Gestational Diabetes (Part 2)

In Part 1 of the gestational diabetes article, we learned, in a nut shell, what gestational diabetes is and how it affects the fetus and mother. Now, without further adieu, is the second instalment of gestational diabetes.

How does GD occur?

It’s believed that pregnancy hormones such as progesterone (being the main culprit along with cortisol), human placental lactogen, prolactin, and estradiol all interfere with the action of insulin. These hormones bind to the insulin receptors on cell membranes.

Insulin’s role is to signal the cell to allow glucose in so it can be used for energy. Since insulin is not being allowed in the cell, the circulating glucose builds in the bloodstream. The body recognizes this and responds by secreting more insulin. This resistance to insulin usually occurs in the second trimester, manifesting itself in the third.

Glucose has the ability to cross the placental barrier whereas maternal insulin cannot. The fetus is exposed to higher levels of glucose. Its pancreas now has to work overtime to combat this high glucose level in the blood. This leads to excessive growth. After birth, the infant’s exposure to high levels of sugar disappears but still has a high level of insulin being secreted. This causes the infant to develop hypoglycemia.

How do you know if you’re at risk?

Some of the risk factors are:

• ·  overweight prior to pregnancy
• ·  family history of DM
• ·  mother-to-be is older than 30 years old (especially over 35)
• ·  previously given birth to a child greater than 9 pounds
• ·  previously given birth to a stillborn baby
• ·  GD in previous pregnancy

Can GD be prevented?

No one knows if it can be prevented. However, nutrition is believed to be the key component in preventing GD. There are not a lot of studies in this area. Very few physicians are well versed in nutritional issues that they do not address the issue of GD until it actually presents itself. (A little too late I think) It is important for the pregnant mother to be as proactive as possible. Change the things she can change. For example, dietary habits, exercise, and sleep.

A study done in 1997 by Dr. Timothy Dye at the University of Rochester found that regular exercise did not really affect average-sized women but among larger women, the chances of developing GD were cut in half. All the more reason to continue exercising during pregnancy.

In 1991, Dr. Edward Horton came to the conclusion that an exercise session not only improved blood sugar after the last meal, but glucose metabolism was elevated for 12-14 hours afterwards. If exercise is continued on a regular basis, then the results are even greater. But, if exercise was ceased for at least 2 days, the benefits diminished quickly.

Exercise does not have to be of high intensity like CrossFit but something to get the heart rate elevated. Some examples include a brisk walk for 20-30 minutes, yoga, swimming, etc. The first few minutes are the hardest because motivation is low; bones, joints, and muscles are sore; and fatigue is a factor. If the pregnant woman can push through the early stages of exercise, things will not hurt as much in the long run and she will feel better.

Is there a treatment for GD?

There is no one exact treatment for GD. Some ideas to control the autoimmune process include, but are not limited to, the following:

• ·  eating balanced meals focusing on a good protein source (meat, fish, chicken, eggs), lots of vegetables, nuts and some seeds, some fruit, little starch, and nothing with sugar or added sugar
• ·  avoid simple sugars and refined products
• ·  take vitamin D supplements for gene transcription (where genetic information is stored in a strand of DNA which is then copied into a strand of RNA) and insulin sensitivity
• ·  omega-3 fatty acids for fetal brain development and decrease the risk of pre-eclampsia

If anyone has any comments/information to add/share please feel free in the comments section.