Coronavirus COVID-19 and gestational diabetes - Instituto Bernabeu

As we know, pregnant women have been advised to self-isolate as a precaution simply because they are pregnant.

Question. Should the pregnant woman leave home isolation to go to a health center to perform the O’Sullivan Test?

Answer. NO.

Question. A pregnant woman with a positive O’Sullivan test. Should she leave isolation to go to a health center to perform the Oral Glucose Overload?

Answer. NO

 What should pregnant women do with regards to gestational diabetes?

Diagnostic tests are performed between 24-28 weeks, but the fetal pancreas is capable of responding to hyperglycemia, manufacturing insulin in a regulated manner from 28-30 weeks. Excess fetal insulin is the leading cause of problems as a result of gestational diabetes.

Given these reasons, and having not received specific instructions in this regard, at Instituto Bernabeu we recommend that patients DO NOT leave self-isolation to do these screening tests.

In HIGH RISK women: pre-gestational obesity, a family history of type 2 diabetes or a personal history of gestational diabetes in previous pregnancies, a healthy diet should be recommended (avoid sugars and fast acting carbohydrates ), dividing the nutrients into small, frequent intakes (breakfast-lunch-lunch-snack-dinner-snack before bed). Exercise can be added if there is no obstetric contraindication. At home, we can follow a gym schedule using, for example, YouTube videos or the like, about 10 minutes after main meals.

If this situation continues and pregnant women reach the 3rd trimester without screening for gestational diabetes, the ultrasound data will guide us to the diagnosis. Fetal macrosomia with disharmonic growth (predominance of growth of the abdominal circumference over other parameters such as length of the femur or biparietal diameter) and increased ILA (polyhydramnios), will require us to establish capillary blood glucose controls in addition to diet in case we need to add insulin to the treatment.

THESE RECOMMENDATIONS ARE SUBJECT TO CHANGE AS THE SITUATION EVOLVES

Dr Navarro, Endocrinology and Nutrition director of Instituto Bernabeu

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