Winter 2010

An Unexpected Diagnosis of Diabetes

A Healthy Baby Girl

Alice Bowman with daughters Charlotte (L) and Ali(R), and Maureen Connick, R.N.

Alice Bowman was surprised when a routine glucose tolerance test during her second pregnancy came back with abnormal results. But the area resident was shocked when she received a formal diagnosis of gestational diabetes.

“I was overwhelmed,” Ms. Bowman said. “I started to cry. I had a two-year-old at home. I felt great and had gained less weight than with my first pregnancy. I was really upset.”

Ms. Bowman’s overall good health was no assurance that she would not develop gestational diabetes. The condition can strike women of normal weight with no other issues, said Maureen Connick, R.N., a certifi ed diabetes educator at the AAMC Center for Maternal-Fetal Medicine.

“It is very random,” Ms. Connick said, noting that 4 to 7 percent of all pregnancies are complicated by gestational diabetes. “We know that there are certain women at greater risk of developing gestational diabetes, including women who are overweight prior to becoming pregnant, women with a family history of diabetes or in a high-risk ethnic group, or women who have previously given birth to a baby greater than 9 pounds.”

For Ms. Bowman, her diagnosis meant an immediate change in diet and closely monitoring how many carbohydrates she consumed each day. It also required the frequent use of a glucose meter, a home monitoring device that reads glucose levels in drops of blood obtained from fi nger sticks.

“Maureen taught me how to read labels and helped me plan meals,” Ms. Bowman said. “She was very reassuring.”

For Ms. Bowman, though, the change of diet was not enough. To manage her gestational diabetes, doctors prescribed medication to lower blood sugars.

This additional measure meant that she needed increased fetal monitoring, including weekly nonstress tests and biophysical profi les to assess the baby’s movement, breathing and level of amniotic fluid surrounding the growing infant.

“At first it was daunting,” Ms. Bowman said about the additional office visits. “But the nurses were so great; they put me at ease. It became something I really looked forward to.”

“Gestational diabetes is really a very manageable condition,” Ms. Connick said, noting she sees about 40 to 50 pregnant patients each month with some type of diabetes. “But because of the program we have in place,” she said, “we have an extremely high success rate. We stay involved until the end of the pregnancy.”

That success rate proved true for Ms. Bowman, who delivered a full-term baby girl on June 11. Even better, Charlotte Grace Bowman arrived weighing 7 pounds, 13 ounces, a healthy and normal birth weight, despite the potential for a much higher birth weight and additional delivery complications due to the diabetes.

“My health team walked me through everything after the baby was born,” Ms. Bowman said. “They tested me. They tested the baby. Everything was great. I knew I was in good hands.”

--Jenny Steffens

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