Researchers at Kaiser Permanente Center for Health Research in Portland, Ore., and Hawaii found that the higher a mother’s blood sugar was during pregnancy, the more likely her baby would be over weight by age 7. “Quite a few studies have shown that if you’re overweightat ages 5 to 7, you’re much more likely to be overweight asan adult,” says endocrinologist Teresa Hillier, M.D., the study’s lead author. Hillier found an increased risk of childhood obesity even among GDM babies who weren’t large at birth. “To me, that suggest ssomething has been metabolically changed that allows the baby tomore easily store fat,” she says.
Among women diagnosed with GDM, 50 percent will develop typeII diabetes within five to eight years, and 70 percent to 85 percent will develop the disease during their lifetimes, says Boyd E. Metzger, M.D.,a professor of medicine and endocrinology at Northwestern UniversityFeinberg School of Medicine in Chicago (see “Life After GestationalDiabetes,” pg. 37). The National Diabetes Education Program and theAmerican College of Obstetricians and Gynecologists recently joined together to state that women who have GDM (as well as their children)should be followed closely after childbirth to monitor—andminimize—their risk of developing diabetes.
In addition, a 2012 study published in the journal Circulation found that having had GDM boosted a 50-year-old woman’s 10-yearheart disease risk by 26 percent. Researchers suggest that women with GDM might need to have their blood pressure as well as their blood sugar checked more regularly as they get older.
Diet and exercise can help
A GDM diagnosis can serve as an early warning,motivating at-risk women to make permanentlifestyle changes. “Even if treatment only delays diabetes by 10 or 15 years, that’s huge,”Metzger says.Hillier found the risks to children were reduced when women with GDM were treated with diet changes, such as eating fewer sweetsand starchy foods, smaller, more frequent mealsand more fruits and vegetables; increased exercise;and, if that was insufficient, by adding medication,typically insulin. When women remained untreated, their baby’s risk of being overweight or obese at ages 5 to 7 was nearly twice as high.“But the children of women who were treatedfor GDM had no greater risk of obesity or being overweight compared with children of motherswho had normal blood sugar during pregnancy,”Hillier says. “This suggests that treating moms during pregnancy gives their babies a fightingchance for a normal metabolism.”Like Paetsch, Jennie Wolter, 32, wasshocked by a GDM diagnosis because she, too,had no obvious risk factors. “But I came to termswith it when I was assured by my health careproviders that I could manage the risks and havea healthy baby,” says Wolter, the community relations manager for a nonprofit organization inSacramento, Calif. In addition to changing her diet with the help of her midwife, a nutritionist,a nurse and a supervising OB, Wolter also creditsexercise with helping her avoid having to takeinsulin. “My team told me that blood sugar couldbe well controlled by getting some exercise aftereach meal,” she says. When Wolter delivered her8-pound, 6-ounce baby vaginally, she was only 15pounds over her prepregnancy weight—with hercaregivers’ blessing.Paetsch did need to take insulin during herpregnancy, and she credits her diet and exercisechanges for feeling better physically at that pointthan she had in a long time, for weighing about10 to 12 pounds less today than when she became pregnant and for teaching her a healthier wayto live, long-term. “Monitoring my diet was ahuge pain at the time, but I learned a lot abouthow much self-restraint I could actually have,”she says. She also learned she could fit in smallamounts of exercise throughout the day and haveit count, the way experts say it will. “GDM feltlike such a devastating diagnosis at the time,”Paetsch says, “but it was actually a bit of a blessingin disguise.”Suzanne Schlosberg is a health and fitness writerin Bend, Ore.
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