Diabetes and Pregnancy

Labor and delivery is not uncharted territory for 38 year old Karen Asar, she’s mom to six year old Ben and four year old Lucas and is due any day now with baby number three. But, unlike her prior pregnancies, Karen developed gestational diabetes this time around. “I have to monitor myself and my blood sugar 7 times a day. I have to really watch what I eat, and monitor the sugars after I eat,” says Karen.

And Karen’s vigilance has paid off, no major health issues during the pregnancy. But, according to new research published in the British Medical Journal, the risk of death and major birth defects are still high in babies born to women with diabetes, despite an international strategy to raise standards of diabetes care.

“They are at risk of the babies themselves of being big and fat. And, having obesity as children and obesity as adolescents, and certainly they’re at risk of developing diabetes later in life,” says Dr. Barak Rosenn of St. Luke’s Roosevelt Hospital.

Gestational diabetes develops in women during pregnancy when the mother’s body is unable to produce enough insulin. It’s the hormone responsible for breaking down sugar to be used as energy. Without sufficient insulin the amount of sugar in the blood rises. “We used to think that a big component was the genetics. The mother has diabetes, and therefore the baby that was born to a mother who has gestational diabetes, has a risk of developing diabetes, but, in fact there are studies showing that these babies are developing in a uterus that is so to say, sweet. The mother that has diabetes creates an environment in the uterus that predisposes the baby itself to develop obesity, being large, and develop the diabetes later in life,” says Dr. Rosenn.

But, Dr. Rosenn says that in many cases, with meticulous monitoring and management of the condition, both mom and baby can avoid health issues.

“They have to look at everything they eat, they have to figure out whether they are allowed to eat it or not, they have to eat at certain times, we want them to eat frequent meals not just 3 meals a day, but rather divide their meals into small portions and then they have to watch what it does to them, in terms of their blood sugar,” explains Dr. Rosenn.

Most of the time, gestational diabetes goes away after baby is born. The changes in your body that cause gestational diabetes normally occur only when you are pregnant. After baby is born, the body usually re-adjusts and the condition goes away.

Urine is routinely tested for sugar throughout pregnancy, and high blood sugar, if present, is usually detected between 24 and 28 weeks. The only way to confirm the condition is with a glucose tolerance test. Women are given a glucose drink… then blood samples are taken and analyzed at different intervals to see how the body deals with the glucose over time.