LALITA PARIS was shocked when she tested positive for gestational diabetes while she was pregnant with her daughter, Zyanae. She was just 25, with no family history of the disease.
"I was floored," she said.
The Philadelphia woman was about 50 pounds overweight when she got pregnant and gained about 80 pounds during her pregnancy. She recalled that her doctor said that "my weight and diet was the major cause of me getting the condition," which developed into type 2 diabetes after her daughter was born.
Paris is working to defeat her diabetes with diet and exercise, but she wishes she'd done more to prevent it in the first place.
"I don't think doctors give [pregnant] women enough information. They just say, 'Eat healthier.' I wasn't given real guidelines about nutrition or caloric intake," Paris said.
Any woman with high blood sugar levels during pregnancy is at risk for gestational diabetes regardless of her pre-pregnancy weight, diet or fitness level. But obesity increases the risk, doctors agree.
According to Montgomery County ob/gyn Deirdre Gundy, "With obesity, increased BMIs [body mass index] and poor nutrition, we are seeing an increase in patients with glucose intolerance requiring more than dietary management alone."
Factors that could put you at increased risk for gestational diabetes include:
_ Family history of diabetes.
_ Gestational diabetes in a previous pregnancy.
_ A prior pregnancy in which the baby was born overweight (more than 8 pounds, 13 ounces), a condition know as macrosomia.
Gundy said that certain ethnic groups also are at increased risk for gestational diabetes: Hispanics; African-Americans; Native Americans; South and East Asians; and Pacific Islanders.
Gestational diabetes, like other forms of diabetes, occurs when the body's insulin levels no longer effectively metabolize blood sugar.
Pregnancy alone can trigger the condition, which affects about 135,000 American women (about 4 percent of all pregnant women) each year, according to the American Diabetes Association. Pregnancy hormones can cause a woman to become insulin resistant, making it more difficult for her body to use insulin. Without sufficient insulin, glucose cannot be converted to energy and could lead to hyperglycemia (high blood sugar).
Women with gestational diabetes are at increased risk for preeclampsia.
Because babies born to diabetic women often are larger than normal, these moms-to-be also are at increased risk for a Cesarean, vacuum or forceps delivery.
And, as Paris discovered, gestational diabetes also puts the mother at greater risk for developing type 2 diabetes.
But moms aren't the only ones affected by the condition, Gundy noted. Gestational diabetes has an impact on the baby, too.
"Infants that are 10 or 11 pounds are often very sick. Once [they are] born, their sugar bottoms out and they can become hypoglycemic, and they are also at increased risk for birth trauma," she said.
If you are diagnosed with gestational diabetes, your doctor may treat it with nutritional counseling, oral medication and insulin shots.
Your doctor also may recommend that you exercise regularly to help regulate your blood sugar. In 2002, the American College of Obstetricians and Gynecologists issued new guidelines for exercise during pregnancy, recommending that pregnant women get an accumulated 30 minutes of moderate exercise most days of the week.
If you're expecting and you're not exercising already, ask your doctor what is appropriate for your fitness level - and get moving!
With proper management, gestational diabetes doesn't preclude a routine labor, delivery and a healthy bundle of joy. Ultimately, it's up to you to give you and your baby a happy and healthy beginning.
(This is the third in a series of columns on diabetes. To read the other columns, go to go.philly.com/kimberly.) *
Kimberly Garrison is a certified personal trainer and owner of One on One Ultimate Fitness in Philadelphia (www.1on1ultimatefitness.com).
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