Gestational Diabetes & Pelvic Floor Health
November is not just a month of falling leaves and cozy sweaters; it’s also a time devoted to raising awareness about diabetes. Included in this is the specific form of diabetes that impacts many expectant mothers. National Diabetes Awareness Month serves as a beacon, shining light on this prevalent health condition and emphasizing the importance of education, prevention, and compassionate support for those impacted by gestational diabetes.
What is Gestational Diabetes (GDM)?
Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes. Gestational diabetes occurs when your body can’t make enough insulin during your pregnancy. Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy. During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively. This is known as insulin resistance. Insulin resistance increases your body’s need for insulin. All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant. They start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.
How Does This Impact Pelvic Health?
GDM is linked to a higher prevalence of issues related to the pelvic floor and urinary control, both during pregnancy and after childbirth. A noteworthy study from 2020 investigated how GDM affects the pelvic floor muscles. The research involved 110 expectant mothers, both with and without GDM, who were examined using 3D ultrasound at 24-28 weeks and 34-38 weeks of gestation. Specifically, the study measured the thickness of the levator ani (pelvic floor muscles) and the hiatal area (area of pelvic floor muscles that support the pelvic organs). During pregnancy, the pelvic floor muscles tend to enlarge. When in labor, these muscles must stretch to facilitate the descent of the fetus. However, this study revealed a distinct pattern among pregnant women with GDM. They experienced less significant changes in the levator ani thickness and hiatal area compared to those without GDM. Contrary to anticipated enlargement of the hiatal area and hypertrophy (when a muscle or organ in the body gets bigger and stronger due to exercise or growth) of the pelvic muscles in pregnant women, this group exhibited the opposite effect. The hiatal area decreased, and the pelvic floor muscles displayed reduced thickness from 24-28 weeks and 34-38 weeks of gestation. This could indicate weakness in pelvic floor muscles. Weakness in these muscles leads to conditions such as pelvic organ prolapse, urinary incontinence, and bowel incontinence, among others. The results of this study emphasize that this recommendation holds particular significance for women dealing with GDM.
We want to ensure that every expectant mother receives the best care and knowledge to navigate this significant phase in their life. Managing gestational diabetes and understanding its potential impact on pelvic floor health is essential. Here at Arancia Physical Therapy, we strongly recommend that expectant mothers partake in a well-supervised pelvic floor muscle training program, involving regular contact with a pelvic floor specialist, to help prevent urinary incontinence before and after childbirth. If you have concerns, questions, or would like to learn more about how to optimize your well-being during pregnancy and beyond, we invite you to schedule an appointment with one of our pelvic floor specialists. Contact us today to prioritize your well-being.