Recurrent GDM, insulin use and future risk of diabetes

[hose1975]

I posted this on the GDM board, but figured it might reach a wider audience here...

Hi,

I had GDM in my first pregnancy, diagnosed at the standard 28 weeks and put on insulin pretty sharpish a week thereafter (overnight, breakfast and lunch). My BMI at the start of that pregnancy was 30.

Now pregnant for a second time (currently 21 weeks), I had the early OGTT at 17 weeks and was diagnosed with GDM again. Within a week I was on insulin for breakfast (yummy!) and have already had to add overnight stuff. Looking at the numbers, lunch and this time dinner insulin can't be far away. My BMI at the start of this pregnancy was 23.

It looks as if the GDM will be more severe this time than last time, which puzzles me rather. I thought that by losing well over two stone I'd significantly improve my insulin sensitivity and possibly avoid GDM altogether.

So, my questions for you all are:

1) For those of you that have had more than one go-round with GDM, did you find that your numbers were worse than the previous time, especially if diagnosed earlier in the subsequent pregnancies?

2) How much bearing on insulin sensitivity does pre-pregnancy weight have? I know that for type 2 diabetes keeping weight down significantly improves insulin sensitivity, so does (should?) the same apply to pregnancy?

3) Have I just got spectacularly **** genes?

4) In others' experience, does being diagnosed earlier in the pregnancy and having to have insulin under halfway into it have any bearing on the likelihood of developing type 2 sooner rather than later post-pregnancy?

Sorry if this has been a bit rambly, but t'interwebs aren't giving me much joy with these questions; maybe I'm phrasing them wrongly!

Many thanks

Jo

 

[jopar]

1) For those of you that have had more than one go-round with GDM, did you find that your numbers were worse than the previous time, especially if diagnosed earlier in the subsequent pregnancies?

Every pregnancy is different, so each pregnancy will have it's own needs..

2) How much bearing on insulin sensitivity does pre-pregnancy weight have? I know that for type 2 diabetes keeping weight down significantly improves insulin sensitivity, so does (should?) the same apply to pregnancy?

First part, your pre-pregnancy weight will have a baring on your starting dose of insulin, but only as part of a formula, then it's see how it goes, as during pregnancy insulin needs/sensitivity will change through the various trimesters.. And a T1 diabetic will tell you that they've had many different carb/insulin ratios, and changes to their background insulin to scary amounts..

Second part, Ensuring that you only put on baby weight, is both good for you and the baby, so a careful diet that ensure's that both you and baby is having the right nutrients for healthy weight for you, and healthy growth for baby...

3) Have I just got spectacularly **** genes?

It seems that somebody dealt a duff card... I wouldn't put as spectacularly though, just an iffy one gene!

4) In others' experience, does being diagnosed earlier in the pregnancy and having to have insulin under halfway into it have any bearing on the likelihood of developing type 2 sooner rather than later post-pregnancy?

It is really difficult to say, as part would depend whether you return to normal level's after you had the baby, the best people to speak to about this side of things is your HCP..