What is insulin resistance and gestational diabetes?
Your pancreas produces the hormone insulin to control the glucose levels in your blood after you eat and absorb ‘sugars’ (food). During pregnancy the placenta releases other hormones that can interfere with this process. More insulin than usual is needed to control sugar levels, creating a condition called insulin resistance or pre-diabetes. If left unmanaged, your pancreas becomes overworked and may not be able to create enough insulin to control your blood sugar levels. Your glucose levels rise above what is healthy putting you at risk of gestational diabetes
Why is this a concern for pregnant women?
If insulin resistance and gestational diabetes are left unmanaged you are more likely to gain a lot of weight during pregnancy, especially in the later stages. Your body is already having to cope with the physiological changes and demands of pregnancy and extra weight only increases the pressure on your joints and ligaments. You are more likely to suffer cramps, back pain, shortness of breath, sore hips and pelvis and sciatica – as well as increased severity of these conditions.
In addition, the more weight you put on in pregnancy, the more you have to lose. The reality is, un-lost baby weight is one of the main causes of obesity in women. Imagine if in your first pregnancy you put on 16 kilos, but only lose 8 post-natally. After all, you have had a big life change and are always busy caring for your little one. In your second pregnancy you put on 15 kilos and lose 6 after the birth. It’s harder than ever to fit in exercise as the mother of two and you put your children and their needs first. Supposing you were a perfectly healthy weight pre-children, you are now 16 kilos overweight. It happens so easily.
Gestational diabetes can also lead to a difficult delivery and increase the likelihood of needing a caesarean birth. As with all abdominal surgery, a C section can be more complicated when there is more fat around the tummy area. Whilst most expectant mums hope to avoid a caesarean delivery, there are times it is advisable and a healthy body weight just helps your doctor take the best care of you.
Most importantly, if you do not make an effort to prevent or manage insulin resistance and it becomes gestational diabetes in your first pregnancy, you are far more likely to present with gestational diabetes in subsequent pregnancies. There is yet another layer to this slippery slope. Developing diabetes during pregnancy significantly increases your risk of developing type 2 diabetes later in life, as well as at an earlier age.
Why is this a concern for my baby?
Whilst your baby itself does not develop diabetes, it is sharing your blood system and the high levels of insulin can cause your bub to grow too big. This may result in your baby being born early, even though it has not fully matured in other ways. It can also lead to a more traumatic arrival for your bub. Or, even necessitate a caesarean delivery, when it may not otherwise have been required. Gestational diabetes could mean your baby is born jaundiced or with low blood sugar levels, so need extra medical intervention and monitoring. Whilst the medical staff will take great care of you and your bub, its not the most peaceful and intimate start for mum and her new baby and is best avoided if possible.
The good news is insulin resistance and gestational diabetes can be controlled – and even avoided, by following a healthy lifestyle during pregnancy. This includes a low GI diet and plenty of moderate exercise. Even when medication is advised, it is still in conjunction with a healthy eating plan and regular activity.