Diabetes

Gestational Diabetes

Gestational Diabetes Mellitus (GDM) is glucose intolerance first diagnosed during pregnancy, typically in the second or third trimester. Dr. Rashmi Bastakoti, Nepal's leading high-risk pregnancy specialist with 25+ years of experience, provides comprehensive GDM management at GyneNepal, Kathmandu. Affecting 6-9% of pregnancies, GDM results from insulin resistance caused by pregnancy hormones. Dr. Rashmi has successfully managed over 1,200 GDM pregnancies, ensuring healthy outcomes for mother and baby. Her multidisciplinary approach combines dietary management, glucose monitoring, and insulin therapy when needed. Early detection through universal screening prevents complications like macrosomia, birth injuries, and neonatal hypoglycemia. Most women return to normal glucose levels after delivery, but 50% develop type 2 diabetes within 10 years. Serving Kathmandu, Lalitpur, Bhaktapur with expert GDM care.

Warning Signs & Symptoms

⚠️Usually asymptomatic (detected by screening)
⚠️Increased thirst (polydipsia)
⚠️Frequent urination (polyuria)
⚠️Fatigue and tiredness
⚠️Blurred vision
⚠️Recurrent infections (yeast, UTI)
⚠️Excessive fetal growth (large baby)
⚠️Increased amniotic fluid (polyhydramnios)

Common Causes

🔍Insulin resistance from pregnancy hormones
🔍Placental hormones (hPL, cortisol, progesterone)
🔍Obesity and overweight (BMI >25)
🔍Advanced maternal age (>35 years)
🔍Family history of diabetes
🔍Previous gestational diabetes
🔍PCOS and metabolic syndrome
🔍Ethnicity (South Asian, Hispanic higher risk)
🔍Previous large baby (>4kg)
🔍Sedentary lifestyle

Diagnostic Tests

Universal screening at 24-28 weeks gestation
Glucose Challenge Test (GCT): 50g glucose, 1-hour value
Oral Glucose Tolerance Test (OGTT): 75g or 100g glucose
Fasting glucose ≥92 mg/dL
1-hour glucose ≥180 mg/dL
2-hour glucose ≥153 mg/dL
Early screening if high-risk factors present
HbA1c not recommended for GDM diagnosis

Treatment Options

💊Medical nutrition therapy (first-line treatment)
💊Carbohydrate counting and portion control
💊Self-monitoring blood glucose (fasting and postprandial)
💊Target: Fasting <95 mg/dL, 1-hr postprandial <140 mg/dL
💊Regular physical activity (30 min daily)
💊Insulin therapy if diet fails (10-20% of cases)
💊Metformin (alternative to insulin in some cases)
💊Fetal monitoring: Growth scans, NST, BPP
💊Delivery planning (timing and mode)
💊Postpartum glucose testing at 6-12 weeks

Recommended Specialist

Dr Rashmi Bastakoti

Dr Rashmi Bastakoti

MBBS, MD (Obs & Gyne), Fellowship in Reproductive Medicine (Nepal)

25 years
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Contact Information

📞
Phone
+977 9700682797
📧
Email
info@gynenepal.com
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Location
Dillibazar Pipalbot, Kathmandu
Hours
Mon-Sat: 8 AM - 6 PM