The Effect of Blood Sugar and Weight During Pregnancy
Note to Reader: I am not a mother. I've never been pregnant and may never be so I may be a surprising choice for authoring such an article, but what can I say? I've got babies on the brain as my brother and sister-in-law prepare for their first child and I soon become an aunt for the fourth time. Like many women, I always imagined myself being a mom. I am not against the idea, but being diabetic for 22 of my 33 years does complicate things. I've had people tell me I shouldn't have kids-that it'd be irresponsible or dangerous. I've had absolute strangers meddle in my business in ways that bewilder me. And I happen to believe that the tendency to think that because a woman is pregnant (especially if diabetic or embarking upon a high-risk pregnancy), she loses some rights as a citizen or as a critically thinking person who is responsible for deciding the course of her own life and choices is absolutely absurd. Still, such comments linger. Some sting. Especially since that proverbial biological clock I've heard so much about has been tick-tock-ticking a lot louder lately.
At thirty-three (and single), I have yet to go there. But a high-risk pregnancy riddled with my own brand of fears and concerns as a new mom and diabetic would be part of the equation. Like many, I fear the consequences to my (hypothetical) babies higher than normal bloodsugar levels would have. I'm also afraid of what might become of my own imperfectly functioning body during and following pregnancy. There's a lot of health information out there, but as a diabetic woman, the implications of prenatal influence on the health of children is of particular interest to me. Mother and author Annie Murphy Paul culled together some of the latest research on the topic in her book, Orgins: How the Nine Months Before Birth Shape the Rest of Our Lives.
For a long time lots of folks thought that the notion of prenatal influence was bogus-that it's all just froo-froo frivolous stuff we lady folk do to make ourselves feel better while we're pregnant. Y'know, like playing Mozart on our bellies, but the influences fetuses and babies are exposed to while in the womb do not go unnoticed-they are visceral and consequential. As Murphy Paul puts it, "the fetus is responding and adapting to cues that it gathers from the mother: what she eats, drinks, the air she breathes, the world she lives in, all impact the fetus before birth." It's very easy to see how such a thing could (inadvertently) put more guilt on pregnant women-especially mothers-to-be with diabetes, who are already burdened with a lot of worries, fears and what I'd consider to be unearned guilt. Some shame may creep in there, too.
Part of what research shows is that there's a higher risk that children will develop high bloodsugar, obesity, and Type II diabetes if exposed to (sustained) high bloodsugar levels during fetal development. Additionally, a child can be predisposed to obesity and possibly Type II diabetes if a mother-to-be is obese or significantly overweight when pregnancy begins or if the mother gains too much weight for her body to handle during pregnancy. However, while prenatal influences like higher bloodsugar levels are by no means entirely determinative.
So while maintaining a healthy weight and bloodsugar level while pregnant is no guarantee your child will avoid disease, current research suggests such things do tip the scales in your child's favor. Conversely, while higher weights and bloodsugar levels throughout pregnancy do not automatically doom children to lives riddled with illness and obesity, there is a correlation there worth noting.
All that being said, we cannot (and should not) blame mothers and our time in the womb for all our ill health and disease. Well, of course not. We know this just as we know how mothers cannot take all the credit for their healthy or well-adjusted children. The research continues to confirm what mothers already instinctively know: time in the womb is important. It matters. That said, illness is an equal opportunity employer. We see this time again time again in the offspring of mothers who maintained consistently healthy glucose levels and healthy weights/weight gains during pregnancy. We also see healthy babies being born every day despite less than ideal prenatal environments. The human body is a miracle, and it's one we're only beginning to understand.
The crux of it is this: the more researchers study both pre and postnatal environments, the more pieces of the puzzle start to fit together. Diseases once thought to be predominately genetic inheritances (Type II diabetes, for example), are being studied more closely, and showing us how prenatal influences and environment play a more important role in the science of human development than previously thought. So far, the correlation between bloodsugar levels of the mother during pregnancy and eventual development of Type II diabetes or obesity in one's child is the most striking. This is both good and bad news, depending on how one looks at it. For example, the Pima Indians of Arizona, who have the highest known incidence of Type II diabetes in the world, may be able to stave off some cases of Type II diabetes and obesity by keeping weight and bloodsugar levels in check during pregnancy. Recent research suggests that for Pimas and each of us, diabetes isn't strictly genetic--the prenatal environment also plays a significant role in promoting Type II diabetes and obesity in offspring.
However, no one's advocating for fetal determinism here (i.e. whatever happens in utero sets the course for the rest of one's life). Managing bloodsugar is an imperfect science. Even with advancing technology like insulin pumps or the ever-evolving CGMS, glucose levels are difficult to control with the precision one ideally wants. This is always the case. To beat oneself up for imperfect bloodsugar levels during a complicated diabetic pregnancy only adds to potential stress and guilt which seem to accompany moms-to-be at some point in their journey toward motherhood. Bottom line: our DNA arrives at the moment of conception, but the way genes behave and are expressed can be influenced by the environment. This can be seen in cases of Type II diabetes and obesity. For better or for worse, the impact of prenatal influence and environment cannot be denied.