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Question:

From Costa Mesa, California, USA:

My mother developed insulin dependent diabetes at age 40 and she is not overweight. I am 30 years old, and I did not have diabetes, but developed gestational diabetes during my pregnancy. During the last 3 months of pregnancy I became insulin dependent in order to control it. I delivered my baby 2 weeks ago and my blood sugar has fallen but still not returned to normal. I am currently using diet and exercise to keep it as low as possible (around 160) without having to resume insulin injections. Why did this happen, and what advice can you give me on the treatment I should seek?

I really do not want to be insulin dependent. Also, what should I do for my baby? I have heard that cows' milk may cause the disease, and that I should never use formula that contains cows' milk. Please give any advice you can, and I will accept e-mail from other readers.

kmstahl@primenet.com

Answer:

It sounds like your diabetes may not have been just temporary during pregnancy, but may be permanent. You should see an endocrinologist and have further evaluation to decide if you have insulin-dependent diabetes (Type 1) and should be on insulin, or if you have non-insulin-dependent diabetes (Type 2) which can be managed with diet alone and/or oral medication. Remember, if you are planning to become pregnant again, oral hypoglycemic agents cannot be taken in pregnancy. Even if your diabetes can be controlled without insulin when you are not pregnant, most likely you will need insulin if you become pregnant again. Strict control of the blood sugar before becoming pregnant is necessary to avoid the increased risk of birth defects which can be seen with high blood sugars in early pregnancy.

As far as cow's milk is concerned, this is very controversial. There is some evidence that early exposure to cows' milk may increase the risk of developing insulin dependent diabetes. There is also evidence to the contrary that there is no relationship between early exposure to cow's milk and diabetes. Further long term studies are necessary to answer this question.

In general, breast milk is the healthiest nutrition for babies and has definite advantages over commercial formula unrelated to diabetes. If you wish to avoid cows' milk formula, you can discuss with your pediatrician using an elemental formula such as Nutramigen. Soy based formula probably is no better than cows' milk formula if there truly is an association between formula and diabetes.

TGL

Original posting 18 Apr 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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