25th July 2024, A/Prof Chee L Khoo
The current gold standard for screening for gestational diabetes mellitus (GDM) for women with no risk factors for hyperglycaemia is an oral glucose tolerance test (OGTT) at 24-28 weeks’ gestation. Women with risk factors are recommended to have an OGTT in the first trimester. Unfortunately, many women are nauseous during the first trimester and performing an OGTT during that time can be very unpalatable.…
24th October 2021, Dr Chee L Khoo
Last fortnight we explored the disease burden in patients who have high lipids from a very young age and the effect on their future cardiovascular risk. This consideration allows us to think about who should be aggressively treated and whom we can just safely watch, at least for a few years. It would be nice to be able identify who we should screen for high lipids from a young age so that we can start lifestyle measures early.…
30th May 2021, Dr Chee L Khoo
Obesity and GDM are the most common clinical risks in obstetric practice increasing the probability of a variety of pregnancy related complications compared to women with a normal BMI and normal glucose tolerance. These complications include pregnancy induced hypertension (PIH), emergency caesarean sections (EMCS), pre-eclampsia (PE), post-partum haemorrhage (PPH), large-for-gestational age infants (LGA) and macrosomia.…
12th October 2020, Dr Chee L Khoo
We know from various diabetes prevention programs that intensive lifestyle interventions can be successful in reducing progression to diabetes. As GDM is more common in women with higher BMI and in the many high- risk groups and it is logical to ask the question “can we prevent GDM in these women?” If we could reduce progression of patients who has prediabetes to diabetes, we should, in theory, reduce prevalence of GDM in women who are at high risk of GDM.…
8th November 2018, Dr Chee L Khoo
When there is so much talk about gestational diabetes (GDM), you can’t help but think that just about every pregnant woman has GDM in south west Sydney (SWS). After all, if you look at the “high risk” group that you ought to be screening for GDM, there is hardly any woman in SWS that is not in the high risk category.…
April 2018, Dr Chee L Khoo
Another day, another study published on the good or bad about metformin use in pregnancy. There is a lot of confusion and unknowns about the benefit or safety of metformin to the mother-to-be or to the long-term outcome of the baby. When there is a lot of conflicting data coming our way, we need to sit back and look at the overall picture of hyperglycaemia in pregnancy and its management before we can make sense of these studies.…
March 15, 2018 Dr Chee L Khoo
Hyperglycaemia during pregnancy has significant metabolic consequences for the mother, the pregnancy as well as for the offspring’s future health. It is tempting to assume that keeping the glucose lower during pregnancy must be beneficial for both parties. Metformin has been used in women with PCOS, GDM and obesity during pregnancy in an attempt to improve pregnancy and foetal outcomes but this practice is not based on solid scientific evidence.…