Diabetes and Pregnancy

Health, Home & Family
on November 30, 2008

Gestational diabetes—a blood sugar imbalance that occurs only during pregnancy and afflicts about 5 percent of expectant moms—can be a frightening diagnosis for an otherwise healthy woman. But as Dr. Allison Hill, one of the partners in an obstetrics-gynecology practice in Los Angeles chronicled on the Discovery Health television show Deliver Me, explains, food choices can go a long way in controlling the temporary condition. Below, Hill answers questions about gestational diabetes.

Q: What causes gestational diabetes and who’s at highest risk?
A: The placenta that’s present during pregnancy produces a hormone called human placenta lactigen (HPL) that raises a woman’s blood sugar levels, and some people’s placentas make more HPL than others. As this hormone level increases—the highest levels are seen in the second trimester of pregnancy—some women have difficulty metabolizing sugar. So their sugar levels stay consistently elevated, which can cause gestational diabetes. Women who have a lot of diabetes in their families are at higher risk, as are women who are obese or at the older end of child-bearing age.

Q: What symptoms can tip women off that they may have gestational diabetes?
A: Actually, there are no symptoms. That’s what’s hard about gestational diabetes. People feel completely normal, and then I’ll say, “You’ve got this condition” and they’ll look at me like I’ve got three heads.

Q: What happens once a woman is diagnosed with gestational diabetes?
A: In most cases gestational diabetes can be controlled with diet, so the first thing we do is send them to a nutritionist who recommends what’s basically a low-carb diet. The idea is that lowering the amount of sugar they’re taking into their system will lower their blood-sugar levels in general.

The nutritionist will recommend that they maintain a food diary, and we’ll have them check their blood-sugar levels about four times a day with a monitor. Then they’ll be able to adjust their diet further if they notice their levels spike after, say, eating cereal for breakfast. The diet can be a challenge. Even fruit and fruit juice can be an issue because they’re high in sugars. It’s a real wake-up call for a lot of women, but it’s a great opportunity for them to develop good eating habits for the future.