The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Diet And Exercise Can Help
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,” Metzger says.
Hillier found the risks to children were reduced when women with GDM were treated with diet changes, such as eating fewer sweets and starchy foods, smaller, more frequent meals and more fruits and vegetables; increased exercise; and, if that was insufficient, by adding medication, typically insulin. When women remained untreated, their baby’s risk of being overweight or obese at ages 5 to 7 was nearly twice as high. “But the children of women who were treated for GDM had no greater risk of obesity or being overweight compared with children of mothers who had normal blood sugar during pregnancy,” Hillier says. “This suggests that treating moms during pregnancy gives their babies a fighting chance for a normal metabolism.”
Like Paetsch, Jennie Wolter, 32, was shocked by a GDM diagnosis because she, too, had no obvious risk factors. “But I came to terms with it when I was assured by my health care providers that I could manage the risks and have a healthy baby,” says Wolter, the community relations manager for a nonprofit organization in Sacramento, Calif. in addition to changing her diet with the help of her midwife, a nutritionist, a nurse and a supervising OB, Wolter also credits exercise with helping her avoid having to take insulin. “My team told me that blood sugar could be well controlled by getting some exercise after each meal,” she says. When Wolter delivered her 8-pound, 6-ounce baby vaginally, she was only 15 pounds over her prepregnancy weight—with her caregivers’ blessing.
Paetsch did need to take insulin during her pregnancy, and she credits her diet and exercise changes for feeling better physically at that point than she had in a long time, for weighing about 10 to 12 pounds less today than when she became pregnant and for teaching her a healthier way to live, long-term. “Monitoring my diet was a huge pain at the time, but I learned a lot about how much self-restraint i could actually have,” she says. She also learned she could fit in small amounts of exercise throughout the day and have it count, the way experts say it will. “GDM felt like such a devastating diagnosis at the time,” Paetsch says, “But it was actually a bit of a blessing in disguise.”
Life After Gestational Diabetes
To date, no intervention has been proven to prevent gestational diabetes [GDM],” says Mark Landon, M.D., chairman of the department of obstetrics and gynecology at The Ohio State University College of Medicine. “However, there is evidence that diet, exercise and medication can help women with a history of gestational diabetes avoid developing diabetes postpartum.”
Breastfeeding may help as well. A 2012 study published in Diabetes Care found that women who’d had GDM and were exclusively or mostly breastfeeding at six to nine weeks postpartum had improved fasting blood glucose levels compared with women who were mostly or exclusively formula-feeding their babies. More research is needed to determine if the benefits are long-lasting, Landon says.
Nursing may also help their children. Researchers reporting this year in the International Journal Of Obesity studied children from birth to age 13 whose mothers had any type of diabetes and found that those who’d gotten at least six months of mother’s milk had significantly lower BMIs, smaller waists and less body fat than the offspring of diabetic mothers who breastfed less.
Did you know? Women who ate the most animal fat before pregnancy were 88 percent more likely to develop GDM than those who ate the least. Replacing 5 percent of animal fat with plant foods reduced risk by 7 percent. — National Institutes Of Health And Harvard University Research.