Yes, you are at high risk both of having type 2 diabetes
in the future and of having diabetes again with your next pregnancy. The reason for this is that women des- tined to get type 2 diabetes
in middle age or beyond tend to be the same women who will develop diabetes in pregnancy. Therefore, the presence
of diabetes
in pregnancy is an indicator of future risk for type 2 dia- betes. Because type 2 diabetes
is a disorder of aging,
the diabetes in pregnancy tends to be more severe and requires more intensive
treatment with each successivepregnancy, unless
steps are taken between pregnancies to reverse one or more
risk factors, such
as excess weight or lack of exercise.
Can diabetes sometimes be temporary and go away again?
Yes, this can and does occur, in the case of both types of diabetes. However, in the case of type 1 diabetes,
the disappearance is very predictably temporary and the diabetes will
almost
inevitably
return within months or a year or two. The reasons for it are com- plex and relate to the fact that type 1 diabetes
is often diagnosed under conditions of physical stress. When the
diabetes is treated and the stress to the body has
resolved, there
may be sufficient remaining
insulin-
producing capability in the pancreas to keep the blood sugar normal under
most
circumstances. Eventually, however, the pancreas fails
and permanent
diabetes supervenes. In the case of type 2 diabetes,
although the hereditary factors causing it cannot be reversed, the environmen- tal and lifestyle factors can be changed. The latter are the cause of the explosive rise in the number of people
affected with diabetes in recent years.Although we do not generally refer to type 2 diabetes
as being cured
once it has been diagnosed it
can certainly go into remission (cease to be an active
medical problem) for long
periods, depending on how successfully the
causative factors are addressed.
Because excess weight and sedentary lifestyle are
the
two most important and serious
causative factors, weight reduction
and adherence to an exercise program can often put type 2 diabetes
into remission for as long as they are maintained. Some- times, all medications,
even insulin, can be stopped
and all measures of
diabetes, including blood glucose and
hemoglobin A1c (HbA1c—the
measure of your blood sugar control averaged over 3 months), will com- pletely normalize. Other associated conditions, such as high blood pressure and cholesterol abnormalities, will also improve greatly. The
possibility of
stopping
all medications is more likely to occur earlier in the course of diabetes and before long-term complications have developed. Unfortunately, many of us in modern soci- ety are unable to sustain weight reduction
and exercise for long periods and the failure rate is high.
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