Did you know that if you’re a mother who developed gestational diabetes during pregnancy, you have an increased risk of developing type 2 diabetes later in life? 

The National Institute of Health’s National Institute of Diabetes & Digestive & Kidney Diseases says that about half of all women with gestational diabetes go on to develop type 2 diabetes.

That’s the NIDDK’s focus during National Diabetes Month, which is observed each year in November: to raise awareness of type 2 diabetes among mothers who suffered from gestational diabetes.

While gestational diabetes, which develops during pregnancy, often goes away after the baby is born, the mother’s lifetime risk of type 2 diabetes goes up. And the increased risk doesn’t stop with the mother. The child, too, has an increased risk of obesity and type 2 diabetes.

Assessing Your Risk

The NIDDK advises women who’ve had gestational diabetes to get tested for type 2 diabetes within 12 weeks after their baby is born. A family physician can accurately test for diabetes with an A1C test, a blood test that measures the body’s average blood glucose levels over the past three months, or may opt for a simple finger prick to detect abnormal blood glucose levels. If the test is normal, women who had gestational diabetes should be retested every three years. 

Additionally, if you had gestational diabetes, your child’s pediatrician should be aware. The doctor may choose to monitor your child more closely for signs of diabetes.

A National Crisis

As of 2015, about one in every 10 Americans had diabetes. Of those, the overwhelming majority had type 2 diabetes — the form of the disease in which the body develops a resistance to insulin. One in four Americans aged 65 or older have the disease, but it’s increasingly being diagnosed in younger Americans.

In fact, type 2 diabetes was once called adult-onset diabetes because the disease didn’t develop until later in life. But it’s becoming increasingly common in youth. In 2012, there were more than 5,000 American children diagnosed with type 2 diabetes — almost a fourth as many as were diagnosed with type 1 diabetes, the form of the disease in which the body stops producing insulin and which typically begins early in life.

The result is a national health crisis. Diabetes was the seventh-leading cause of death in the United States in 2015, and the American Diabetes Association believes that number may be under-represented. Last year, the total cost of diabetes in the U.S. was $327 billion. For the average person, the cost of medical expenditures are 2.3 times higher for diabetics than for people who do not have the disease.

Complications

While careful control of type 2 diabetes can delay and even prevent most complications, and many people with the disease live full and productive lives, diabetes increases a person’s risk for a large number of serious health problems.

Diabetes doubles the risk of cardiovascular disease, and three out of every four diabetic deaths are due to coronary artery disease. Diabetes also greatly increases the risk for stroke and peripheral artery disease.

Over time, diabetes also causes damage to the small blood vessels in the eyes, kidneys and nerves. Diabetic retinopathy, a condition in which the blood vessels of the eye are damaged, can cause gradual vision loss and eventual blindness. In fact, diabetes is the leading cause of adult-onset blindness. Other eye problems, including glaucoma and cataracts, an also occur. Damage to the kidneys can eventually impair their function and lead to kidney failure, sometimes requiring dialysis. Damage to the nerves, known as diabetic neuropathy, is the most common complication of diabetes, and can lead to amputation of lower limbs. Each year, thousands of lower limbs are amputated in the U.S. due to diabetic neuropathy. Even in patients who do not require amputation, painful muscle atrophy and weakness can occur.

Diabetics are also at an increased risk of certain kinds of cancer, and have a much greater rate of decline in cognitive function. 

Prevention

For people who have been diagnosed with type 2 diabetes, careful lifestyle management is important. By tightly controlling blood glucose levels and keeping close check on blood pressure levels, diabetic complications can be delayed or prevented.

But the best way to prevent the side effects of diabetes is to prevent diabetes. 

Experts say that genetics plays a role in the development of type 2 diabetes, meaning that not all cases can be prevented. But lifestyle factors play a significant role. 

Obesity is commonly linked to the development of type 2 diabetes. A lack of physical activity, poor diet and stress are linked to the disease, as well. Specifically, experts say that excess body fat is associated with up to 80 percent of diabetes cases among people of European and African descent, while a lack of physical activity is linked to 7 percent of type 2 diabetes cases. Consumption of sugar-sweetened drinks has been linked to diabetes, as have diets high in white rice and other starches. Diets high in saturated fats and trans fats are believed to be associated with an increased risk for diabetes, as well.

Know the Risks

In pregnant women, classic risk factors for the development of gestational diabetes include being overweight, a previous pregnancy in which the baby was born with a high birth weight, smoking, a previous diagnosis of gestational diabetes, a family history of type 2 diabetes, and maternal age — its more common in women over the age of 35.

Still, as many as 60 percent of pregnant women who develop gestational diabetes have none of the risk factors, which is why expectant mothers are routinely screened for the condition during their pregnancy.

Symptoms

Symptoms of uncontrolled diabetes include frequent urination, increased thirst, increased hunger and weight loss. Less common symptoms can include blurred vision, itching, vaginal testing and fatigue. 

However, many people with type 2 diabetes can have the disease for several years without symptoms; diagnoses are routinely made through routine testing. Sometimes, people may not know they have diabetes until they experience complications, including medical emergencies like hyperosmolar hyperglycemic state, which causes very high blood sugar, low blood pressure and decreased consciousness, and can be life-threatening. Another medical emergency that can result from poorly-controlled and sometimes undiagnosed cases of diabetes is diabetic ketoacidosis, a life-threatening condition in which the body begins to break down fat due to insulin insufficiency, causing a dangerous buildup of ketones in the blood. However, DKA usually occurs in people with type 1 diabetes.

This article is the November 2018 installment of Focus On: Health, presented on the second week of each month by Brennan's Foot & Ankle Care, Big South Fork Medical Center, Roark's Pharmacy and Danny's Drugs as part of the Independent Herald's Focus On series. A print version of this article can be found on Page A3 of the November 8, 2018 edition of the Independent Herald.