's plan to combat the risks associated with diabetes and provide the patients with latest global treatment systems.
The UAE was the second or third country in the world to register or include these drugs within its services.
The new medicine is a small titanium device and is placed under the chest's skin for both men and women. It contains a micro pump that injects a daily dose regularly and lasts up to six months, and is expected to reach up to a period of 12 months in mid-2018.
What you need to know about diabetes
Types of diabetes
Type 1 diabetes - (Insulin-dependent or childhood diabetes) - When your body can't produce enough insulin.
Type 2 diabetes - (Adult onset diabetes) - When your body produces insulin but cannot use it properly. Type 2 is a preventable form of diabetes.
Pre-diabetes: A warning sign
- > Pre-diabetes is when your blood sugar is high, but not high enough to be diagnosed as diabetes. It is also called borderline diabetes.
- > Almost everyone with type 2 diabetes had prediabetes first - but most didn't know it.
- > Pre-diabetes can be treated, even reversed with lifestyle modifications! There are certain conditions which you can change, like unhealthy diet, extra weight and lack of physical activity. However, there are other risk factors, like your age and family history which you cannot modify.
Preventing and managing type 2 diabetes starts with a healthy lifestyle
Exercise regularly: Do at least 150 minutes of moderate physical activity (i.e. brisk walking) every week
Control high blood pressure and cholesterol - to reduce the risk of diabetes and its complications
Maintain a healthy body weight
Eat healthy - Include more fibre: whole grains, fruits, vegetables, dry peas and beans. Reduce saturated fats, salt (sodium and added sugars)
Avoid tobacco use: Smoking doubles the already high risk of heart disease among diabetic people
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