I think many mothers will say that their pregnancies were all different. I can remember being close to the cut off on the OGTT with my son. Some of my regular blood sugars during visits were slightly elevated and had the nurse asking about the last time I ate. Although they were all within the guidelines, there was more concern over my glucose levels than a couple years later when I was pregnant with my daughter. With my daughter everything was ‘normal’. I gained more weight with my son and also had a lot bigger appetite. During both pregnancies I was highly active, going to cycling classes even past my due date.
Wondering if gender had a role in my different experiences, I was intrigued when I saw an article entitled, “Fetal Sex and Maternal Risk of Gestational Diabetes Mellitus: The Impact of Having a Boy
,” by researchers at the Mount Sinai Hospital in Toronto. They studied 1,074 pregnant women with about half carrying a female fetus and half carrying a male. They examined beta cell function, prevalence of gestational diabetes and insulin sensitivity.
Women who were carrying boys had lower beta cell function and higher mean adjusted blood glucose compared with the women carrying girls. As published in the February 18, 2015 online issue of Diabetes Care, “male fetus further increased the relative risk of GDM conferred by the classic risk factors of maternal age >35 years and nonwhite ethnicity by 47 and 51%, respectively.”
With more conclusive research, we may see GDM screening for women carrying boys earlier than women carrying girls. I’m interested to know if some practices have different protocols for the different genders. Please comment if you have noticed differences and if your practice has made some GDM screening adjustments.
Figure 1 (below): Comparison of women carrying a male fetus and those carrying a female fetus, with respect to mean adjusted insulin levels during the OGTT, adjusted for weeks gestation at OGTT, maternal age, ethnicity, family history of type 2 diabetes, pre-pregnancy BMI, weight gain in pregnancy up to the OGTT, and infant birthweight. Data are presented as adjusted mean with standard error. Mean adjusted insulin levels during the OGTT. Read the full study here