There's one more cause of diabetes: pregnancy. It's called gestational diabetes, and the rate is increasing fastup eight-fold in the last two decades.
The increase might be because women are having babies when they're older, or because obesity, a risk factor for diabetes, is increasing. The extra stress of pregnancy on the body can cause high glucose levels, but often pregnancy highlights a woman's predisposition for diabetes: up to 50% of women develop l)pe 2 within five years of having the baby, not because of the gestational diabetes, but because they were on course to get the disease anyway.
Women with a predisposition to diabetes are at particular risk while they're pregnant because their energy needs increase, plus hormones produced by the placenta can block the action of the mother's insulin, causing
insulin resistance. These factors mean insulin needs in pregnancy are two or three times greater than normal from about 24 weeks. Up to 16% of women develop gestational diabetes and it's usually picked up with a routine glucose tolerance test between 24 and 28 weeks of pregnancy.
Alafiya Firoz, 29, a Chennai housewife, is 11 weeks pregnant and has been diagnosed with gestational diabetes. She isn't surprised-she was diabetic during her previous pregnancy four years ago too. "The diabetes was then diagnosed in the 36th
Adds Dr Greg Fulcher, an Australian expert, "As we learn more, we can identify the conditions more accurately; for example if they're caused
by different genetic abnormalities.
We even talk about a Type l'e, which has elements ofType 1 and Type 2. One day they may become categorized by the underlying abnormalities rather than just being bundled under one issue."
The Warning Signs
Here's what should ring alarm bells:
Sudden weight loss
Frequent urination Feeling tired and lethargic Slow-healing wounds itching and skin infections
Pregnant and over 30 years of age Family history of Type 2 diabetes.
Certain ethnic groups including Indian, Vietnamese, Chinese, Middle Eastern, Polynesian/Melanesian, indigenous Australians
Gestational diabetes in previous pregnancy
Previous problems carrying a pregnancy to term .