Is Gestational Diabetes Caused By Air Pollution?

Gestational diabetes, or diabetes that is triggered by the grown of the unborn child and ends when the child is born, is an extremely common complication of pregnancy. Worldwide, it affects about one in seven pregnancies. In the United States, there are about 200,000 cases of gestational diabetes every year.

Developing diabetes during pregnancy can have serious consequences for both mother and child. Children whose mothers were diabetic when they were in the womb have about a one in three chance of developing type 2 diabetes later in life. Mothers who had gestational diabetes are more likely to develop cardiovascular diseases later in life.

There are also serious short-term complications due to the condition. It is not unusual for the offspring of a mother who had diabetes during pregnancy to exhibit macrosomia, unusually large body mass. My own grandmother had diabetes during her last two pregnancies, bearing children who weighed 17 pounds (about 8 kilos) and 19 pounds (over 9 kilos). My aunt and uncle died within a few hours of their births, and my grandmother herself succumbed to heart disease a few years later.

Gestational diabetes can cause complications during delivery. Shoulder dystocia, a condition in which the head of the child passes through the birth canal but the shoulders cannot pass the pubic bone because the child is too large, can require significant manipulation of the baby to enable birth. There is a danger the child will suffocate during the procedure. Some babies born to mothers who have gestational diabetes are born diabetic, and many face developmental issues in childhood. Intellectual development of the child may be slower than expected.

The Persistent Problem Of Air Pollution

Links Between Air Pollution And Diabetes

Why Should Air Pollution Cause Diabetes, and What Can We Do About It?

• 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.