What exactly is gestational diabetes? Is it the same as a patient with diabetes becoming pregnant?

Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes.

To understand gestational diabetes we need to understand what diabetes is. In simple terms diabetes is a condition where the glucose level in blood is higher than normal because the body cannot use it properly. All of us have an organ called pancreas in our abdomen which makes a hormone called insulin. Insulin is the key that unlocks the door to the body’s cells. Once the door is unlocked glucose can enter the cells where it is used as fuel. Diabetes develops when we either make too little insulin or the insulin we are making is not working properly.

Gestational diabetes is a type of diabetes that arises during pregnancy usually around 24 to 30 weeks. Gestational diabetes occurs when the body cannot produce enough insulin to meet the extra needs of pregnancy.

How common is gestational diabetes?
Although in USA it happens in about 4 % of all pregnancies, in India about 15% of all pregnancies may develop this condition.

What exactly causes gestational diabetes?
We do not for sure as what causes gestational diabetes but there are a few theories. The placenta supports the baby inside the uterus as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother’s insulin in her body. This leads to the glucose level to rise in the mother`s blood.

Which groups of women are more likely to develop gestational diabetes?
The risk factors for developing gestational diabetes include
• Obesity
• Family history of diabetes
• Large baby in the previous pregnancy (> 4.5 kg)
• Gestational diabetes in previous pregnancies.
• Unexplained stillbirth in the previous pregnancy.

How do we diagnose gestational diabetes?
This is done by two blood tests: one fasting and the second two hours after ingestion of 75 grams glucose by talking blood from a vein. A fasting glucose value of > 126 and/or a two hour post 75 grams glucose value of 140 imply that there is gestational diabetes.

How can gestational diabetes affect the baby?
The high blood glucose levels in the mother`s blood reaches the baby and as a result the baby gets more energy than it needs to grow and develop and this extra energy is stored as fat. This can lead to macrosomia, or a “fat” baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. The newborn may also have very low blood glucose levels at birth.

How do we treat gestational diabetes?

Treatment for gestational diabetes aims to keep blood glucose levels equal to those of pregnant women who don’t have gestational diabetes. It may also include daily blood glucose testing. Often blood glucose levels can be controlled by diet .If blood glucose levels cannot be controlled by diet alone then insulin may be needed.

Does it go away after the baby is born?
It does go away in most cases. The diabetes treatment is stopped after delivery. However, to be sure the mother should have blood tests (fasting glucose and glucose level two hours after 75 grams glucose) about two months after delivery.

Women with gestational diabetes have a 30% risk of developing diabetes during their lifetime. Healthy diet and maintaining appropriate weight for height may prevent progression to diabetes later in life.

While gestational diabetes is a cause for concern, the good news is that you and your diabetologist, gynaecologist and dietitian can work together to lower your high blood glucose levels. And with this help, you can turn your concern into a healthy pregnancy for you, and a healthy start for your baby.

Thousands of people could benefit from a new operating technique which is believed to halve the pain normally associated with open-heart surgery.The so-called mini-bypass is done through a cut in the chest which is three times smaller than usual.By causing far less trauma to the patient, surgeons say the recovery time is significantly reduced.

Within a day of the operation, patients can begin their recovery on paracetamol instead of the morphine painkillers they would usually need.Because the hospital stay is so short and the drugs bill so low, the operation is a third of the cost of a normal bypass.

The technique is currently done in just six surgical centres around the world. But its advantages are so great that it is expected to be rapidly adopted by other hospitals.

Recently Sky News was  there to  film the procedure at the Fortis Hospital in Bangalore. The patient was Abayomi Adebayo, a Nigerian man who travelled 5,000 miles to India because he was determined to have the mini-bypass.

He said: “With a smaller cut and a good rate of early recovery, it is far better for me. I am looking forward to seeing my children and grandchildren.” Cardiac surgeon Dr Mohammed Rehan Sayeed made a cut just 8cm (3ins) long in the lower part of Mr Adabayo’s chestbone.

Usually the incision would have to be 24cm (9ins) long, resulting in pain every time patients breathe.With a much smaller cut in the sternum, Dr Rehan had to carefully manipulate the heart until the diseased artery was directly below the hole.

He re-routed the blood supply to Mr Adebayo’s heart muscle through the mammary artery, which lies close by, and a transplanted section of artery from the lower arm.

Dr Rehan said patients leave hospital in as few as three days instead of seven, are back at work in two weeks instead of four, and are able to drive after one month instead of three.

He said: “What really pushes them to work quickly is the fact they don’t have pain. They can get up and walk the next day and not realise they have had some surgery done to them.

“I think it is the future of heart bypasses. If you can give the patient something that is less painful, then why not.”

Health Check Up  Package at Fortis Hospitals,Anandapur,

BASIC HEALTH CHECK

Physician consult

Complete Haemogram with ESR ( Hb TC,DC )

PVC,MCH,MCH ,Platlet

Blood Glucose Fasting and PP

Total Cholesterol

Creatinine

SGPT

Urine Routine

Xray Chest

USG Abdomen with Pelvis

ECG

MASTER HEALTH CHECK ( MALES – 20-40 )

Physician Consult

Complete  Haemogram with ESR (hb,TC,DC,PCV,MCH,MCH Platelet

Bloof Group and Rh Type

Blood Glucose fasting and Post Prandial

Kidney profile

Blood  Urea Nitrogen

Creatinine

Uric Acid

Lipid Profile

Cholesterol Total

Triglyserides

HDL Cholesterol

LDL Cholesterol

LDL Cholesterol

Total Cholesterol

HDL Ratio

Liver  Function tests

Total Bilurubin

SGOT

SGPT

CGTotal Protein Albumin

Globulin Ratio

Alkaline Phosphatase

Urine  Routine

Stool Routine

ECG

Chest Xray PA view

Ultrasound Abdomen

Nutritionist  Consult

Pulmonary Function Tests

MASTER HEALTH CHECK( MALES 40 TO 50 YEARS)

Physician consult

Complete Haemogram  with ESR( Hb,TC,DC,PCV,MCH,MCHC Platelet

Blood  Glucose  and Rh Type

Blood Glucose Fasting and Post Prandial

Kidney profile

Blood Urea

Creatinine

Uric Acid

Lipid Profile

Cholesterol Total

Triglyserides

HDL Cholesterol

LDL Cholsterol

Total Cholesterol

HDL Ratio

MASTER HEALTH CHECK UP ( MALES OVER 50 YEARS )

Physicial consult

Complete Haemogram with ESR ( Hb,TC,DC,PCV,MCH,MCHC,Platelet

Blood Group  and Rh Type

Blood Glucose Fasting and Post Prandial

Kidney profile

Blood Urea

Creatinine

Uric Acid

Lipid Profile

Cholesterol Total

Triglyserides

HDL Cholesterol

LDL Cholsterol

Total Cholesterol

HDL Ratio

Liver  Function tests

Total Bilurubin

SGOT

SGPT

CGTotal Protein Albumin

Globulin Ratio

Alkaline Phosphatase

Urine  Routine

Stool Routine

ECG

Chest Xray PA view

Ultrasound Abdomen

One Additional Referral

Nutritionist Consult

Pulmonary Function Tests

Stool for occult Bloof

Cardiac Treadmill test

Serum Calcium and Phosphorus

Prostatic Specific Antigen(PSA)

Special Consultation If req

MASTER HEALTH CHECK ( females -20 to 40 )

Physician Consult

Complete Haemogram with ESR( Hb,TC, DC, PCV, MCH, MCHC,Platelet

Blood Group and Rh type

Blood Glucose Fasting and

Post Prandial

Kidney Profile

Blood Urea Nitrogen

Creatinine

Uric Acid

Lipid profile

Cholesterol Total

Trigyleceride

HDL cholesterol

LDL Cholesterol

Total Cholesterol

HDL ratio

Liver Function Tests

Total Bilirubin

SGOT

SGPT

GGT

Total  Protein Albumen

Globulin Ratio

Alkaline phosphatase

Urine Stool

Stool Routine

ECG

Chest XRay PA View

Ultrasound  Abdomen

Nutritionist Consult

One Additional referral

Specialist consult if required

PAP Smear

Breast Examination/Pelvic Examination

Gynaec Consultation

** Mammography  Optional

MASTER HEALTH CHECK ( Females  over 40 years)

Physician Consult

Complete Haemogram with ESR( Hb,TC, DC, PCV, MCH, MCHC,Platelet

Blood Group and Rh type

Blood Glucose Fasting and

Post Prandial

Kidney Profile

Blood Urea Nitrogen

Creatinine

Uric Acid

Lipid profile

Cholesterol Total

Trigyleceride

HDL cholesterol

LDL Cholesterol

Total Cholesterol

HDL ratio

Liver Function Tests

Total Bilirubin

SGOT

SGPT

GGT

Total  Protein Albumen

Globulin Ratio

Alkaline phosphatase

Urine Stool

Stool Routine

ECG

Chest XRay PA View

Ultrasound  Abdomen

Nutritionist Consult

One Additional referral

Specialist consult if required

PAP Smear

Breast Examination/Pelvic Examination

Pulmonary Function Tests

Serum Calcium & Phosphorus

Stool For Occult Blood

Gynaec Consultation

** Mammography  Optional

WELL WOMAN HEALTH CHECK UP

Physician Consult

Complete Haemogram with ESR( Hb,TC, DC, PCV, MCH, MCHC,Platelet

Blood Group and Rh type

Blood Glucose Fasting and Post Prandial ( PP )

Total Cholesterol

Creatinine

SGPT

TSH

Urine Routine

Xray Chest

USG  Abdomen with pelvis

ECG

Gynaec Consultation

Breast Examination

PAP Smear

COMPREHENSIVE  HEART

Physician Consult

Complete Haemogram with ESR( Hb,TC, DC, PCV, MCH, MCHC,Platelet

Blood Group and Rh type

Blood Glucose Fasting and

Post Prandial

• Kidney Profile

Blood Urea Nitrogen

Creatinine

Uric Acid

• Lipid profile

Cholesterol Total

Trigyleceride

HDL cholesterol

LDL Cholesterol

Total Cholesterol

HDL ratio

• Liver Function Tests

Total Bilirubin

SGOT

SGPT

GGT

Total  Protein Albumen

Globulin Ratio

Alkaline phosphatase

Urine  Routine

Stool Routine

ECG

Chest Xray PA View

Ultrasound Abdomen

Nutritionist  Consult

Pulmonary Function test

GUIDELINES FOR   USERS FOR HEALTH CHECK

• Kindly take prior appointment at least 24 hours in advance between 9.30am to 6.00am
• The approximate time for the completion of the health check up package is  6 to 8 hours. Patients are requested to report for registration at the allocated time
• We can provide additional tests/investigations procedures/ at request . However these will be billed separately
• Patient files will be given along all reports. You should bring these files on all subsequent visit at Fortis Hospitals
• A special Breakfast planned by our dietitian  will be provided  which is included in our package.
• Men are requested to shave off their chest  to ensure good  ECG/Treadmill results
• Blood and urine samples  are collected as fasting samples therefore patients are advised  to report in the morning with 12 hours fasting  and complete  abstinence of drinking alcohol
• Please be advised  for certain tests like X Ray as it should not be performed if you are pregnant

Contact Numbers: 24 Hours emergency

Health Check Up: 66284300

Help Line: 6628 4444

Cardiac Consultancy : 6628 4400

Neuro Science/  6628 4100

Radiology :6628 4200

Nephrology 6628 4200

730 Anandapur ( Near Kolkata International school)

EM Bypass Road, Kolkata 107

Email for Enquiries: enquiries@Fortishospitals.in

For appointments log on to http://www.fortishospitals-kolkata.com/ or call  6628 4300 ( prefix 033 if calling from another state)