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Jul 17, 2014

Healthy Living Looks at Gestational Diabetes

There aren’t statistics available in Belize about how often women develop gestational diabetes. In the US, though, it is estimated that as many as one in ten women will develop this condition. The main population affected is women of African and Hispanic descent. This would mean that based on our ethnicities, Belizean women are at a greater risk of developing this form of diabetes. Anecdotally, doctors can verify that the diagnosis is made very frequently. So tonight on Healthy Living, we learn more about this topic including prevention and treatment.


Marleni Cuellar, Reporting
A glucose tolerance test is usually administered to all expectant mothers by their doctors. The test is a first screening for a very common and not so sweet pregnancy complication.


Dr. Mauricio Navarette, Obstetrician/Gynecologist

Mauricio Navarette

“Gestational diabetes is defined as a condition where glucose intolerance is formed for the first time during pregnancy—whether it happened before pregnancy or it is just appearing during pregnancy—but just the fact that you identify it within pregnancy classifies a woman as having gestational diabetes. Gestational diabetes occurs during pregnancy actually due to the pregnancy. There are certain hormonal changes that take place. The placenta which is where the baby feeds from actually produces a myriad of hormones. One of these hormones called Human Placenta Lactogen (HPL) causes women, all pregnant women to have a diabetogenic stage. So all women would tend to retain more carbohydrates in order to nurture the fetus; however, in some women there is an exaggerated response to this hormone so they would develop gestational diabetes.”


In his practice as an OBGYN, Dr. Navarrete says he does find women developing gestational diabetes very often in Belize.


Dr. Mauricio Navarette

“Gestational diabetes is frequent in Belize. Like I said, we are not going to talk about numbers but it is quite frequent. One of the problems that we have in Belize is that gestational diabetes, according to the US, is most common in women of black and Hispanic women which is the majority of our population. So we do find it quite often. Second, all women can—although all women of different sizes and shapes could—develop gestational diabetes, we do have a problem. That’s what I think; we do have a problem with our diet. Our diet is very high in carbohydrates, very high in fats, so our women are more predisposed to having gestational diabetes because of those factors as well. The most common misconception women have with gestational diabetes is that it is something that they might inherit from somebody else and the second most common one is that just by eating sweets, you will develop gestational diabetes. That’s not necessarily true. Although there can be some familiar influences—women who have family members who have diabetes, you have a slightly higher risk of having gestational diabetes. Any woman can have gestational diabetes though—from overweight women to very slim women.”


The main concern of the expecting mom’s once diagnosed is “Is my baby going to be ok?” While, that is completely natural concern, Dr. Navarette says the moms to be should focus on their own health and that includes a healthy eating & exercise.


Dr. Mauricio Navarette

“When we talk about diet thought=, we don’t ask them not to eat because they have to gain weight, they have to nurture the baby. So what we ask them to do is to spread out their meals; women who are eating three meals a day or two meals a day, we ask them to do five or six meals a day. That’s the first important step in doing so. The reason is very simple. When you eat one or two meals a you’re your body has to work only once or twice at burning the calories that those meals have. If you spread those meals in five meals then your body has to be working throughout the day to burn those calories. So actually you don’t absorb or retain those calories as if you did if you only ate two or three meals. The other thing we ask them to do is when we tell them to eat five meals a day, we noh ask them to eat five large meals. The same two or three meals that you were eating before, you split them up and spread them into five or six. What I always tell women is instead of eating a plate of rice and beans, you eat a cup of rice and beans along with fruits and vegetables and meats; meats don’t have a lot of carbohydrates. Remember you want to decrease the amount of carbohydrates you are eating which have a lot of calories. So women don’t necessarily have to lose weight when they are on treatment for diabetes and pregnancy, they just have to eat smarter and healthier. It’s been proven that exercising two or three times a week for twenty to thirty minutes a day, does decrease the caloric intake of women and then increases their metabolism; therefore, they burn calories a lot faster. So many women would be able to manage their diabetes with exercise and diet alone.”


The management for gestational diabetes starts with lifestyle changes and the use of oral medication or insulin is only if it is absolutely necessary. The greatest risk associated with the condition is excess growth in the baby.


Dr. Mauricio Navarette

“Having a large baby is one of the most common complications in gestational diabetes and of course, large baby doesn’t mean a healthy baby in this case. The risk of having a larger baby than normal comes because of course the hormone, HPL, causes more insulin to be produced by the baby as well. So the baby ends up absorbing more nutrients and therefore becomes larger. One of the risks though is that women who have very large babies may not be able to deliver vaginally so the incidents of C-sections are much higher in women who have gestational diabetes. But more importantly though, we don’t know quite why yet, but there is a higher incident of death in the last two to three weeks of pregnancy in babies who are infants of gestational diabetic mothers, especially the larger babies. So there is a true concern with regards to these babies; therefore, most of the time, the protocols would call for the babies to be taken out at thirty-eight, no later than thirty-nine weeks in women who are not well controlled because of the risk of death.”


Mom is still at risk post-delivery too as some women remain diabetic while the others are at risk of developing type 2 diabetes down the road.  The baby is also at risk of becoming pre-diabetic. While, anyone can develop gestational diabetes, there are still some changes you can make early in your pregnancy to lessen your risk.


Dr. Mauricio Navarette

“Early in pregnancy, one of the best advice we can give is for them to start on a good exercise regime—again, two to three times a week; a short walk—and diet, a good diet—not starving yourself, but eating right, eating smart…a lot of vegetables, lots of meat and less carbohydrates.”

Viewers please note: This Internet newscast is a verbatim transcript of our evening television newscast. Where speakers use Kriol, we attempt to faithfully reproduce the quotes using a standard spelling system.

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