Gestational Diabetes after weight loss?

[CamilleBethany]

I am just 5 weeks pregnant with baby #4 (Technically 6th pregnancy-2 miscarriages). I was diagnosed with GD with 2 of 3 babies, and did have a 10 pounder, but had all 3 kiddos naturally/pain med free, though at the hospital.

I'm so hoping for a home  birth this time around. I have super fast deliveries (barely made it to the hospital in time for the last one, I was 10cm dilated, water not broken, and delivered pretty much as soon as I was on a bed). So I'm preparing for a homebirth regardless, because I think it will just happen! Well lucky me, I found a midwife, who it turns out, is just a few blocks away, and she doesn't think the GD would get in the way of a home birth.

But my question is this!

Since delivering my last child (march 09), I've lost 27 pounds. My BMI is in the lean category, my fat percentage is the healthy category. My diet has changed drastically (mostly, I just wasn't eating enough before...being a mom of young kids, I put everything before feeding myself. I've learned to take the time to eat 3 healthy meals a day, with healthy snacks in between).

So my question is... do these factors lower my risk for getting GD again? Or am I just doomed to be pricking myself every day for the next 9 months? I can't seem to find any concrete research!

[Nutter]

I've actually declined GD testing in my pregnancy because the research shows that the ONLY change in outcomes when a woman is diagnosed and treated for Gestational Diabetes is an increased risk that she'll give birth by cesarean.  GD treatment doesn't appear to offer any benefits to mother or baby.  I would encourage you, if you haven't already, to read some of the information on GD by Michel Odent, and Henci Goer, before stressing too much about trying to avoid a repeat diagnosis.  This downloadable birth planning guide also contains really helpful info about the GD tests.

[Tumble Bumbles]

You know, GD is a funny little monster. I am obese and yet I didn't have it with my first and don't have it now. I'm not even doing the test, as I think it is highly flawed and quite disgusting, not to mention unrealistic. Who in the universe consumes that much sugar in such a short span, especially without anything coupled with it to slow the insulin response (such as fat or protein)?

 I have lean friends who are in shape and eat healthy and have had GD, which is why I think the test is totally flawed. Both of them ended up with what I believe are unnecessary c-sections because of their massively huge, in danger babies that were both well under 8lbs and healthy

 I know losing weight can help, and being as fit as you can be is just common sense,  I just wouldn't stress about it, like the pp said. Magnesium helps a lot with regulating insulin levels and is just a smart supplement anyway (or you can get it through epsom salt baths).

I would just home monitor if I were you (if you're concerned about it) and adopt a low glycemic diet -- or a diabetic-type smart carb diet if it helps you feel better mentally/physically,  if you are concerned about it.

[Youngfrankenstein]

My sil was about 25, very healthy and thin for her first pregnancy and had GD, same body for her second and didn't have it.  I find the whole topic suspect the more I research it.

I can only say that there is no downside to me to eating a GD diet really.  I would think long and hard about it if they were recommending insulin or invasive treatments.

[ShwarmaQueen]

Agree with a pp. A healthy, lower carb diet AND walking 2 times daily (ideally morning and night), for 10-20 minutes, minimum, has been shown to do wonders for gestational diabetes. I wish more docs would prescribe that more than the fingerpoking. 

[msmiranda]

I'm sure that losing weight and changing your diet will absolutely lower your risk ... and even if you do get it, you'll be in a much better position to control it since you've already done the work of altering your diet (that was the hardest part for me initially -- not doing it, per se, but accepting that I had to do it).  Exercise will help too, in both prevention and control.

Every OB I've ever talked to about this thinks I'm weird, but I would rather do a few weeks of finger sticks than take the GTT.  I mean, I guess for me, I know what the result will be already (I'm 21 weeks and can already tell that my body's tolerance for carbs has declined significantly) so I don't see any need to drink that nasty s**t.  Eating a strict low-carb diet is just part of pregnancy for me -- no cookies, no candy, no cake, no bread.  But honestly, if you are already doing that and plan to continue it for the duration, then the only thing you need to know once you hit 28 weeks is whether that diet is adequately controlling your blood sugar -- so again, home monitoring would be more informative to you than the GTT.  I know it's a pain to do the monitoring, but once you know how you're responding you don't have to do it every day.  I did it every day for 2 weeks, and then maybe one day a week thereafter.

[ShwarmaQueen]

Msmiranda, I poked my finger a few times every week too. lol I kept an informal log. My father was type 2 diabetic so I was paranoid. There were a few time my blood sugar was around 130 and so I would walk 20 min or climb stars (slowly) for 10 min and it would ALWAYS bring my blood sugar down at least 15 pts within just a few minutes of resting. It works magic. I felt that was was easier (along with diet modifications) than putting my body through the stress of GD testing.