Changes in the diagnosis of gestational diabetes and what you can do to change your risk

Face made out of fruits and vegetablesWith the release of the American Diabetes Association changes in the guidelines for the diagnosis of gestational diabetes, many more women are likely to have this diagnosis.  This is due in part to recommendations to screen women for pre-existing diabetes that has yet to be diagnosed, as well as decreasing the cut off limits for women when they are screened between 24-28 weeks of pregnancy.  In addition, The American Diabetes Association is also recommending that women who were diagnosed with gestational diabetes be screened 6-12 weeks postpartum for diabetes type II.

For some providers and pharmaceutical companies, these changes in diagnostic criteria mean more income through increased numbers of office visits and prescriptions for medications such as metformin.  For other providers, these changes mean more opportunity to educate and counsel patients regarding diet and lifestyle changes that will provide benefits both for mother and baby.

It is already known that women who are diagnosed with gestational diabetes are at increased risk for developing type II diabetes in their lifetime, some research suggesting as much as a seven fold increased risk compared to pregnant mothers who were not diagnosed with gestational diabetes. Hospital based research performed by Kwak and colleagues found in their study of 370 women, 105 went on to be diagnosed with type II diabetes at 8 weeks postpartum, with another 80 being diagnosed within the first year. Additionally, their babies are also at increased risk for the development of type II diabetes.

To help decrease the risk for developing diabetes mellitus following a diagnosis of gestational diabetes, breastfeeding appears to confer some protection to the mother.  This was seen in work performed by Jenum and colleagues who investigated the gestational diabetes rates in European Ethnic minorities who developed the disease even though they tended to be younger and have lower body mass index (BMI) compared to other Europeans.

Here are 4 ways to reduce the risk for developing gestational diabetes:

1.  Achieve and maintain a healthy BMI prior to pregnancy.  Women who are overweight or obese are at risk for impaired glucose regulation both in the pregnant and non pregnant states.

2.  Physical activity:  In pregnancy this does not have to mean training for a marathon level of physical activity.  Even a modest 15 minute walk can improve glucose metabolism to decrease risk.

3.  Adopt a whole foods diet which includes minimal amounts of refined sugars.  Eating less processed foods provides increased amounts of dietary fiber which helps to stabilize blood sugar.

4.  Increase protein from vegetable and nut sources while reducing protein intake from red meat.  Research published in Diabetes Care  found that by replacing 5% of protein from red meat with a 5% intake of protein from non-meat sources decreased the risk for developing gestational diabetes by approximately 50%.

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In health and wellness.

Dr Amanda Hochman, N.D.