“I said why did I get this? Wasn’t that enough?” she said.
Spiegelman immediately referred Abramowitz to a nutritionist to discuss a diet. Hoping to find a diet more in line with what she already eats, Abramowitz then decided to meet with a second nutritionist.
“The nutritionist worked with my lifestyle and tailored the diet around that and helped me with what goes into the diet, rather than just saying eat this amount of proteins and this amount of carbs,” she said.
While she doesn’t mind the food covered by the diet, she has been struggling with the amount: three meals plus two to three snacks.
“When you’re pregnant and getting bigger and bigger, you don’t want to eat so much,” she said.
In addition to testing her sugar throughout the day, every morning she must check her urine to ensure limiting her carbs is not causing her body to literally start attacking itself in search of other sources of energy. Sure enough, Abramowitz developed this condition, called ketosis, but remedied it by changing her carb intake.
Like most women with gestational diabetes, she has been able to control it through diet alone. A small percentage of women will need to take insulin or other medicine that spurs insulin production, Spiegelman said. And of those, anywhere from 20 to 50 percent will end up being diabetic for life, according to the NIH.
Those women need to be retested six weeks after they deliver “to see if they are truly diabetic,” Spiegelman said. “We know being a gestational diabetic is a risk factor for people who will become diabetic. It doesn’t cause it, but it teases out those people a little earlier.”
Babies are also typically born with elevated sugar levels, he said, which can then plunge. So doctors need to monitor that because “if the baby is very, very hypoglycemic, that can cause seizures. And that’s not a good thing.” Neonatal diabetes, a very rare form that afflicts only one in about 100,000 babies, is completely unrelated to gestational diabetes, he said. Researchers have increasingly linked it to a gene mutation.
While diet can help symptoms, there is no preventing gestational diabetes, Burkett said.
“Exercise, proper diet and maintaining your weight are going to be important in allaying the problem, but can you really prevent it? I’m not sure you can,” he said. “So what we have to do is screen patients.”
And because it can be a warning, women who develop gestational diabetes need to take heed and pay extra attention to their weight, diet and exercise. In addition, they need to keep a careful eye on their children: the NIH reports that of the children born to women with gestational diabetes, about 10 percent are overweight in early adolescence.
“It’s something we have to be aware of,” Burkett said. “It also comes back to the question of whether or not we can prevent it. I don’t think we can. I think we can diagnose it and minimize some of it by changing the way people live and by the way they eat and exercise.”