Q. I am pregnant and am wondering how likely it is that I will get diabetes. Is there anything I can do to avoid it?
A. Diabetes is a disease in which the body can't properly absorb the glucose (sugar) from foods. Cells -- especially brain neurons and red blood cells -- need this glucose to function properly.. Normally, the hormone insulin helps to shuttle glucose into cells that can use it. But when a person has diabetes, this action is impaired. Either they don't make any, or enough, insulin, or the cells have problems that impair their ability to use the glucose.
One type of diabetes occurs for the first time in women who are pregnant. Most women with some risk of developing the condition are screened during their 24th and 28th weeks of pregnancy. Around five percent of all pregnant women develop gestational diabetes, according to the National Institutes of Health. You are at some risk if you have at least one of the following factors:
- You are Hispanic, African American, Native American or Pacific Islander
- You are overweight (a Body Mass Index of 25 or greater)
- You are related to someone with diabetes
- You are older than 25 years old
- You have had a still birth or very large baby during a past pregnancy
- You have a history of abnormal glucose tolerance
Having diabetes in pregnancy is a problem because it can affect the health of the infant, and the child may be more likely to become obese and/or develop diabetes later. The mother who has it is also at greater risk of developing Type 2 diabetes after the pregnancy. So, it's important to avoid this complication if possible.
Exercise studies have shown that working out while pregnant can have a protective effect. A 2012 study published in the British Journal of Sports Medicine compared over 80 women during pregnancy. In this randomized, controlled trial, half of the women exercised and half were "controls" who did not exercise. None of the women had ever had diabetes and all were healthy at the start of the study.
At the start of their pregnancy (weeks six through nine), the women who exercised did standard aerobic dance for 35 to 45 minutes on two days per week and did water aerobics on one day a week for the same amount of time. They continued this exercise three days per week until the end of their third trimester (weeks 38 through 39.)
The women were screened as normal with an oral glucose test for gestational diabetes during weeks 24-28 of their pregnancies. The exercising women had significantly lower blood glucose scores during the tolerance test. At the end of the exercise period, there were no cases of gestational diabetes among the women who had exercised, whereas there were 3 cases among the controls, a statistically significant difference between the two groups.
There was a higher incidence of caesarean sections among the exercisers. But the researchers speculate that this may have been because more women in this group were pregnant for the first time and so more likely to have complications during delivery. So, there is no clear evidence that the fact that women in this group exercised played a role in their needing a caesarean section.
Some doctors do not recommend that a woman exercise when they are pregnant. I've written more about that here. But this and other studies suggest that among the many benefits, controlling blood glucose and potentially avoiding getting gestational diabetes is an important reason to stay active during your pregnancy, as long as it is safe to do so.
There is increased concern that pregnant women avoid gaining more weight than they should since excessive pregnancy weight gain has also been found to be linked to an increased risk of gestational diabetes. It is hypothesized that regular exercise can help prevent excessive weight gain, and that this may be one of the reasons why gestational diabetes risk is lowered. So, consult with your doctor and figure out the best workout plan for you to follow.
