Gestational diabetes occurs in one out of twenty pregnancies in the U.S., affecting more than 240,000 births annually. Compared to caucasians, gestational diabetes mellitus (GDM) occurs more often in blacks, native Americans, Asians, and Latinos.
So What’s the Big Deal?
Numerous problems are associated with GDM, for both the mother and the baby:
- dangerously high blood pressure (preeclampsia)
- excessive amount of amniotic fluid (the baby in the uterus floats in this fluid)
- delivery requiring an operation
- early or premature delivery
- death of the baby
- birth trauma, such as broken bones or nerve injury
- metabolic problems in the baby (low blood sugar, for example)
- abnormally large baby (macrosomia, a major problem)
Having had gestational diabetes once, a woman is at increased risk of developing type 2 diabetes later in life, when she’s not pregnant. Can this be prevented?
From the Journal of the Academy of Nutrition and Dietetics:
Based on the current evidence, a specific dietary intervention for diabetes prevention in women with prior GDM [gestational diabetes mellitus] can therefore not be recommended. Previous systematic reviews have also consistently concluded that evidence for an effect of combined diet and physical activity interventions is inconclusive, with the exception of strong evidence from the Diabetes Prevention Program. Findings from that intensive intervention that focused on diet and physical activity to achieve and maintain weight loss of at least 7% of initial body weight showed >50% reduction in the risk of developing T2DM in women at high risk of T2DM including women with previous GDM; however, this personalised lifestyle intervention is unlikely to be feasible for implementation in routine care. As a limited number of studies have examined diet-alone and physical activity-alone interventions, it remains unclear which diabetes prevention approach would be most effective for women with a GDM history.
Source: The Role of Diet in the Prevention of Diabetes among Women with Prior Gestational Diabetes: A Systematic Review of Intervention and Observational Studies – Journal of the Academy of Nutrition and Dietetics
If it were me at risk for T2 diabetes? I’d lose the excess weight with a reasonable diet and exercise regularly.
Steve Parker, M.D.