Health & Fitness

Girls, women at risk for diabetes

TREATING GESTATIONAL DIABETES: Melissa Wolf meets with Dr. Jason James, her obstetrician.
TREATING GESTATIONAL DIABETES: Melissa Wolf meets with Dr. Jason James, her obstetrician. FOR THE MIAMI HERALD

For girls and women, puberty and pregnancy are times to be on the lookout for diabetes.

With puberty comes a chance of developing Polycycstic Ovarian Symptom, or PCOS. The sometimes embarrassing condition causes fluid-filled sacs (called cysts) to grow on the ovaries — and can lead to diabetes.

During pregnancy, an estimated 2-10 percent of women develop gestational diabetes, according to the Centers for Disease Control & Prevention. Gestational diabetes puts babies at higher risk for eventually developing the disease, too.

Here is a look at diabetes during milestone moments in a female’s life.

PCOS

Puberty is already a difficult time for many girls. For those with PCOS, it can be even harder.

PCOS is basically a hormone imbalance that causes the ovaries to release more testosterone. That can lead to weight gain, facial hair growth and irregular periods. The consequences carry later into life, too. PCOS is one of the leading causes of infertility because it interferes with ovulation.

And, 30 percent of the time, PCOS leads to insulin issues, according to a study by the University of North Carolina School of Medicine in Chapel Hill.

Girls who develop PCOS tend to start menstruating earlier in adolescence, and quickly become irregular, said Dr. Luis Gonzalez-Mendoza, the director of pediatric endocrinology at Miami Children's Hospital.

Gonzalez-Mendoza said young women also tend to be overweight at the onset of puberty — a problem that lingers through life. According to the American College of Obstetricians and Gynecologists, 80 percent of women with PCOS are overweight.

Being overweight is a major risk factor for developing diabetes.

“Most of the women with Polycystic Ovarian Symptom have the weight issue, and we don’t know exactly why,’’ Gonzalez-Mendoza said. “I think it’s sort of ‘chicken-and-the-egg,’ because as you become more overweight, you become more insulin resistant.’’

Though the name may suggest otherwise, those with PCOS don’t tend to develop large cysts. But when they do, it’s painful and surgery may be required. Dr. Cathy Burnweit, the chief of pediatric surgery at Miami Children’s, said the goal of surgery is to prevent large cysts from causing the ovary to twist, which can kill the ovary.

Surgeons remove the fluid from the cyst by a simple surgery through the bellybutton. Sometimes, Burnweit said, the ovary will be sewn into the uterus to keep it from twisting.

GESTATIONAL DIABETES

The news was devastating at first. Five months into her pregnancy, 30-year old Melissa Wolf found out she had gestational diabetes.

“I wanted to make sure that I knew everything that I could to understand and control everything that was happening to me,’’ Wolf said.

Gestational diabetes is glucose intolerance that presents for the first time or only during pregnancy. Though having gestational diabetes leaves women at a higher risk of developing diabetes later in life, most women do not develop the disease.

There’s more good news: As Wolf soon learned, women often manage gestational diabetes without insulin injections. Instead, it’s all about diet and exercise.

For Wolf, that actually means eating more — but healthier. With the help of a dietitian, Wolf devised a meal plan heavy on whole grains, fresh fruit and healthy snacking.

Coupled with regular walks — “even in the rain,’’ Wolf said — she has been able to manage gestational diabetes without medication.

“I’m not a big fan of taking medication and I’m not a big fan of taking medication while pregnant. I just feel if I can control it with whatever I’m capable of doing, that’s what I’m going to do,’’ she said.

Left unchecked, gestational diabetes affects more than just mom.

Babies of women with gestational diabetes are often bigger, which may mean broken bones during delivery or prompt a Cesarean section. Newborns can even go into withdrawal-like symptoms at birth, said Dr. Jason James, chair of the Department of Obstetrics and Gynecology at Baptist Hospital.

"Diabetes is a problem that affects both the mom as well as the baby, and has long-term implications for both. So the sooner you can treat it, the better," he said.

The time to start thinking about gestational diabetes is before conceiving. Women who are obese are more likely to develop insulin intolerance during pregnancy, so losing weight before getting pregnant is a good idea, doctors say.

Also, gestational diabetes runs in families, so know your history before getting pregnant.

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