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There was a time when pregnant women who developed diabetes were chastised by their doctors for eating too much. Now gestational diabetes is known to be influenced by purely external factors, such as air pollution.
The underlying mechanism through which air pollutants cause all the changes in the metabolism that lead to high cholesterol, high triglycerides, high blood pressure, weight gain, and diabetes seems to be oxidative stress. Ozone, in particular, is a strong pro-oxidant, the opposite of an anti-oxidant. The body has to use its antioxidants to deal with the effects of pro-oxidants, and doesn't have enough left over to deal with the free radicals of oxygen generated by the burning of sugar. There are extra free radicals of oxygen during pregnancy because of the simple reason that pregnant women have to eat more.
Most women can't move to enjoy fresher air during pregnancy. There are air filtration systems that remove enough particulate matter to make a difference, but there aren't any inexpensive systems to remove ozone. Chances are that the local authorities won't shut down nearby freeways just because someone is pregnant. However, that doesn't mean there is nothing to be done.
- Prenatal care is a must for all expecting mothers, not just those who have gestational diabetes. The standard test for gestational diabetes requires drinking a "shot" of glucose and having blood drawn one and three hours later. This test is done about the twenth-fifth week of pregnancy. However, you can test your blood levels at home before the twenty-fifth week of pregnancy and get earlier treatment--and one less visit to the doctor.
- Vitamin D and calcium seem to relieve the worst effects of gestational diabetes. In one study, women who took two doses of vitamin D3 of 50,000 IU each, three weeks apart, and 1,000 mg of calcium a day for six weeks, beginning the twenty-fourth week of pregnancy, had lower cholesterol, triglycerides, LDL cholesterol, and blood sugar levels, and better HDL during the last trimester of their pregnancies. Calcium and vitamin D may not be enough for treating gestational diabetes every time, but they seem to be very helpful in borderline cases.
- Pregnant women who are obese may benefit from calorie restriction. This doesn't have to be a severely calorie-restricted diet. Generally, doctors recommend about 25 calories per day per kilogram of body weight. A woman who weighs 80 kilograms (about 175 pounds) would still eat 2,000 calories per day. Calorie reduction leads to better blood sugar control, and less risk of gestational diabetes.
- It's usually better to eat five or six smaller meals than two or three larger meals. The pressure of the growing baby on the digestive tract, of course, makes it easier to digest smaller amounts of food at a time. This kind of diabetes doesn't necessarily stop the pancreas from making insulin, but it interferes with abilty of the pancreas to release it, so it's important not to eat too much carbohydrate at any one time so that the insulin release by the pancreas can keep up.
- Women who are already diabetic when they become pregnant need ongoing medical care throughout pregnancy.
- Andersen ZJ, Raaschou-Nielsen O, Ketzel M, Jensen SS, Hvidberg M, Loft S, et al. 2012. Diabetes incidence and long-term exposure to air pollution: a cohort study. Diabetes Care 35:92–98.
- Brook RD, Jerrett M, Brook JR, Bard RL, Finkelstein MM. 2008. The relationship between diabetes mellitus and traffic-related air pollution. J Occup Environ Med 50:32–38.
- Photo courtesy of LoXsToCkK: www.flickr.com/photos/43410638@N05/16373341201/
- Photo courtesy of serenityphotographyltd: www.flickr.com/photos/serenityphotographyltd/5260784249/
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