Supplement Detective

By Curtis Alexander, Pharm.D.

Summary: Gestational diabetes risk is a concern for every pregnant woman.  It’s important to control first and foremost with how you eat.  Secondly with activity.  Finally, your doctor may put you on medications to help control it.

Q: My doctor has been testing my blood sugar and has discussed that I might be at risk for gestational diabetes.  No one in my family is diabetic.  He said it happens to a lot of women and they just manage it and it will likely go away.  My doctor didn’t think it was a big deal and didn’t have a lot of time to discuss it.  Frankly, I’m worried.

A: OK, first a few ground rules.  Pretty much all pregnant women (like diabetics) develop some degree of insulin resistance.  Now, the end result of being insulin resistant is the same for a pregnant women or a regular diabetic.  But, also remember that the causes of the insulin resistance are different in each case.  I’ll get to that in a second, but first you need to understand what insulin resistance is and why it’s important for you to control it as best you can.

Insulin Resistance

You’ve probably heard me talk about this before but insulin resistance is really the gateway to developing diabetes down the road.

So, think of it this way: when your cells start becoming insulin resistant they don’t respond to insulin as well.  So, your body has to start putting out more and more insulin to do the same job as before.  This increase in insulin only makes the cells more resistant to insulin over the long run because they are seeing more and more of it.

A good way to think of it is violence on television.  What was considered violent or racy 50 years ago would be commonplace today.  That’s because we’ve become accustomed to it.  Just like your cells have become accustomed to the higher and higher insulin levels.

Eventually what happens is that it will lead to diabetes type 2 where your pancreas is still functioning – but barely and they put you on medications to improve your insulin sensitivity.  Or, you become a type 1 diabetic where the pancreas simply burns out and can’t produce insulin anymore.

Either way that is a road you don’t want to go down.  The thing to remember is this: the insulin resistance that you get during gestational diabetes isn’t like the insulin resistance with regular diabetes (explained below).

What they’ve also found in pregnant women is that those who develop gestational diabetes have about a 50% higher chance of developing diabetes than the rest of the population.

What Causes Gestational Diabetes?

Frankly, the causes of gestational diabetes isn’t known.  But researchers suspect that it might be due to the placenta which releases hormones during pregnancy that block the action of the mothers own insulin in her body?  This is also why if you are diagnosed with gestational diabetes it will likely go away with the birth of the baby as you have expelled the placenta.  The result is that you will have much higher circulating blood levels of glucose.  This could be a problem for both mother and baby.

In the mother the glucose in her bloodstream is not being converted to energy so she will likely be suffering from hyperglycemia and may experience some of those effects.  For example, with all this glucose in your blood you’ll likely be hungrier.  Remember, because the actions of insulin are being blocked you can’t bring the glucose into the cells for energy.  In addition to being hungry some of that excess glucose may spill over into your kidneys where they ‘try’ to get rid of it in the urine.  Naturally, water will follow the glucose so you end up peeing more.  Because your peeing more you may get dehydrated and get thirsty.

As for the baby, it will now be getting much more glucose than needed which will be converted to energy – most likely in the form of fat.  The baby is able to do this because it is NOT resistant to insulin.  And if it’s pancreas is functioning it will be converting much more of the circulating glucose in the mother’s blood stream to energy.  This is why babies of mothers who are diabetic come out bigger (usually).

Obviously, having a “fat” baby has it’s own set of problems down the road because the child is more likely to be diabetic because of what happened in the womb (insulin resistance).  But also, a large baby increases the chances that the mother will have to deliver via a C-section and if there is a vaginal birth the baby could have head and shoulder injury issues.

Naturally Controlling Glucose and Insulin Levels

Obviously, your doctor is closely monitoring your situation.  If it were my wife I would have her eat the type of foods that are outlined in my healthy eating section.

You want to limit foods that promote ’spikes’ in insulin release and high glucose levels.  That means eating naturally with calorically light, but nutrient dense foods: vegetables, some fruits, lean meats, nuts and even butter.  Avoid all processed foods like the plague (breads, pasta’s, chips, fries, margarine, etc.)

I’d also talk to your doctor about supplementing with a high-quality cod liver oil.  It’s loaded with nutrients and is a good, inexpensive all-around supplement.

Also, stay active if you can.  Obviously, I wouldn’t recommend a marathon for a women at 37 weeks – but – stay active with common sense.  The glucose (sugar) that is building up in your bloodstream will immediately be used as an energy source during activity and will help control the gestational diabetes.