Gestational diabetes: a threat to mom and baby
It's not just babies who may be affected over the long term. Among women diagnosed with GDM, 50 percent will develop type II diabetes within 5 to 8 years; 70 percent to 85 percent will develop the disease during their lifetimes, Metzger says. A GDM diagnosis can serve as an early warning, motivating at-risk women to make permanent lifestyle changes. "Even if treatment only delays diabetes by 10 or 15 years, that's huge," he says.
Limiting sweets and eating smaller, more frequent meals and more fruits and vegetables, is typically the first line of treatment, but exercise can help. Downs is researching how much and what type of physical activity works best. Though gestational diabetes is often associated with overweight, sedentary women, she notes that only 50 percent to 60 percent of women diagnosed with GDM are overweight. Age is a factor—women over age 25 are at greater risk due to declining pancreas function—and there's a big genetic component.
"You could be healthy, thin and still get GDM because of a genetic predisposition," says Downs, noting that "Bachelorette" Trista Sutter was forced to deliver a month early partly because of complications due to gestational diabetes. Downs herself, a marathon runner with a family history of diabetes, came within two blood-sugar points of a GDM diagnosis during her first pregnancy at age 31. In her second pregnancy, she passed the screening tests with flying colors, attributing her better blood-sugar levels to "being more stringent with my diet and maintaining a moderate-intensity exercise plan."
More than 75 percent of women who "fail" the one-hour glucose challenge, as I did, end up passing the three-hour glucose-tolerance screening, the one with the unbearably sweet soda. I didn't have gestational diabetes, but the testing experience was a reminder to keep cranking on the elliptical trainer and eating my vegetables.