New York Times Columnist Discusses Gestational Diabetes

Main Category: Diabetes
Also Included In: Pregnancy / Obstetrics
Article Date: 29 Oct 2008 - 9:00 PDT

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New York Times columnist Jane Brody on Tuesday examined gestational diabetes, the incidence of which has almost doubled since 1990 because of an increase in prepregnacy weight among women in the U.S. Gestational diabetes affects about 4% of pregnant women, usually in mid-pregnancy, or the 28th week of gestation. Although the causes of gestational diabetes are "unclear," the risks of the condition can be avoided by "maintain[ing] a normal blood sugar level and to keep the level as even as possible throughout the day," Brody writes. Women with the condition should "follow a sensible meal plan consisting of three small, well-spaced meals and up to three snacks each day," Brody recommends, adding that refined starches and sweets should be limited. A woman with gestational diabetes "must know when and how much carbohydrate-rich food to consume, and her diet should include fiber-rich vegetables, fruits, dried beans and peas, and whole grains," Brody writes, adding that regular physical exercise is "important."

Insulin might be required if "such self-help measures" do not work to normalize a woman's blood sugar, Brody writes, adding that to ensure blood sugar levels remain stable, a woman with gestational diabetes "should test herself via a finger prick and blood glucose monitor at regular times: when she wakes up, before meals and an hour or two after meals." Brody also recommends that a woman with the condition be retested six to 12 weeks after giving birth and should "keep her own -- and her child's -- weight down and be tested periodically for signs of diabetes as she ages."

There are some "clues" that a woman might have gestational diabetes, Brody writes, adding that one is "placental hormones that suppress the action of insulin in the mother," which can result in insulin resistance and an increase in the amount of sugar passed on to the infant. This could "giv[e] the baby more energy than it needs to grow normally," which can lead to an overweight infant, increased risk of breathing problems, low blood sugar at birth and the potential for obesity in childhood.

Brody writes that a pregnant woman is "unlikely to know her blood sugar is running high unless she is tested," adding that a screening test should be conducted at the first prenatal screening for women at risk. "Women not at high risk for gestational diabetes should be tested between weeks 24 and 28 of pregnancy," Brody recommends, adding that the risk of gestational diabetes is higher in black, Asian and Hispanic women. Women who are older than age 25; overweight; have had the condition in a previous pregnancy or a family history of diabetes; were told they were "prediabetic"; or gave birth to an infant weighing nine pounds or more are also at "higher than average risk" of the condition, Brody writes. She also profiled Elise Bloustein, a woman who had gestational diabetes (Brody, New York Times, 10/28).

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