WEIGHING IN ON GESTATIONAL DIABETES
Q: Why should I start my pregnancy at a healthy weight if I’m just going to gain weight anyway? A: Vanessa answers: Gestational diabetes particularly affects women who are overweight or obese. Women should consider losing excess weight before falling pregnant, but if this isn’t the case, eating sensibly during pregnancy can go a long way to reducing the risk of gestational diabetes. Most gestational diabetes occurs in women with risk factors for type 2 diabetes. They’re unable to secrete sufficient insulin to overcome the increased insulin resistance that normally results as pregnancy proceeds. Gestational diabetes affects about one in seven births, and may persist as type 2 diabetes or “pre-diabetes”, or resolve completely when the pregnancy is over. Women who have had gestational diabetes are at an increased risk for developing type 2 diabetes later in life. A further often unappreciated fact is that children whose mothers had diabetes during their pregnancies have a greater likelihood of becoming obese during childhood and adolescence and of developing type 2 diabetes later in life. The number of women being diagnosed with gestational diabetes is increasing around the world, so finding simple and cost-effective ways to prevent women developing it is important. The rule of thumb is to choose healthy living during pregnancy. A healthy body means a stronger body, which will not only benefit the baby while in utero, but will also assist during the birth and recovery thereafter. Healthy living means eating properly, exercising regularly and doing away with bad habits such as smoking. Limit your intake of sugar and processed food, and opt for a variety of real, whole foods. Gestational diabetes may end after the baby is born, but women with gestational diabetes have a 20 to 50 percent chance of developing type 2 diabetes in the five to 10 years after childbirth. Treatment of gestational diabetes includes healthy eating, exercise and possibly insulin therapy. It’s important to monitor blood glucose levels regularly to assess whether the ideal targets are being met. You should continue self-monitoring of blood glucose after delivery of your baby. Some women with gestational diabetes will revert to normal glucose tolerance in the weeks following delivery, but with a high risk of developing type 2 diabetes in the future. In others, diabetes remains and treatment should continue. If blood glucose levels return to normal on home monitoring without any diabetes treatment, an oral glucose tolerance test (OGTT) should be done in a laboratory six weeks after delivery. This necessary stress test for your insulin-producing beta cells assesses for any abnormality in glucose tolerance. It is done by checking the fasting blood glucose level, and if indicated by that result, drinking a solution containing 75g of glucose. The blood glucose response to the oral glucose challenge is then measured two hours later. If this test is normal, screening for diabetes should be repeated annually. To reduce the risk of developing type 2 diabetes in the future and to keep those annual tests negative, it is vital to continue with healthy eating, exercise and maintenance of a healthy weight range. Remember, your child needs you to be healthy! YP