WOMENS-HEALTH Messages for December, 1997: Re: Gestational Diabetes

Re: Gestational Diabetes

From: Stormy (anonymous@obgyn.net)
Tue, 30 Dec 1997 17:48:21 -0600 (CST)

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In reply to: Daniel: "Gestational Diabetes"

I, too had GDM with my pregnancies. I wasn't tested with the first 2...my OB took over at 8 mo. gestation with #2 due to a move and he suspected it agter my daughter weighed 9lbs. 8oz. Babies 3 & 4 I had GDM and controlled it with diet.

Stats I've read linking it to type 2 DM didn't mention the number of pregnancies that you have and seem to vary a bit as to estimations of those who will develop DM, but generally it seems to be a 40-50% chance of developing type 2 DM within 5-15 years after pregnancy. One study I read broke it down into 10% chance for white females, 20%chance for Black females, and 50% chance for Hispanic females. As weight increases so do the chances of developing DM. So, as I understand it, unless there is new research out there regarding the number of pregnancies related to type 2 DM, I am not aware of any correlation there.

But, in deciding about future pregnancies you should take into account that her risk for developing GDM is almost a given considering her history and it can lead to complications like high blood pressure, PIH, urinary tract infections, preterm labor, very large infants, etc. And, it seems like it was worse for her the last go-round if she was insulin dependent.

However, risk for both GDM and type 2 DM can be decreased by maintaining an ideal body weight, exercising regularly, eating lots of fruits and vegies and limiting fat intake to less than 30%,etc. As I understand it, you can have inherent factors like family history of the disease but it usually takes another factor like obesity to bring it on. Age seems to impact type 2 DM as most folks that get it are over 45 as opposed to type 1 DM where most are younger than 25.

My best guess, without knowing your wife, is that weight or decreased activity may have played a role in why it was harder to control with the last pregnancy. The reason I say this is that it has been my experience with my patients as well as myself, that most of us with little ones don't have as much time to spend exercising, both during and after pregnancy, as we did with our first pregnancies and most of us pack on a few extra pounds that stick around after each baby.

Hope this helps!

At Tue, 30 Dec 1997, Daniel wrote: >
>My wife, Rachel, of 27 years developed gestational diabetes during her
>first pregnancy 7 years ago and again during her her 2nd pregnancy about
>4 and a half years ago. In both instances, she effectively controlled
>her sugar levels by diet. Her most recent pregnancy (last year) was
>again met with high levels of sugar but this time she needed insulin to
>control it.
>
>Rachel's mother developed gesational diabetes with her last pregnancy
>which later in life turned into type 2 diabetes (She was taking pills
>and is now taking insulin to control her diabetes.). She is Rachel's
>only blood relative with this condition.
>
>Thankfully all of Rachel's deliveries were trouble free and our children
>are thank G-D healthy. Our question is with respect to future
>pregnancies. Will additional pregnancies increase Rachel's risk of
>developing type 2 diabetes? Could it be that her last pregnancy was met
>with harder to control sugar levels only because of her age?
>
>Our questions are as follows:
>One one hand we feel that because she may develop full diabetes, as is
>common in over 50% of women with gestational diabetes, then why avoid
>having more children. On the other hand if she is at higher risk of
>developing type 2 as a result, or if additional pregnancies can speed up
>this process, we would consider not having more children. Also, is
>there anything Rachel can do when she is not pregnant to help reduce her
>risk? We have not been able to receive clear answers from Rachel's
>personal GYN/OB or endocrinologist regarding the above and are hopeful
>that you could answer our questions and share some experiences.
>
>Thank you from both of us.
>
>Sincerely,
>
>D.H.

--
  Stormy, RN, BSN

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