Gestational Diabetes And The Glucola Test

Gestational Diabetes and the Glucola Test

June 14, 2012 by Rebecca Dekker, PhD, RN, APRN
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In the comment sections of one of my first posts, I received this question from a reader named Lela:
“I would like to know more about what routine tests are actually necessary. The one that particularly caught my interest is the gestational diabetes test. The American Diabetes Association presents a list of low risk women who should not need the glucose test , even though I fit all those categories, my physician’s office still insists I take it. Is the glucose test truly the only way to catch gestational diabetes? Am I really risking both the health of me and my baby if I declined?”
**This post was written before the 2013 NIH Consensus conference on “Diagnosing Gestational Diabetes.” Since then there has been new evidence published on this topic. To read updated, in-depth information about the glucola test and screening for gestational diabetes, you can read these blog articles about the conference: Day 1 and Day 2.**
This article has taken me quite a bit of time to write for several reasons. First, gestational diabetes is a very complex and controversial topic. Second, there is a ton of research that has happened in the last 10 years, and it took me a long time to read the literature. Third, my readership has really taken off in the past few weeks, and I want to make sure that my posts are of the highest quality. Fourth, my kids have had a bad virus and I was very sleep-deprived this week. It was hard for my brain to function well and critic Continue reading

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Gluten and Diabetes: Is There a Connection?

Although many people continue to buy gluten-free foods at grocery stores and restaurants, it appears the gluten-free trend is waning for those looking to lose weight or gain energy, according to Packaged Facts, a market research company. For those who have to restrict gluten for medical reasons, such as managing celiac disease, gluten-free foods are necessary.
A key treatment for those with celiac disease, a recognized and diagnosable medical disorder, is to avoid gluten. But some celebrities and popular diet books have demonized gluten, elevating gluten-free diets to the mainstream. This exposure has led people with no medical reasons to attempt to eliminate gluten from their diets. “It’s caused a bit of hysteria,” says Pam Cureton, a registered dietitian at the Center for Celiac Research in Baltimore.
Some people incorrectly associate a gluten-free diet as synonymous with choosing to restrict the amount of carbohydrate they eat. Consumers see the gluten-free label on packaging and assume it must be better. Often, however, the gluten-free food is lower in nutrients and higher in added sugars, saturated fat, and sodium, making it a less healthy choice for most people—especially for those with diabetes.
Celiac Disease and Gluten Intolerance: What’s the Difference?
Celiac disease, a chronic autoimmune intestinal disorder, affects about 1 percent of the general population. It’s about 8 percent more common among people with type 1 diabetes, according to the Celiac Disease Foundation. Celiac disease is characterized by intestinal damage, nutrient deficiencies, joint Continue reading

Gluten and diabetes: The headlines get it wrong again

Another study was released recently that purports to “prove” that gluten-free diets are associated with increased risk for type 2 diabetes. As with many studies of this type, the findings were misinterpreted but fed into the media’s continual need for titillating headlines. I thought this hubbub would pass by now, but reports about this study (such as this piece of tripe from The Washington Post) seem to be gaining more traction than usual, fueling the misunderstanding and misinformation that plagues nutritional thinking. While I thought this would just pass, it looks like it will not and I’m therefore posting my comments.
First, a few words about epidemiological studies of the sort this group used, the Physicians’ Health Study population of health professionals. The participants were asked diet questions, then health status was tracked over several years. Putting aside the imprecision of such dietary recall questionnaires, we know that such studies simply cannot—no matter how large the study, no matter how meticulous the questions—establish cause-effect relationships; they can only suggest a potential association. The purported 13% difference in type 2 diabetes incidence is minor, given the dramatic imprecision of epidemiological studies; confident associations are typically much larger than this: 40% or 50%, for instance. This does not stop, of course, media people, who are journalists at best, paid marketing people for the grain industry at worst, to propagate their misinterpretations.
To further illustrate the problems inherent in epidemiological studies, Continue reading

Gestational Diabetes: Please Don’t Drink the “Glucola” Without Reading the Label

I’m a midwife and MD who specializes in the health and wellness of pregnant mommas. While I’m one of the original crunchy mamas, I got the science thing down tight in my medical training at Yale, so I can keep you informed on what’s safe, what’s not, and what are the best alternatives.
This article, in which I take on the toxic ingredients in oral glucose test drinks, is the first in a 3-part series on gestational diabetes. If you’re pregnant, planning to be pregnant, or working with pregnant mommas – this series is for you!
Is Gestational Diabetes Really an Issue?
In the past decade obesity has become rampant in our country. With it the rates of diabetes in the general population, and gestational diabetes (GDM) – which is an excessive increase in glucose intolerance in pregnancy (some increase in glucose intolerance is actually normal and allows more sugar to get to the baby for growth) – have risen dramatically. Current estimates are that 5%-7% of pregnant women in the U.S. develop GDM.
Gestational diabetes increases the risk of a host of serious medical problems for mom and baby. However, at levels even lower than those that would qualify a woman for a GDM diagnosis, chronically elevated blood sugar also puts mom and baby at much higher risk of pregnancy and birth complications.
Elevated blood sugar creates a condition in the body called “oxidative stress” and in pregnancy, which is already a state of somewhat increased oxidative stress, this can lead to high blood pressure, preeclampsia, and preterm birth. Also, babies born to overweight or diabetic Continue reading

Low-gluten or Gluten-free Diets Linked to Type 2 Diabetes

Does reduction in gluten consumption provide long-term health benefits?
Gluten is a protein that is commonly found in wheat, rye and barley, which gives bread and other baked goods elasticity and a chewy texture. It is avoided in a small percentage of the population that cannot tolerate gluten due to Celiac disease or gluten sensitivity. Gluten-free foods often contain less dietary fiber and other micronutrients, such as, vitamins and minerals, thus making them less nutritious and they also tend to cost more. However, recent popularity of gluten-free diets has been trending even among people without any health problems.
A ‘Gluten-free’ diet has been interchangeably used to represent a ‘healthy diet.’ On the contrary, researchers have shown concern that it may actually lead to the development of type 2 diabetes (T2D) over a period of few decades. Although there is no scientific evidence that low-gluten will contribute to diabetes, the scientists are concerned about the long-term health benefits with the reduction in gluten consumption. An analysis of a large study of U.S. health professionals observed the effects of food on health in nearly 200,000 subjects. The study suggested that gluten intake might not exert significant adverse effects on the incidence of T2D or excess weight gain. Thus, limiting gluten from the diet is unlikely to facilitate T2D prevention and may lead to reduced consumption of cereal fiber or whole grains that help reduce diabetes risk. The purpose of the study was to determine if gluten consumption would affect health in people with no apparen Continue reading