August 13, 1999
Family Planning
Question from Baltimore, Maryland, USA:
I am a 28 year old woman currently 16 weeks pregnant with my third child. My first two pregnancies were without complications. About 6 months ago, I was diagnosed with “mild PCOS” — Polycystic Ovarian Syndrome — due to my lack of ovulation, abnormal hormone levels and ovarian cysts. I am fortunate in that my secondary symptoms (weight gain, hirsutism, acne) were mild. I also have a history of regular menses as well as no problem conceiving when in my early 20’s.
I was able to regulate my cycle through a low carbohydrate, high protein diet that a dietitian suggested I try since my case was rather mild. This diet worked quite well for me and I assumed that like many women with PCOS, much of my hormonal imbalance was due to insulin resistance. After changing my way of eating, my cycles shortened to “normal” range and I started ovulating again!
All that said — I am curious if this history puts me at a greater risk for gestational diabetes? My obstetrician knows about the PCOS but has not said that I am any more likely to develop GD, but I wonder if there is anything I can do at this stage in my pregnancy to prevent any tendencies towards gestational diabetes? Do I have cause for concern, in your opinion?
Answer:
Because you already have some degree of insulin resistance, you may have a greater tendency to develop gestational diabetes, although, as you said, you sailed through your first two pregnancies without difficulties. However, you may want to speak with your obstetrician about an early glucose test. If it is normal, then I would still recommend testing at the usual time (24-28 weeks gestation). The diet you describe may be helpful even if you are at low risk. Other than that, there is nothing you can do at this point to prevent gestational diabetes, if it is going to occur.
OWJ
