GESTATIONAL diabetes mellitus (GDM) poses health risks for pregnant Filipinas, many of whom were unable to seek usual prenatal care because of lockdown restrictions.
“During this COVID-19 [coronavirus disease 2019] pandemic, pregnant patients had restriction to mobility because of the lockdowns as well as access to healthy foods. These factors have seemingly contributed to the increased the number of pregnant women with GDM during this period,” said Theresa Marie V. Faller, endocrinologist at the World Citi Medical Center, in an e-mail to BusinessWorld.
GDM is defined as the presence of a glucose abnormality, usually elevated blood glucose levels, first recognized in the second or third trimester of pregnancy and caused by insulin resistance, or the state by which the body does not respond well to insulin.
Risks for the baby include growing too big, which increases their chances of obesity and diabetes during childhood, and pre-term birth, which can result in breathing difficulties.
As for the mother, GDM may increase risk of high blood pressure as well as preeclampsia (characterized by hypertension, proteins in the urine, and swelling of both legs) that can threaten the lives of both mother and baby, Dr. Faller added.
The Philippine Statistics Authority reported that diabetes mellitus was the fifth leading cause of death across the country, accounting for 6.3% of total deaths from January to November 2021, an increase of 22.4% from the same period a year before.
Though it’s unsure how many Filipino pregnant women suffer from GDM due to lack of local studies on the matter, past surveys by the Asian Federation of Endocrine Societies Study Group on Diabetes in Pregnancy in 1996 and University of Santo Tomas Hospital in 2009 have shown a prevalence of 14% and 7.5% respectively.
Unfortunately, the implications of GDM don’t get much attention since it only occurs for a small part of the population, said Dr. Faller.
For 25-year-old expectant mother Sherielou Flores, the tough part of having GDM was the need to change her diet and regularly monitor her blood sugar.
“I wanted to avoid unnecessary medical interventions while giving birth, so I worked towards controlling my condition so I would not need medications such as insulin,” she said via e-mail. Her doctor had said too much insulin would not be safe for childbirth.
Aside from frequent urination, fatigue, and weakness, Ms. Flores shared that her own child’s safety fueled much of the fear she felt during her complicated pregnancy.
Technology was what helped her manage her health and access necessary services.
“It positively impacted the way I addressed my condition, from tracking blood glucose levels, monitoring stress levels, to observing carbohydrate intake. Mobile health applications like the mySugr app helped me learn more about my condition,” she said.
Dr. Faller, who recently studied Asian pregnant women’s progress in blood glucose control after six months of their use of mobile health applications, found that data management is indeed key to personalized diabetes care.
“This enables GDM patients to share that information with the caregivers and physician for further consultation and adjust their treatment plan for a better and personalized diabetes care,” she explained.
Even after delivery of the baby upon which GDM is resolved, the patient may still suffer repercussions later on, like developing type 2 diabetes and other related conditions. This is why monitoring is essential in long-term treatment, according to Dr. Faller.
“Managing diabetes today is starting to get easier and that’s what we want for our patients,” she said. — Brontë H. Lacsamana