Untreated Diabetes During Pregnancy May Raise Kids' Risk for Obesity Later

How Gestational Diabetes Works

During pregnancy, the placenta not only provides the fetus with nutrients and oxygen, it also produces hormones that change the way insulin works. A chemical made by the pancreas, insulin helps the sugar from food (called glucose) get converted to energy.

A pregnant woman gets gestational diabetes when her pancreas can't make enough extra insulin to overcome the effects of placental hormones. This causes high levels of glucose to build up in her blood. That extra glucose can then cross the placenta, giving her growing baby a high blood sugar level, too.

The baby's own pancreas then also starts making more insulin to handle the extra glucose. The calories from the extra blood sugar are stored by the baby as fat, causing the baby to gain more weight than normal (which also makes a C-section more likely). Exposure to high sugar levels can also increase the risk of birth defects in the infant. Scientists also think that the abnormal energy and hormonal balance these babies experience in the womb may make them handle energy differently after birth, possibly increasing their risk for obesity.

What This Means to You

If you're pregnant, a glucose screening for gestational diabetes is a must. The simple prenatal test involves drinking a sugary liquid and then having your blood sugar level checked.

Women with a higher risk of having gestational diabetes are screened at 12 weeks. That includes expectant moms who:

• have previously had a baby that weighs more than 9 pounds (4.1 kilograms)
• have a family history of diabetes
• are obese
• are older than 30

All other pregnant women are tested for diabetes sometime between the 24th and 28th weeks. But if you've tested positive for sugar in two of your routine urine tests, your health care provider may order blood testing earlier.

Although gestational diabetes usually goes away after the birth, and it's very manageable when it's caught and treated early, many women with the condition may still experience it again with future pregnancies. They also have a higher risk of developing type 2 diabetes later.

If you have gestational diabetes, your health care provider will work with you to create a treatment plan that will include a well-planned diet, regular exercise routine, and sometimes medication. Keeping your blood sugar levels in check now can make for a much healthier start for you and your growing baby.

Source: "Childhood Obesity and Metabolic Imprinting," Diabetes Care, September 2007.