Common pregnancy conditions linked to future diabetes risk

Jelly beans, chocolate and peanut butter.

These are three foods expectant mom Hannah Beckett from St. Albert likes to snack on, especially during pregnancy.

Recently the 25-year-old was diagnosed with gestational diabetes, a condition that complicates her cravings for sweets.

"I was very disappointed," admitted Beckett. "I like to eat a lot of sugary things and I thought [gestational diabetes] would be very restricting."

Although Beckett, now 32 weeks pregnant, has made significant lifestyle changes in order to manage her blood sugar levels, she will have to maintain her vigilance even after giving birth.

Recently, a new study by Canadian researchers has found women with gestational diabetes, combined with two other common pregnancy conditions, had 20 to 21 times greater risk of developing diabetes later in life.

Pregnancy diabetes

Gestational diabetes, also known as Gestational Diabetes Mellitus, is a temporary condition three to 20 per cent of pregnant women develop, according to the Canadian Diabetes Association.

Due to changing hormone levels and the effects of a growing baby, some women's bodies are unable to produce enough insulin to control their blood sugar levels.

Women are usually screened for gestational diabetes between 24 and 28 weeks of pregnancy using a blood test and/or an oral glucose tolerance test. Risk factors include conceiving at the age of 35 years and older, having a family history, having diabetes during a previous pregnancy and obesity.

"One of our issues now is that the general population is carrying more weight so as a result we're seeing more gestational diabetes," said Shelley Nadolski, registered nurse at the Sturgeon Community Hospital's diabetes education centre in St. Albert.

If unchecked and untreated, gestational diabetes can increase a woman's risk of delivering a baby weighing more than 9 lbs. (4 kg), create difficulties during delivery and put the child at a greater likelihood of becoming overweight and developing diabetes later in life.

"If the [mom's] blood sugars are not well controlled, there could be some issues with the baby over-producing insulin themselves and then actually having low blood sugars when they're born," said Nadolski.

Researchers from the University of Toronto have found women with pre-eclampsia – a pregnancy condition marked by high blood pressure, fluid retention and protein in their urine – as well as gestational hypertension (high blood pressure during pregnancy), are more likely to be diagnosed with diabetes after pregnancy.

The study used health information from more than one million women. It found the incidence of developing Type 2 diabetes later in life was increased more than 13 times if a woman had all three conditions, compared to gestational diabetes alone. Without gestational diabetes, both pre-eclampsia and gestational hypertension were associated with a two-fold increased risk of diabetes in the years following pregnancy.

The study suggests the need for more vigilant screening for diabetes in women with a history of these conditions and to now consider pre-eclampsia and gestational hypertension as risk factors for the disease.

The study was published in the journal PLOS Medicine and funded by the Canadian Diabetes Association.

Timing is everything

"Experiencing it myself, I now look at food a lot differently," said Beckett, who will soon be a mother for the second time. Although she didn't have any risk factors such as diabetes during her first pregnancy, Beckett said the diagnosis has changed the way she looks at food.

She acknowledged she is now more conscious about purchasing foods "as close as they come in nature" and is more discriminating of their sugar, carbohydrate, fat and protein contents.

Beckett can still eat her jelly beans, chocolate and peanut butter, but only in moderation since she checks her blood sugar four times per day.

Diabetes educator Nadolski explained many women that are referred to the clinic after diagnosis manage their diabetes through diet and exercise as well as insulin when necessary. Patients log their blood sugars up to four times per day and come in for a follow-up every two weeks.

Women planning to conceive can prevent gestational diabetes by adopting a healthy lifestyle and maintaining their blood sugars prior to pregnancy.

"[Moms] are worried about their babies of course," said Nadolski. "I tell them that when gestational diabetes is diagnosed … the baby is already built in the first trimester. It's a little different for moms with Type 1 and Type 2 diabetes, if their blood sugars are not well controlled when they conceive, there [are] more problems that can happen."