Preventing or Reversing Gestational Diabetes
Gestational diabetes mellitus (GDM) is a condition that affects almost 10% of pregnancies in Western countries. It is usually diagnosed between gestational weeks 12 – 16 and rapidly abates following delivery. The presence of gestational diabetes has consequences for both the baby and the mother. Babies can be very large and suffer birth injuries. Women with gestational diabetes have higher rates of Caesarian section and induced deliveries.
Why do some women get GDM? It is believed that the cause is the same as with anyone who develops Type 2 diabetes: certain cells in the body, especially muscle cells, become “insulin resistant,” meaning that they do not recognize the presence of insulin outside the cell and therefore do not allow glucose to enter. This leaves glucose in the bloodstream, thus high blood sugar and eventually diabetes. It is thought that liver and fat cells also become insulin resistant. Since GDM occurs relatively rapidly compared to Type 2 diabetes in general and disappears soon after delivery, scientists believe the placenta is responsible for triggering or significantly worsening insulin insensitivity in the above three cell types.
But could this really be true, I ask? I am very doubtful that this theory makes sense. With over 200 types of cells in the human body, why and how do “messengers” from the placenta zero in on the same three – muscle cells, liver, and fat – as in Type 2 diabetes, to tell them to resist insulin? How do those three types of cells decipher the message to make them insensitive only to insulin and not other hormones in the body? Since each cell is an independent living unit, how is it possible that a significant number of the billions of cells in these three tissues all become insulin resistant within just a few months of time?
Moreover, when these 3 types of cell become insulin resistant, why is it that they do so in an inconsistent way?
- in a muscle fiber, insulin resistance prevents glucose from getting in
- in liver cells, insulin resistance pushes glucose out
- in fat cells, insulin resistance causes fatty acids to be released
And finally, why is it that cells in the above three sites cease being insulin resistant within days after the woman delivers her baby. Before you answer that they stop being insulin resistant after delivery because the placenta is gone, consider that 40% of the mothers who developed gestational diabetes end up developing type 2 diabetes within the ten subsequent years after giving birth. This suggests that factors other than the presence of the placenta were responsible for the development of GMD.
My Alternative: The Fatty Acid Burn Theory
I propose an alternative bodily mechanism that could explain high blood sugar in GDM, as well as high blood sugar in anyone with Type 2 diabetes, because in my view, GDM and Type 2 diabetes result from exactly the same cause.
Your body’s cells are like a hybrid car – they can burn either glucose or fatty acids. The burning of fatty acids is a normal metabolic process. It occurs when you don’t eat for a long time, or when you exercise heavily for a long period of time and your body needs energy. I suggest that high blood sugar is the result of the body switching to burning fatty acids rather than glucose, leaving the glucose in the bloodstream.
The reason for this switch is equally valid for people who develop Type 2 diabetics as it is for pregnant women who develop GDM. It results from overconsuming grains and grain-based products. Carbohydrates such as grains (e.g., wheat, corn, barley, oats, and rice) and grain-based products break down in the intestine into glucose molecules, as does fruit sugar (fructose) and milk sugar (lactose). After a meal, the liver stores about 120 grams of glucose for release in times of need (such as between meals) and converts any glucose that your body cannot immediately use into triglycerides, which are stored in your fat cells.
The problem is, each person’s body has only a limited fat storage capacity based on one’s genetic inheritance. If the liver keeps producing triglycerides and you fill your fat cells, whether you are a child, adult, lean, or pregnant, large quantities of fatty acids begin circulating in the bloodstream. Coming back to the hybrid car analogy, your cells, especially muscle cells, automatically switch to burning these fatty acids, which can enter the cells more easily than glucose can.
The fatty acid burn switch theory is far more biologically sensible than the insulin resistance theory to explain the origin of GDM and Type 2 diabetes. It can be shown that high levels of fat and fatty acids are found in people months before their blood sugar level start climbing. It coincides with why we see Type 2 diabetes increasing everywhere in the world where grains are becoming a major component of diets. It explains why some pregnant women, but not all, can develop diabetes. It illuminates why some ethnic groups who are inherently lean and have had limited need for fat storage capacity for generations are more prone to Type 2 diabetes and GDM. It explains why type 2 diabetes improves after weight loss that empties fat cells, and after delivery when the woman’s body experiences the same. Finally, it explains why some pregnant women who develop GDM also develop type 2 diabetes within ten years (their body’s fat cells get filled up again, just like any adult who overeats and develops type 2 diabetes).
Preventing and Reversing Gestational Diabetes
The most significant upshot of my fatty acid burn switch theory is that it offers pregnant women a way to prevent GDM or to reverse it quickly if it has already developed, without having to use medications. That solution is to eliminate the consumption of grain-based complex carbohydrate as soon as elevation of blood glucose is detected in a pregnant woman. Since the consumption of grains and grain-based products is not essential for the wellbeing of a human being, this restriction should not adversely affect the developing fetus.
Adhering to a diet of vegetables, legumes (beans, lentils), nuts, meat, eggs, seafood, fresh fruits and dairy can be the start of a new approach for the prevention or reversal of gestational diabetes.