Gestational Diabetes at 21 weeks.

[ckanand]

My wife (33 years old) recently had an early abortion at 21 weeks (first pregnancy), after she unwillingly leaked out a large amount of Amniotic liquid, which was diagonized as due to a rupture owing to gestational diabetes. The D.C read: G2 A1 at 21+ 1 weeks with PPROM with cord prolapse with GDM on diet with Hypothyroidism with retained products following expulsion of POG, came with c/o leaking PV since 2 days. Able to percieve FM well.
OBH: ML-2 years, G1-MTP at 4 weeks, G2-PP spontaneous conception.
Past History: Known case of Hypothyriodism (on tab Thyroxine 125 mg). Paternal Grandmother diabetic. Maternal father diabetic.
After 100+ hours of hospitalization, contractions had begun and the fetus was aborted after a 6 hour induced labor.
Blood Sugar tests on admission showed: Glucose Tolerance 1st sample 204 mg/dl, 2nd sample 200 mg/dl, 3rd sample 117 mg/dl.
I wanted to know if the next pregnancy, which she wants to conceive in the next 6 months, will lead to any further complications. Also, I was very eager to validate the above diagnosis and any and all hidden information that you could derieve out of it. Please let me know about all precations to be taken, here onwards.
A little more background: My wife is 5' 3" and about 20% overweight. Her medical record had been eventless so far. She has a generally active lifestyle, but nothing particular in Exercize other than general striding.
Please davise if any more information is required from my end in this regard. I am anticipating your response with high regards.
Thanks,
Anand C K Shashidhar, Bangalore, India.

[JDRF-Team-LRS]

Hello Anand,
I'm so sorry to read about your & your wife's unsuccessful pregnancy.  I'm sure it's been an emotional time for you both.

We're volunteers here and not medical professionals, so you & your wife do need to work with her doctors for specific guidance.

Most of the results you report are beyond anything I know about and I'm sorry that I can't comment on them for you.  If your wife has a tendency toward Type 2, her doctors may recommend that she become more physically active and that she get into the normal weight range.  Many folks with Type 2, or with borderline diabetes, can avoid symptoms by taking those steps.  I'm not sure if there are ways to avoid Gestational Diabetes, but physicians who specialize in high risk pregnancies should likely be consulted.

Good luck.

[JDRF Team SGG]

From what I have read about gestational diabetes, it is a problem with the body's hormone changes causing insulin resistance while the woman is pregnant. Insulin resistance is made worse by having an excess of fat cells, which are also insulin resistant. So losing a few pounds may help your wife prevent a recurrence of the gestational diabetes condition. It is suggested that a woman maintain excellent glucose control in the first few months of a pregnancy, for this is the time when the baby's cells are developing and the baby is the most vulnerable to damage. Again, at the end of the pregnancy, is another critical time when the mother's glucose levels should be kept as normal as is possible.

The best thing your wife can do to prevent problems if she does become pregnant again is to work very closely with her doctor, starting even BEFORE she becomes pregnant, to keep her glucose levels as normal as possible. Now that she knows that gestational diabetes is a danger, she can be tested earlier and hopefully can be treated earlier so she can have  a healthy pregnancy.

I am a diabetic, and I have two healthy children. So it is possible to have healthy babies. I wish you and your wife the very best.

[ckanand]

Thank you all so much.
Every bit of advise is like a prayer for us now, and I am sure your kind words matter positively.

Anand C K Shashidhar