Pregnant or thinking about pregnancy? You should know about diabetes of pregnancy, called gestational diabetes, or GDM. Gestational diabetes usually goes away when you give birth, but it can complicate life for both mother and child.
Gestational diabetes is a disease of insulin resistance, very much like Type 2 diabetes. Pregnancy increases insulin resistance, to save more sugar for the growing baby. That’s good when food is in short supply, but too much glucose in the blood can cause your baby to be too large. It increases risk for premature birth, respiratory problems, and low blood sugar for the infant after birth.
Gestational diabetes puts baby and mother at risk for Type 2 later on. More than 50% of women who have diabetes of pregnancy will get Type 2 diabetes 5–10 years later.
About 10% of mothers in the United States develop gestational diabetes. You may be at extra risk if you are overweight prior to becoming pregnant; have a family history of Type 2 diabetes; or have prediabetes, high blood pressure, or polycystic ovary syndrome (PCOS). Women older than 25 and those who are of African, Native American, Asian, Latino, or Pacific Islander descent also have a higher risk of gestational diabetes, as do women with a history of gestational diabetes or a history of having large (over 9 pounds) babies.
If you develop gestational diabetes, you will probably be treated with diet, exercise, and medications, often insulin. You’ll have a crash course in diabetes management. You can do that, but it’s much better to prevent it.
Preventing gestational diabetes
You can do a lot to prevent gestational diabetes. Here are some of the most effective ways found yet.
• Exercise. In one large study, researchers found that women who got roughly four hours a week of physical activity before and during their pregnancy lowered their risk of gestational diabetes by about 70% or more.
• Fiber intake. In one study, increasing fiber intake by 10 grams per day reduced risk of gestational diabetes by 26%. Ten grams of fiber would be about the amount in a cup of cooked squash or kidney beans. You can also take fiber supplements.
• Probiotics. Probiotics are “good bacteria” found in yogurts and other fermented foods. They have been found in a few studies to reduce the risk of gestational diabetes.
More and more research supports that the right gut bacteria help prevent health problems such as diabetes, but we don’t yet know that probiotic supplements help. Instead of supplements, you might try foods such as yogurt, kombucha, sauerkraut, kefir, dark chocolate, pickles, or kimchi.
Other studies of probiotics are ongoing, and researchers hope to have additional results soon.
• Inositol. Studies are looking at the use of the supplement inositol, a sugar alcohol that used to be considered a B vitamin, in gestational diabetes. Research appears to support its role in treating PCOS, and it is considered an insulin sensitizer like the thiazolidinedione (TZD) drugs pioglitazone (brand name Actos) and rosiglitazone (Avandia).
• Get checked. If you are in one of the high-risk groups mentioned above, get a diabetes test during the first trimester. If you’re not in a high-risk group, testing will typically take place between weeks 24 to 28, according to the University of California San Francisco Medical Center.
• Diet. You’ll need to check with a doctor, but many nutritionists agree that it’s good to eat more vegetables, fruits, fats, and protein. Sharply limit sugars and grains. It’s very much like a healthy diabetes diet, except you don’t want to go low calorie while the baby is growing.
The best time to prevent gestational diabetes is before you are pregnant. Start exercising, eat more fiber, and figure out how you’ll get the quality nutrition you and your baby will need. Don’t worry about it; you can prevent gestational diabetes.
Teens with diabetes have an extra layer of complexity to deal with during their formative years. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn strategies that can help.
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