W OM EN’S H EA LTH Gestational Diabetes: Taking Steps to Protect Women’s Health During and After Pregnancy About 9 percent of women develop diabetes for the first time while pregnant. Gestational diabetes, like type 1 and type 2 diabetes, causes blood-sugar levels to become high. This places a woman at a greater risk for delivering a larger baby weighing 9 pounds or more and high blood pressure. The condition typically resolves after childbirth, but not before setting the stage for potential health problems down the road. In fact, women with gestational diabetes have a 30-to-60 percent risk of developing type 2 diabetes 10-to-20 years later. “Pregnant women normally become a little resistant to insulin. This helps provide more glucose to their growing babies,” says Alexander Chiang, MD, a UCLA obstetrician/gynecologist in Santa Monica. “Women who develop gestational diabetes during one pregnancy are more likely to have it again during the next pregnancy. This can greatly diminish the ability of the pancreas to do its job.” To check for elevated blood-sugar levels, doctors administer glucose tests during a woman’s second trimester. Women with gestational diabetes need to monitor their blood-sugar levels. Dietary changes and exercise are equally important to maintain appropriate blood-sugar levels. Many of the same risk factors that make women more prone to gestational diabetes, such as being overweight and having a family history of diabetes, also contribute to type 2 diabetes and heart disease. Women who are African American, Asian American, Pacific Islanders, Native American or Alaskan natives also are more at risk. “A history of diabetes combined with high blood pressure can negatively affect heart function,” Dr. Chiang says. “That’s why it’s important for women to take steps to protect their health now.” Dr. Chiang advises his patients to make certain lifestyle modifications, such as eating a heart- healthy diet and getting regular exercise. “Breastfeeding also lowers the future risk of type 2 diabetes,” he says. For more information and to find an office location near you, go to: obgyn.ucla.edu uclahealth.org/endocrinology Women with gestational diabetes should get a blood-glucose screening six-to-12 weeks after delivery, and then every one- to-three years during checkups, depending on individual risk factors. “I encourage my patients to enlist the help of their loved ones. Their support makes it easier to adopt lifestyle changes like exercise and a healthy diet,” Dr. Chiang says. “This also has a cumulative beneficial effect since moms who take good care of themselves tend to have healthier families.” Alexander Chiang, MD LAW Vital Signs Winter 2017 Vol. 73 3