September 11, 2004
Gestational Diabetes
Question from Augusta, Georgia, USA:
I am 25 and was diagnosed with gestational diabetes last Friday. I was shocked because I have none of the risk factors. I am a runner. I have competed in races, including a marathon in under four hours, although I have been walking, swimming, and doing the elliptical trainer throughout my pregnancy because of the heat. I am Caucasian and I was following the Bradley Method/Brewer diet and eating very healthy throughout my pregnancy; I have felt physically and emotionally great the whole time. My BMI was less than 25 when I became pregnant, and I had only gained 12.9 pounds at my six month check-up. I have no family history of diabetes, except for my grandmother’s sister who had type 1 diabetes.
After I’d been following the diet for only two days, I went into see the midwives I see and my two hour post-meal level was 74 mg/dl [4.1 mmol/L]. I meet with a maternal fetal specialist on Tuesday.
How common is it for someone of my fitness level/health level to get gestational diabetes? My midwives were wonderful and said this is NOT my fault, but I am just so confused by my diagnosis. Also, how come health providers don’t test my blood sugar when I’m eating my normal diet since it was so healthy before?
I keep reading that I am now at risk for type 2 diabetes and will need to be tested every year. With my health status, how can this be?
Can a past eating disorder lead to gestational diabetes? I have been recovered from an eating disorder for about four years now, making this diagnosis and concentration on diet and my weight even more difficult. So, I am curious if this could have contributed to my diagnosis. I was anorexic for a year and then I struggled with bulimia for another year. I recovered and then had a relapse in college. I was clinically diagnosed and had counseling. As a bulimic, I never binged. I only rid myself of what I ate to control my intake.
Answer:
Gestational diabetes occurs as a result of the production of hormones that specifically block the action of diabetes. Thus, any pregnant woman is at risk. Although, those with a family history or who may already have some degree of insulin resistance such as polycystic ovarian syndrome are at higher risk. Incidentally many women with PCOS are thin. Regardless of the cause, you can manage it. Usually, a properly structured diet is adequate for glucose control. Occasionally, women require additional medications such as glyburide (oral hypoglycemic agent) or insulin. The maternal-fetal medicine specialist will fill you in on all the details. The risk for future diabetes may not be as high for you, nevertheless, you should be screened periodically.
OWJ
