Tuesday, August 30, 2011

Are you a Diabetic Mom???

This month out of 20 patients whom I delivered , 3 were Diabetics on Insulin and 2 had a Gestational diabetes controlled on Metformin.We as Asians are more prone to diabetes.Our eating habits have changed drastically, not for good and Pregnancy itself is a diabetogenic state.India for sure is the diabetic capital of the world.
So ,what do we do?Should we panic.Not really.......but yes it needs a lot of commitment from the mom to be herself as well as the doctors taking care of her.One of these ladies who is a Insulin dependent diabetic shared with me that when she met an Obstetrician after she tested positive for pregnancy,the doctor gave her a horrified look.This lady had a mildly raised blood pressure and deranged thyroid function too.She was told that it was a very high risk pregnancy with a high probability of complications.That scared this lady and she ultimately landed under my care.
I do agree that these pregnancies complicated by medical conditions are challenging for physician and patient alike but it isn't some thing to panic about.Patients need to be realistic in accepting the condition and comply to what their doctor advises.At the same time we as a doctor  need to make the patients aware of complications of possible uncontrolled condition without scaring them.It is a fine balance between telling the truth and make it sound scary.
And how can I leave my all time favourite topic....Cesarean vs Vaginal delivery.......It never means that if you have diabetes you need to have Cesarean for sure.
Most of the Obstetrician have special interest in high risk pregnancy,but as a patient choose your doctors carefully,comply to their advise and I am sure you and your baby will be fine :))

Monday, August 22, 2011

The St Vincent Declaration

Representatives of government health departments and patients’ organisations from all European countries met with diabetes experts under the aegis of WHO Regional Offices for Europe and the International Diabetes Federation (IDF), European region, in St Vincent, Italy on 10–12 October 1989. They unanimously agreed on the following recommendations and urged for their implementation in all countries throughout Europe.
“Diabetes mellitus is a major and growing European health problem, a problem at all ages and in all countries. It causes prolonged ill-health and early death. It currently threatens at least ten million European citizens.
It is within the power of national governments and health departments to create conditions in which a major reduction in this heavy burden of disease and death can be achieved. Countries should give formal recognition to the diabetes problem and deploy resources for its solution. Plans for the prevention, identification and treatment of diabetes and particularly its complications – blindness, renal failure, gangrene and amputation, aggravated heart disease and stroke – should be formulated at local, national and European regional levels. Investment now will earn great dividends in reduction of human misery and in massive savings of human and material resources

It was also one of the major concerns of st vincent Declaration that Diabetic Mom's should have same pregnancy outcome as others.

Recently I have found a sudden increase in number of patients and who need Insulin for blood sugar control during Pregnancy.With the combined effort of our Diabetologist and their team,it is heartning to see that these ladies have the same outcome as a non diabetic mom. 

Rare and interesting.........Ectopic Pregnancy in Rudimentary Horn of Uterus

Ectopic Pregnancy in left Rudimentary horn.
There was congenital abscence of tube and ovary on that side

Rudimentary horn removed laparoscopically.Methylene blue dye coming out of Cornual opening

Removed rudimentary horn with ectopic pregnancy