Moms-to-be can take charge of diabetes
Pregnant with my first son, all I wanted to eat was ice cream. Breakfast, lunch, and dinner. But sweet stuff hadn't been anywhere on the menu since early on, and I developed gestational diabetes, a hormonal condition that causes insulin resistance and elevated blood sugars during pregnancy.
Pregnant with my first son, all I wanted to eat was ice cream. Breakfast, lunch, and dinner. But sweet stuff hadn't been anywhere on the menu since early on, and I developed gestational diabetes, a hormonal condition that causes insulin resistance and elevated blood sugars during pregnancy.
Frightened about the impact high glucose readings could have on my unborn child and me, I followed my doctor's orders to the letter.
That meant weighing and measuring every bite, taking my sugars before and after every meal, and exercising a whopping two hours a day on a stationary bike and in a nearby indoor swimming pool.
The baby (now age 30) arrived healthy, but when I became pregnant again, my sugars spiked once more. Older and a bit less energetic, I added insulin shots during pregnancy to keep my blood glucose readings in check and to allow myself more food options.
Before my pregnancies, I had never heard of gestational diabetes.
But these days, it's not that uncommon. Though the precise incidence is not known, a report from the U.S. Centers for Disease Control and Prevention last year said at least 9 percent of women in this country experience high blood sugars during pregnancy.
And, according to Mark Schutta, medical director of the Penn Rodebaugh Diabetes Center, those numbers are growing. Consequently, women at high risk are tested early in their pregnancies, and all others are tested at 24 weeks.
My father was diabetic, and it turns out that having a first-degree relative with the condition is a risk factor for developing gestational diabetes. So is being over 25. Members of certain ethnic groups - American Indians, African Americans, Asians, and Hispanics - are also more prone to the condition. Obesity can play an important role, Schutta said, but it's not established that being overweight alone causes the condition.
"It's really important that women in high-risk groups who are pregnant get screened early," Schutta said. "It can profoundly affect both them and their babies."
For moms, gestational diabetes can lead to serious side effects, including dangerously high blood pressure. Babies can be born with elevated blood-sugar levels and are often overweight, which can cause complications at birth.
After one pregnancy with gestational diabetes, a third to two-thirds of women will have the condition in a subsequent pregnancy.
In addition, there is an increased chance these women will eventually develop full-blown type 2 diabetes. Nine months after pregnancy, about 3.7 percent of gestational diabetes patients will be diagnosed with type 2; within 10 years of pregnancy, that number jumps to almost 20 percent.
For me, about five years after my second pregnancy, I was diagnosed with type 2 diabetes. I wasn't overweight, but for many people, whether they will develop type 2 depends on waist circumference and body-mass index, Schutta said.
Treating gestational diabetes isn't all that different from treating type 2 - the first line of defense is diet and exercise. By balancing appropriate weight gain during pregnancy with proper diet and exercise and keeping track of sugars with a glucose monitor, many women can maintain steady sugars and beat any side effects.
"We recommend three meals a day and two snacks," Schutta said. "The ideal goal would be to have a glucose reading of about 120 an hour after eating and a fasting glucose reading of between 60 to 90 - although the numbers vary depending on which clinical guidelines are consulted.
"There are quite a few people who can do this," said Schutta, who also suggests patients see a nutritionist to help them plan their diet.
Elina Veksler, 39, a student at Bucks County Community College, is 32 weeks pregnant with her second child, and again has gestational diabetes. But, like the first time, she's fighting back. Her daily regimen includes an hour walk on a treadmill and a diet of vegetables, meat, fish, some fruit and dairy, and no processed foods. She combats pregnancy cravings for chocolate and sweets with homemade low-carb desserts and tracks her blood sugars religiously.
"The hardest part is worrying about those numbers," Veksler said. "I know how dangerous gestational diabetes is for my fetus and myself."
"It's a lifestyle change," said Kelly Moyer, 38, an administrative assistant who lives in Springfield. Moyer, who started off with blood glucose readings of 244, now registers between 92 and 115. She has abandoned white flour, white pasta, and fruit juices in favor of more water and vegetables. Moyer also uses an insulin pen.
"It's not a good diagnosis," she said of gestational diabetes, "but it helps to stay positive. You have to look out for the baby."
It also helps to have a compassionate endocrinologist. On the day I was about to be induced to give birth to my first son, my doctor said, "Now." It was the password I had been waiting for.
I ran with my husband to a nearby store, bought a small container of Breyer's chocolate ice cream, and plunged in a spoon. After nine months, I satisfied my ice cream craving and then welcomed a healthy baby boy.
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