Gestational Diabetes as a risk factor for Type 2

[Anonymous]

I’m floored. My annual bloodwork A1C came back in the low-end of prediabetes. My sole risk factor is having had GD with my 3rd pregnancy (at 42, if that factors; I had flunked the 1-hr test but passed the 3-hr GTT with the first 2 pregnancies). I’d love to know if others with GD as history and an otherwise athletic lifestyle, and are at a healthy weight, were able to overcome their prediabetes status without a lot of food sacrifices.

I am now 58. When I think Type 2 diabetes, I picture someone who is overweight, sedentary, eating a lot of processed food. I gave up alcohol 18 months ago and lost 17 lbs rather quickly (I’ve learned how in some bodies the sugar from alcohol is metabolized first, and right into the fat cells, and I seem to have one of those bodies). I went from 5’5” and 158 at my peak to 133 lbs. At the time I stopped drinking, I injured my hip and I could not do any exercise for more than a year. In the last four months I reengaged in a competitive sport at the masters level, and am doing high-intensity workouts 4x weekly for 60-75 min session. I’ve lost another 5lbs and now weigh 128. And I have prediabetes! There is zero family history of diabetes, and none of my sisters had GD. My lipid panel is in the “zero-to-worry-about” category (all that exercise+genetics). My diet is pretty good: we eat family dinners that I cook from whole ingredients five nights a week, though there are areas I can improve.

I feel like after giving up alcohol, plus working out at a high level, I should be able to enjoy a couple of Milano cookies. Has the gestational diabetes doomed me that significantly? I managed my GD just fine with CICO (I could enjoy a latte if I walked to the Starbucks six blocks from my office for it), otherwise I followed your basic low-carb/South Beach diet. I realize A1C measures glucose levels over time, and as I’ve only recently become very physicially active again (four months), perhaps the benefit of that new activity hasn’t been measured yet?

[Anonymous]

I'm sorry OP, this sucks. The good news is that pre-diabetes is not diabetes.

I'm not an expert - my spouse and child are Type I, but my spouse was mistakenly diagnosed as Type 2 because he was in his 20's when symptoms appeared. So we did a lot with diet at that time. One thing we learned is that it's hard to find endocrinologists and dieticians who are experts and will think out of the box. When presented with problem X, the solution is Y, and that's it. That's how my spouse ended up in the hospital with DKA.

Anyway, if you have the resources and time I'd try to find an endocrinologist and dietician that have experience with someone like you who shouldn't have pre-diabetes. But I'd first wait for your second A1C to come back and see where you are with it. There's also some thinking out there that metformin should be prescribed to people at much lower levels of A1C/insulin resistance.

Good luck.

[Anonymous]

Are you sure it's type 2 and not type I diabetes? If not, ask them to run the tests.

[Anonymous]

Diabetes is not a moral failure caused by you not working hard enough. Yes, GD is a risk factor. You are not in control of how your body responds to having a placenta in it. Take it easy on yourself, OP.

[Anonymous]

No gestational diabetes that I know of, but when my 9.5 pound 2nd baby was born, doc at hospital warned me of the correlation between having high birth weight babies and higher risk for Type 2 diabetes. It was a good reminder to keep an eye on my blood sugar as I age.

This is reversible. Use a continuous glucose monitor for a couple of months to figure out which foods cause spikes, and adjust your diet accordingly. Some of the foods that cause problems will surprise you. It is all very individual.

[Anonymous]

My SIL had gestational diabetes and now in her 60s has type 2 but controls it with diet, weight loss, and exercise. I don't think she takes insulin but she does keep track of her blood sugar. FWIW she was never obese, just maybe a tad overweight for some years, but nothing remarkable - you'd not have thought she was heavy.