Insulin Resistance and Pregnancy

Insulin Resistance (IR) is defined as “the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues.” (www.medterms.com) When the muscle won’t accept the insulin, the pancreas overcompensates by producing more insulin. Insulin is a hormone and its main job is to aid in the metabolism of carbohydrates. When carbs are not broken down, they turn onto sugar and end up becoming stored in the body. This makes it increasingly difficult to lose weight. Insulin resistance can also lead to Type 2 Diabetes.

Pregnancy can be very difficult for women who are insulin resistant. Insulin Resistance makes it much easier for a pregnant woman to develop gestational diabetes. Gestational Diabetes is tested around twenty-four weeks of pregnancy. It is important to make sure your doctor is aware if you have IR so that additional tests for gestational diabetes may be ordered before and after the standard test is given. My personal experience was a test at twenty weeks and every four weeks after until thirty-two weeks.

The test is a simple one, except for the fasting because every pregnant woman knows that hunger comes on strong and often. After a night of fasting, you will need to drink a bottle of a special glucose concoction. There are a few flavors available but they all pretty much taste like super sugary, flat soda. Some doctors will send you home with the bottle and tell you to come in an hour after drinking it, while others want you in the office for the full hour after drinking it. A few tips for getting this drink down without the pregnant woman gag reflex setting in; make sure the drink is cold. Refrigerate the drink or pour it into a glass with some ice. Also, use a straw to drink it. The straw allows you to push it past your tongue without having to taste it too much. The drink has to be finished within a certain time frame and so it is important to get it down quickly and keep it down. It is important to realize that all of this sugar suddenly surging through your body on an empty stomach can cause intense feelings of nausea and headache. Luckily this goes away fairly quickly.

If by chance a pregnant woman’s initial one hour glucose test comes back high, she will be sent for the three hour test before a course of treatment is decided. This is protocol for all pregnant women, not just those who are insulin resistant. This test is simply drinking the glucose drink and having blood taken after one hour and again at the two and three-hour mark. Just because a woman is insulin resistant prior to and during pregnancy does not mean she will develop gestational diabetes. Some doctors will be overly cautious with the course of treatment through the pregnancy.

It is possible to treat IR with any number of medications; the most common is currently glucophage. It is possible to take this medication while pregnant, although some doctors will not allow the patient to continue use based on older medical information. While insulin resistance makes it easy to gain weight, and difficult to lose it, glucophage can help a woman with IR to gain only a minimal amount of weight. It is important that the use of glucophage be stopped towards the end of pregnancy. There are serious medical complications if glucophage is used within days of a surgery. This includes a cesarean section.

Insulin resistance and pregnancy is not an ideal situation. Gestational Diabetes is a serious condition that can cause severe damage to both the health of the mother and her unborn child. It is important for a pregnant woman with insulin resistance to be monitored closely so that gestational diabetes can be detected early. It is not guaranteed that gestational diabetes will develop in a woman with insulin resistance. The use of glucophage can aid in staving it off.

My personal story is one where my doctor was overly cautious with me. I informed him at my first eight-week appointment that I was insulin resistant and taking glucophage. He instantly made me stop taking the medication. It took me two weeks and loads of literature to convince him that the glucophage was beneficial. I became the first patient in the practice to stay on glucophage during pregnancy. After the end of all my glucose testing at thirty-two weeks, all of which came out normal, my doctor began giving me weekly ultrasounds and non-stress tests. Nothing developed during my pregnancy to warrant any concern, and shortly after giving birth, I was able to start the medication again. Overall, the pregnancy and birthing experience was perfectly normal and beautiful experience in which my insulin resistance played little part. Even with my next child, I will be as cautious because insulin resistance is a big problem even when not pregnant, it can be a scary notion while pregnant. So, if you are pregnant and insulin resistant, make sure to tell your doctor to ensure proper treatment. It will keep you and your baby healthy.