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April 5, 2003

Gestational Diabetes, Type 2

Question from Midland Park, New Jersey, USA:

I had gestational diabetes which needed to be treated with insulin during my first pregnancy, and did not have diabetes after delivery. I was probably 10 pounds overweight prior to my next pregnancy and have a family history of diabetes, so I had rigorous testing to confirm I did not have it. However, seven weeks into my pregnancy, I developed gestational diabetes. The initial standard diet did not help so I substituted whole grains for all wheat flour and potato foods and got control almost immediately. When the second trimester began, the gestational diabetes disappeared (levels better, food tolerances normalized again). How likely is it that the gestational diabetes will return as my pregnancy progresses? If so, how likely is it that insulin will be necessary again? Is the helpfulness of whole grain foods typical? How likely is it that I will get type 2 diabetes?

Answer:

It is likely that the gestational diabetes will again reappear. The longer the duration of the pregnancy, the more insulin resistance there is. Whether insulin is required or not is dependent upon the rise in blood sugar and the response to lifestyle intervention. With pregnancy, there are not a lot of other good choices for alternative therapies when the sugars are high.

It is also more likely that you will develop type 2 diabetes in the future. Your best insurance is lifestyle modification. Whole grains are one good choice but will not be the difference between having diabetes and not having diabetes.

JTL