Dr Bernadette Carr answers your questions on diabetes and psoriasis
Gestational diabetes or a raised blood sugar in pregnancy (impaired glucose tolerance) is a condition that develops during pregnancy when the body is not able to make enough insulin. It usually develops during the third trimester (after 28 weeks).
The lack of insulin causes the blood sugar level to become higher than normal. This usually resolves shortly after delivery but some will remain diabetic. It is estimated that gestational diabetes occurs in two- to five-per cent of all pregnancies. Symptoms include:
* Tiredness.
* Having a dry mouth and feeling thirsty.
* Frequent need to pass urine.
However, not all pregnant women will experience any symptoms.
The chances of developing gestational diabetes increase with:
* Increasing age.
* High body mass index before pregnancy (threefold risk for obese women).
* Smoking doubles the risk.
* Changing in weight between pregnancies — an inter-pregnancy gain of more than three units (BMI) doubles the risk.
* Short interval between pregnancies.
* Family history of type 2 diabetes or gestational diabetes.
Many women worry about weight gain during pregnancy and the weight gain will vary as every woman’s body will respond differently to pregnancy.
It will also depend on your pre-pregnancy weight. For women with a normal pre-pregnancy weight, a weight gain of 10-12.5 kg over the pregnancy is associated with the lowest risk of pregnancy complications.
It is very important to be as healthy as possible starting pregnancy so you should have a healthy diet, keep to an ideal weight and take regular exercise.
When you become pregnant, it is important that your GP and obstetric team is aware of your family history so do advise them of this and they can screen you for diabetes. They will be able to reassure you and to monitor you throughout your pregnancy.
I am a woman in my forties. Recently I noticed some red scaly patches on my scalp. There is a family history of psoriasis and I wonder if I should visit my GP or see if the patches fade.
Psoriasis is a common skin condition which causes inflammation of the skin; patches of red, scaly skin.
Our skin is made up of layers of skin cells, the top layer of cells gradually sheds and new cells are constantly being made in the lower layers to replace the shed top layer, this would usually happen normally over the course of 28 days.
In people with psoriasis the turnover of cells is faster and this leads to a build up of cells on the top layer which form flaky patches on the skin, sacral area, over the skin of knees and elbows or scalp.
The skin underneath the patches is usually red as small blood cells widen and increase in number.
The patches tend to be on the elbows, knees and lower back. Patches may also appear on the scalp but scalp psoriasis can occur alone in some people. It commonly develops between the ages of 15 and 40 years and more than one family member may have the condition.
Although the reason for flare-ups is unknown, they are more likely in the following circumstances:
* Stress.
* Infection, for example a sore throat.
* Some medicines are believed to aggravate the condition.
* Smoking.
* An injury to the skin.
* Alcohol.
* Exposure to sunlight my cause a flare-up in some people.
* Some medications.
The severity of the condition also varies from mild to severe with some people having a few small patches and others large widespread rashes.
With your family history, getting a diagnosis is important so I would advise you to make an appointment with your GP, who will advise on the appropriate management.
