"Your baby is going to be so fat," a friend told me with a smile last spring. To some people, there is nothing cuter than a chubby baby, so calling a baby fat is somewhat of a compliment. But for someone with type 2 diabetes, who has struggled with her weight for a good part of her life, the fat baby comment stings.
"You have diabetes, so of course your baby's going to be chubby," she continued. "They call them sugar babies."
It's a label that left me steamed for months. My child wasn't even born yet and already he's being called fat. I could envision a plump future laid out before him. Shopping in the husky section. Getting picked last in gym class. Being called Jupiter during lessons on the solar system. All this before the cruel middle school years.
Was my friend just being mean? Misinformed? Actually, no. One complication of a diabetic pregnancy is macrosomia, which essentially means big, fat babies. It's caused by maternal high blood sugar crossing the placenta, causing the baby's pancreas to work overtime producing insulin to bring baby's blood sugar down, which leads to hyperinsulimia and, as a result, a chubby baby.
Macrosomia can lead to immediate complications, such as respiratory distress and even death. In the long term, however, it's laying the groundwork for the child to develop type 2 diabetes as an adult. This excessive "baby fat" starts the insulin resistance cycle even before the baby is born. Not so cute after all, is it?
Any mother with diabetes can tell you, it's heartbreaking to think about passing this disease on to your child. And comments from well-meaning friends don't help matters.
Still, this myth of the sugar babies isn't completely unfounded. Some 20 years ago, before the use of synthetic human insulin, animal insulin was used. While human insulin (and the insulin some of our bodies produce naturally) does not cross the placenta, animal insulin does. And when this happens, hyperinsulimia can occur, resulting in big babies. In other words, no matter how good the mother's glucose was controlled, the baby still had a pretty good chance of macrosomia.
The good news is the use of human insulin alleviates this problem. Today, diabetic mothers are statistically more likely to have normal babies than not. Research shows 60 percent of infants born to diabetic mothers with high blood sugar are normal birth weight. Factor in good control and the odds of a healthy baby are even better. Just 13 percent of babies born to diabetics mother with tight control are large.
In the end, my obsessive worry and tight control was successful. My son was a healthy 5 pounds, 14 ounces at birth. And that friend who expected my boy to be fat? She thought his scrawny little chicken arms were adorable.


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