Gestational Diabetes, Is the prevention possible?
Gestational Diabetes occurs in roughly 200,000 women in the US yearly. This number is increasing and peaks between ages 19-40 though this could be due to the fact that those ages are when most women are having babies. Regardless GDM is a huge cost and risk factor for many pregnant women that could possibly be prevented or addressed before it begins.
So what is the deal with GDM, and postpartum weight loss resistance? Weight gain and weight loss resistance can be caused by many things. One of which being hormones in the human body. During pregnancy and the postpartum period our bodies hormones are fluctuating at an amazing rate.
Adiponectin is a protein hormone which is involved in regulating glucose levels as well as supporting fatty acid breakdown. In GDM it has been noted that adiponectin levels are low pre-pregnancy and continue to remain low during and after pregnancy contributing to the development of the disease.
Let’s take it back to the science for a minute then we can get to some action steps for prevention, recovery and even postpartum weight loss.
Pregnancy is a pro inflammatory state in the body and insulin resistance is increased to roughly 3x the pre-pregnancy level. There is also decreased GLUT4 mobilization and decreased insulin sensitivity. GLUT4 is the insulin-regulated glucose transporter found primarily in adipose tissues and striated muscle. The downregulation of this is important when we consider the importance of insulin sensitivity to a healthy weight.
No wonder we gain weight during pregnancy and sometimes even the healthiest women get diagnosed with gestational diabetes.
It has also been noted that low adiponectin independent of insulin resistance or weight pre-pregnancy could be an important indicator of fetal growth and body weight. Ironically adiponectin levels drop to their lowest during the third trimester.
Additionally due to the pro-inflammatory state of pregnancy it has also been noted that antioxidant levels specifically glutathione peroxidase and SOD decline during pregnancy. How crazy is this. One of the most important antioxidants in our bodies is decreased just because we are pregnant.
So how do we prevent or support a GDM diagnosis? As with anything taking a whole body, whole person approach is needed.
Top 3 Methods for Prevention
Eating a whole food diet with a balance of veggies, protein, fruit, nuts and seeds, and limited processed or fast foods.
Daily Omega 3 support has been shown to increase adiponectin levels by 14-60%
Daily fiber intake can increase adiponectin by 60-115%
Decreasing oxidative stress and increasing antioxidant production: Nrf2 activation has been shown to do just this. Including a known Nrf2 activator that is safe for pregnancy and breastfeeding can help support this need in the body.
Daily exercise is safe and recommended during pregnancy and has been shown to increase adiponectin by 18-48%.
What about testing? Can we test for this hormone protein?
The short answer is yes, but you still have to know what to do when it is low pre-pregnancy or in the first trimester. Early antenatal testing could help providers manage their patients care throughout pregnancy. Management could include nutrition counseling in office, group nutrition classes, support of women who want to begin or continue and exercise program, and providing safe nutraceutical support for women.
Ultimately all pregnancies could be managed in a preventative manor, vs waiting until the second trimester to uncover a problem. It is also important to consider that fertility nutrition should begin early ideally 3-12 months prior to conception as this can help assure a healthy egg and even healthy sperm.