HEALTH & FITNESS - Gestational diabetes not always temporary

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Kyla Nunes feels more than a little cheated. This isn't how it was supposed to work out, she said.

At 32, the co-owner of a Walla Walla home decor store is the mother of two healthy boys, 31/2 years and 16 months old.

Dark-haired and pretty, Kyla is like an exclamation point of energy as she ka-chings the register and lifts metal art the size of manhole covers off the wall for curious customers.

Sometimes she's running the forklift and slicing open boxes of new stock all day.

Once upon a time, after such a day at work, Kyla would go home to a dinner of whatever she liked. "I was a huge sweets and carbs eater. I would eat (Dairy Queen) Blizzards and pastas and bread and you name it. There were not nearly as many vegetables in there as there should have been."

The young woman knew diabetes ran in her family like red hair in an Irish clan. But she was slim and young and there was plenty of time to worry about that later, she believed.

With her first pregnancy, Kyla gained a whopping 72 pounds, but everything tested in normal ranges. That changed with her second child however.

"What they have you do at six months is take this general glucose test. I took it the first time, it was no big deal. This time they wanted me to take a more in-depth test."

Kyla took inventory as she waited for the results. Yes, she had excessive thirst, which she slaked with as much milk as she wanted. In other words, a lot.

And, indeed, she was often tired after eating. But she was a pregnant working mom with a toddler, after all.

The test results explained it all. Kyla had developed gestational diabetes.

The news was a minor blow, but she knew she could follow a strict diet for three months to keep herself and Baby healthy.

To make up for lost sweets, however, Kyla gave the baby's visitors explicit instructions for gift giving, she said. "I told them bring me chocolate, bring me brownies, bring me donuts."

Two weeks or so later, a post-delivery glucose recheck was done, which the new mom figured was a formality to prove the disease had departed with the birth of her little one. She, like most of us, had always heard that's the way it works.

Wrong.

"I got the call and I cried for two days. I was devastated. The nurse said, ‘Sorry to tell you this, but the diabetes did not go away. You need to make an appointment with your doctor.'"

Which, with no health insurance, was not going to be walk in the park.

"I honestly thought my world was ending," Kyla told me, in a voice that said she meant it.

"I was told all along it would go away … that in three months it was going to go away and I could go back to the horrible diet I followed all of my life."

The truth is women who develop gestational diabetes have a lifelong risk of getting type 2 diabetes, according to the National Institute of Health.

Physicians may be tempted to relax after a patient gives birth, said the American Diabetes Association. It's often assumed, as in Kyla's case, "that no further management is needed."

Research says otherwise. Moms who get diabetes while pregnant may have a 50 percent chance of developing type 2 diabetes within 20 years of the pregnancy, according to research from Weil Cornell Medical College based in New York.

As I say in every column, an important tool in controlling the disease is to count and restrict carbohydrate consumption. Not something Kyla wanted to hear at the time. "I am, literally, a carb lover. I didn't need to go into detail if someone asked me my favorite food, I just said ‘carbs.'"

Changing the menu seemed overwhelming, she recalled. Slowly, however, she learned many delicious foods still have the green light, such as sweet potatoes and low-carb bread.

Kyla feels fortunate, in a way, that her system sends a strong signal when she's eaten a no-no. Candy makes her sick almost immediately, while other foods - say a sandwich with traditional bread - can take 45 minutes to begin making her miserable. "Nausea is an awful feeling, so I just avoid it."

Now she's doing the things for herself like she always has done for her kids, she pointed out. "This childhood obesity thing is huge."

Yet it's never going to come easy, the shop owner predicted. "There are people who totally embrace the healthy lifestyle. They love it - they love the running, they love veggies, they love water. That's never going be me. I drink water because it's the only thing to drink."

Kyla has some advice for other young women: ask your doctor to test for diabetes before it physically affects you, she pleaded. "You have to ask that. You have to make them."

And examine your own preconceptions, as well, she cautioned. "I thought gestational diabetes was for very, very fat women."

Sheila Hagar can be reached at sheilahagar@wwub.com or 526-8322.

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