Pregnancy can provide window into a woman’s risk for diabetes

Gestational diabetes can point to undiagnosed disease or future occurrence

According to the National Institutes of Health (NIH), more than one-third of American women at reproductive age are obese, placing them at greater risk for developing gestational diabetes if they were ever to become pregnant.

Gestational diabetes is a type of diabetes that develops only during pregnancy; however, studies have shown that its presence can have consequences to a mom and baby’s long-term health. According to the American Diabetes Association (ADA), women with gestational diabetes are more likely to develop type 2 diabetes later in life. Likewise, children born to mothers with gestational diabetes are at a higher risk for obesity and type 2 diabetes as adults.

Diabetes means a woman’s blood glucose, or blood sugar, is too high. Glucose, which the body uses for energy, can be harmful to the woman and her baby when it is elevated. Women who have uncontrolled diabetes throughout their pregnancy place their baby at risk for macrosomia (a condition where the baby is larger than normal), respiratory problems and possibly death. It is estimated that gestational diabetes affects nearly 10 percent of pregnant women, according to the ADA.

One of the greatest risk factors for gestational diabetes is a woman’s weight. Women who are diagnosed with gestational diabetes may have had type 2 diabetes before becoming pregnant and never knew it or were on the road to developing diabetes, said Ronald Hirth, MD, a gynecologist and obstetrician with the Center for Women’s Health & Wellness in Mason.

“The American population is larger and heavier than we used to be and that increases our risk for diabetes. When you are overweight your body cannot produce enough insulin to cover all the blood sugar that is going around in your blood stream so eventually your pancreas cannot keep up and your blood sugar increases,” says Dr. Hirth, who practices with Premier Health Specialists. “That is a process that takes years to develop and, for some women, the extra weight and hormones of pregnancy pushes them over the edge into diabetes.”

Women undergoing prenatal care with a physician are tested for gestational diabetes at 28 weeks gestation or at the beginning of their third trimester. Testing involves drinking a glucose solution drink and waiting two to three hours before blood is drawn as a sample. Women who have risk factors for type 2 diabetes may be tested earlier in the pregnancy, Dr. Hirth says.

There are risk factors that increase a woman’s chances of developing gestational diabetes, the NIH says. These include being overweight, having previous pregnancies with gestational diabetes, previously giving birth to a baby nine pounds or heavier, the presence of pre-diabetes, and having a hormone disorder called polycystic ovary syndrome. Genetics play a part as well. Women who have a parent or sibling with type 2 diabetes should be tested as well as women of certain ethnicities.

The good news is that women have power to lower their risk for the disease, Dr. Hirth says.

“The best way to reduce your risk for gestational diabetes is to come into your pregnancy fit and healthy,” he says. “If you come into your pregnancy with normal weight and eat healthy and continue to exercise throughout your entire pregnancy then your risk for gestational diabetes is very low.”

Women who are diagnosed with gestational diabetes can work closely with their health care providers to properly control the disease and keep their baby healthy. Providers can also help them plan for what foods are best to eat to keep blood glucose in a healthy range. Physical activity can help control gestational diabetes, and help reduce her risk for developing type 2 diabetes later in life. The NIH recommends 30 minutes of exercise most days of the week, but women should speak with their physician first to get approval.

“We all have control over the choices we make during the day,” Dr. Hirth says. “And almost every doctor will tell you that it begins by eating healthy and exercising regularly. It really does make a difference.”

ABOUT PREMIER HEALTH SPECIALISTS: Premier Health Specialists is one of the largest groups of specialty care practices in Southwest Ohio. More than 130 physicians serve patients in a variety of specialties such as bariatrics, breast care, burn and wound, cardiology, cardiothoracic surgery, cardiovascular-thoracic surgery, general surgery, gynecologic oncology, hand and reconstructive surgery, infectious diseases, maternal-fetal medicine, neurosciences, obstetrics and gynecology, orthopedic surgery, orthopedic spine surgery, ophthalmology, palliative care, physiatry, plastic surgery, podiatry, psychology, pulmonology, sports medicine and urology. Premier Health Specialists is part of Premier Health, which includes Miami Valley Hospital, Good Samaritan Hospital Dayton, Atrium Medical Center and Upper Valley Medical Center. For more information, visit www.premierhealthspecialists.org.

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