April 13, 2008
Question from Roswell, Georgia, USA:
What is the risk of getting gestational diabetes if you had insulin resistance as a child? I had undiagnosed insulin resistance for more than six years and had acanthosis nigricans for those six years. After losing 30% of my weight, the issue was resolved for the past 10 years, with yearly blood glucose checks and daily exercise. What is the risk of developing gestational diabetes when I get pregnant, since this manifests with insulin resistance? Can I avoid this through continuing exercise while pregnant?
Since you have already manifested insulin resistance, I would think that your risk of developing gestational diabetes is higher than in the average population. Depending on your ethnic background, your risk of developing gestational diabetes is 1 to 8%. Pregnancy itself causes some degree of insulin resistance. However, if you keep your weight stable prior to conception and do not have excessive weight gain, you may be get away without diabetes. Continued exercise may be of benefit. It may be worthwhile to screen for glucose intolerance early in the pregnancy (less than 24 weeks). If the initial screening is negative, then you will still have to be screened at 24 to 28 weeks.