DIABETES A MAJOR HEALTH PROBLEM ESPECIALLY IN PREGNANCY

Abstract

Prevalence of type 2 diabetes has significantly increased in last two decades globally. Developing countries are affected more and more then 80% of the rise is seen in these countries. More then 60% of the affected population lives in southeast Asia and Pakistan. We have seen this increase especially in younger population. Predisposing factors are urbanization, Dietary Preferences, sedentary lifestyle, envoirmental pollutants and so on Some of the studies have included stresses and sleep disturbances. Impact of this increase in type 2 diabetes is seen in pregnancy as well Here it is not only the increasing age of pregnancy and epigenetics but decrease in muscle mass, central obesity and insulin resistance are the predisposing factors n mother. Hormones of the pregnancy further increase the insulin resistance and leads to diabetes in pregnancy. Multiple complications of these are seen in both mother and fetus. It includes miscarriages, recurrent infections, large for dates babies, intrauterine deaths, difficult deliveries and increase in caesarean section rate. N e w b o r n b a b i e s c a n h a v e p r o b l e m s o f hypoglycemia, electrolyte disturbance and jaundice Inutero envoirment and epigenetics can lead to long term problems in these babies in the form of diabetes hypertension and cognition problems Now is the high time we address these problems of type 2 diabetes in general population and expectant mothers specially. We have to change our life style, make exercise essential part of our life. Change our diet from refined carbohydrates and animal fat to more vegetables, fruits and roughage containing diet. Refined and polished rice and sugar containing beverages has to be decreased. We need to help expecting mothers to decrease stresses of life and improve sleeping habits. We feel that diabetes screening should be universal rather then selective in pregnant woman at 24 to 28 weeks of pregnancy in our country. These ae some of the measures we need to adopt to follow WHO's globally agreed target to halt rise in diabetes and obesity by 2025. We also need these measures to protect our next generation