Like many moms, Mariska Hargitay, who plays Det. Olivia Benson on the popular series Law and Order: SVU, developed a fairly common problem during her recent pregnancy. And, if you’ve been diagnosed with gestational diabetes, as she was, you probably feel as conflicted as any good SVU episode. Gestational diabetes affects anywhere from 4% to 7% of all pregnant women -- amounting to about 135,000 cases in the United States each year.
Gestational diabetes begins when your body is unable to produce and utilize all the insulin necessary for pregnancy, most likely because hormones in your placenta are keeping the insulin from doing its job (that makes charge #1 -- obstruction), leading to hyperglycemia. This usually occurs late in the pregnancy, so your baby is not at risk of birth defects. This doesn’t mean that uncontrolled gestational diabetes won’t hurt your baby, however. Your high glucose levels are passed on to your baby via the placenta, making that baby pancreas work overtime to get rid of the extra glucose. When the glucose isn’t filtered out, it ends up being stored as fat -- leading to macrosomia, or a “fat” baby. Macrosomia carries its own host of health problems, including damage to the baby’s shoulders during birth (because the baby is too large for the birth canal) and putting newborns at greater risk for breathing problems. These babies are also at risk for obesity and Type 2 diabetes as adults.
Luckily, developing gestational diabetes doesn’t mean that you'll be chased down by a crack team of cops. However, you are twice as likely to develop preeclampsia as other women, so you need to start treatment as soon as you are diagnosed. Treatments include a special meal plan and regular physical activity, and sometimes daily blood glucose testing and even insulin injections. It might sound like jailhouse torture, but keep your eyes on the prize: sticking with your treatment plan can mean lowering the risk of a c-section.
Oddly, gestational diabetes often has no symptoms, so you will probably be screened at your first prenatal visit and then again between 24 and 28 weeks if the first result is negative. A simple glucose screening test is all it takes! It is true that some women are at a higher risk for developing gestational diabetes. You may be at a higher risk if you are obese, you have a history of the condition or you have a strong family history of diabetes.
Gestational diabetes typically fades away after pregnancy, but your chances are significantly higher of redeveloping it with future pregnancies. There are some women who develop Type 2 diabetes years later. So, it’s best to continue making the healthiest lifestyle choices possible even after your gestational diabetes disappears. And, be sure to tell your pediatrician that you had gestational diabetes, so that she has all the information she needs to treat your child.
© 2007, Megan Southwick
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