This is a little long, but there will be a question at the end of the story.
I have this friend who developed gestational diabetes twelve years ago during her first pregnancy. After the birth of her child, the diabetes didn’t go away. She spent the next twelve years giving herself daily insulin injections. Last year, she finally gets pregnant again after years of trying. She gave birth about six months ago. The weird thing is, the diabetes is now gone. She spent twelve years being a diabetic, and then it suddenly goes away. I searched through Medline, but couldn’t find anything like this. Has anybody ever heard of this? I was under the impression that once you are a insulin-dependent diabetic, you remain so for the rest of your life (unless you get a pancreas transplant).
I don’t think they know all there is to know about gestation diabetes connection. 16 years ago I gave birth to an extremely large baby (10 pounds, 12 ouches), at that time, the common wisdom was that women who gave birth to large babies often developed diabetes. So I was tested, negative. However, about 1 1/2 years ago, I was tested again. Positive. No further children (would you temp it again?) anyhow. I’ve since found out that common wisdom is NOW that women who have large babies 15 years later get diabetic.
now, the other thing is that my doctor’s not sure that I might not start producing usable insulin again. maybe that’s what’s happening to your friend?
In any case, good news for her, but I’m still not gonna have a second baby…
Her use of insulin didn’t define her as being dependent on insulin. Quite possibly, it was simply her physician’s choice. The doctor might have just as easily chosen to treat with pills. Your friend may have been best described as “insulin-using”.
In terms of her remission, it is unusual. I would want to know if she lost a lot of weight after the delivery (is she depressed?). Has she developed a deficiency of another hormone which has, in turn, led to a lessening of her diabetic tendency (eg. hypothyroidism?). Is she taking other medications? Has her diet or exercise pattern undergone a major change?
Her doctor tried a couple of years ago to switch her from insulin to the pills, but her blood sugars got wildly out of control and they had to switch her back to insulin.
She was pretty overweight before the pregnancy. She is apparently back to her pre-pregnancy weight, but she is still probably 75-100 pounds overweight. She doesn’t appear depressed. On the contrary, she is so excited about her new baby, plus her husband got a real good job this year and they are finally mostly out of debt for the first time in their married lives.
As to whether she has developed some other disease or is on some other medication, I haven’t a clue. I could ask her the next time I see her. Her only diet change is that she is finally eating all of those “bad” foods that she was never able to eat before. She still religiously checks her blood sugars every day, and they have been totally normal.
I was just curious if anybody else had ever experienced this or knew of somebody who had.
Just to clarify. The use of the term dependent in “insulin-dependent diabetes” refers to the person’s dependence on insulin to prevent diabetic ketoacidosis - the life threatening condition which used to kill before the discovery of insulin. So, even if someone’s blood sugars are sky high in the absence of insulin use, so long as they don’t get ketoacidotic off insulin, they’re not considered insulin-dependent. Insulin requiring, perhaps. But not insulin-dependent. The terminology is somewhat silly, but has “official” status.
I assume that your friend has noninsulin-dependent diabetes (NIDDM) that first materialized in the setting of pregnancy (in fact, about 20% of “gestational diabetics” are actually NIDDM’s that start with pregnancy - pregnancy is a huge metabolic stress for a person at risk of NIDDM).
NIDDM can remit. Usually, though, there’s an obvious explanation such as weight loss. Your friend is unusual. Especially because her remission occurred postpartum, I still wonder about a hormone problem (thyroid and pituitary problems are common postpartum). By the way. Was she able to breastfeed?
Karl, since you seem to know a little more about this than me…
Juvenile-onset diabetes runs rampant in her family. She was in her mid 20’s when she was pregnant the first time, which is just about the same age that her dad and her brother both were when they developed diabetes. Her doctor was of the opinion that she was due to develop it anyway and that her becoming pregnant sped up the process. What has the doctor stumped is the fact that after having it for twelve years, it inexplicably went away completely. The only medical condition they know of is the second pregnancy which resulted in the birth of her son about six months ago. She apparently was still diabetic throughout that second pregnancy. It is only in the last couple of months or so that her doctor discovered that her diabetes seems to have vanished.
Well, I better heed my own advice and not try to diagnose or give medical advice in any Net forum. I will make a couple of more points and then try to stay quiet.
The fact that your friend is overweight argues against her having autoimmune diabetes (essentially synonymous with insulin-dependent diabetes - IDDM). Obesity is the hallmark of NIDDM. The reason I dwell on this is that IDDM, but not NIDDM, is strongly linked to other autoimmune hormone problems. Such problems could lead to an apparent remission of the diabetes.
All diabetic women, by virtue of a tendency to have big babies, can have complicated deliveries (how much did your friend’s baby weigh? was the birth complicated?). If they lose a lot of blood or go into shock around the time of the delivery because of this, it can damage their pituitary gland. This can rarely lead to remission of diabetes. Pretty rare though.
Bottom Line: Common things being common, I’d guess that either your friend has lost more weight than you realize (and that could easily account for her remission) or she’s got a low thyroid (very common after a pregnancy).
If an explanation is ever made explicit, please post it!