44: Dr. Mary Vernon on Gestational Diabetes, its Causes, Prevention, and Treatments

Summary: It is my honor to have Dr. Mary Vernon as my featured guest for today’s Carbohydrates Can Kill Podcast, the final episode of a special series on gestational nutrition. Childbearing women, like the rest of us, have risks of diabetes mellitus and diseases including gestational diabetes, which are a result of hyperglycemia. In the introduction of this special series on gestational nutrition, I told you the effects of gestational hyperglycemia on the potential of gestational anomalies. Now, I am concluding this special series with an interview with Dr. Vernon who is a family physician specializing in general practice, including prenatal care and obstetrics. Dr. Vernon has enormous experience in treating obesity and diabetes mellitus, including gestational diabetes. I am going to ask her to help us understand more about gestational diabetes including its cause(s), prevention, and treatments. As we have already learned the importance of gestational nutrition from three experts, and the impacts of gestational hyperglycemia on the health of both the expecting Mom and newborn, I trust you want to hear what Dr. Vernon will tell us about gestational diabetes. Let’s get ready for this interesting interview now! Website: https://www.myimsonline.com/ Episode 44 Transcribed by Yael S. Balazs, Ph.D. http://www.carbohydratescankill.com/1835/44-dr-mary-vernon-on-gestational-diabetes-its-causes-prevention-treatments Dr. Mary Vernon on Gestational Diabetes, its Causes, Prevention, and Treatments Dr. Robert K. Su: When we are talking about gestational nutrition we want to make sure that the woman is eating properly the foods which are not only keeping her healthy throughout the pregnancy, but also providing the fetus with the right amount of nutrition for healthy growth. We do not want to have a newborn with congenital anomalies, birth defects, and the potential of becoming a diabetic. On March 16, 2011, I discussed on the show the relationship between maternal hyperglycemia and gestational anomalies. I believe you have already learned about the grave impacts of maternal hyperglycemia. Today I am honored to have Mary Vernon, M.D. as my special guest. . . . Dr. Vernon: This topic of glycemic index and pregnancy or hyperglycemia and pregnancy is finally getting the appropriate attention that it deserves. And this has really been just recently that the medical literature is starting to reflect studies that examine this relationship. Although those of us who treat people with carbohydrate restriction have known for a long time that this was absolutely an important connection, but there are connections beyond this. Which include the connection of the hypertension of pregnancy or preeclampsia, which is often related to this underlying tendency to have impaired glucose tolerance during pregnancy. Dr. Su: Very good. But, let’s back up a bit. What is the definition of gestational diabetes? Dr. Vernon: The definition of gestational diabetes, and, let me just say, this has been a moving target during the time that I have been in the practice of medicine, which is more than thirty years, that the definition of gestational diabetes has changed several times. So, what I really want to do is to say to your audience that this is usually determined by screening which happens at the beginning of the third trimester with a glucose load being delivered, the “glucose tolerance test” and you do a fasting [measurement] and a two hour [measurement]. The amount of glucose [ingested] is already decided, “here’s how much you drink,” and if your blood sugar goes up above a certain amount, then you have to have a three-hour glucose tolerance test to actually determine if you have gestational diabetes or not. Now the truth is, like we said before Dr. Su, this is not an on or off kind of thing. Just because your blood sugar numbers are one point below the cutoff for gestational diabetes does not mean that you’re safe and in good shape. You’re not. And so, it’s impo[...]