Gestational

Most pregnant women don't get diabetes. Why not? Is it because their fetuses don't send forth chemical signals to cause insulin resistance, which would free more glucogen for the fetus, or is it that their bodies stretch out and accommodate the baby more readily, so that extra pressure from the precious cargo doesn't end up strangling the pancreas? Why is it that obese women are more likely to get gestational diabetes than fit women? It seems obvious to me that obese women already have a head start on pancreatic strangulation. There's only so far a person can expand, and if the space is already partially taken, extra pressure on the pancreas ensues. Else, what is your theory? Is it that the fat produces unknown chemical B7, which doesn't cause diabetes in itself unless in conjunction with a chemical produced by the fetus, unknown chemical B8, which doesn't cause diabetes by itself, but in combination with B7 does cause diabetes, and only in some women? Science is about prediction, about disprovable theorems. Find me these chemicals, and write me guidelines that can predict which women when pregnant will get diabetes. Find me these chemicals, tell me the proportion and concentration already present in diabetics, and we will inject non-pregnant, non-obese, non-diabetic test animals with just the right amount of them and see if they get diabetes.

Why do some big women not get diabetes and some thin women do get diabetes? If my pressure theory is correct, it's because of dumb luck. Some women, even if large, accommodate the baby without putting extra pressure on the pancreas; some women, even if thin, do not accommodate the baby and, because of the size of the baby, or because of a lack of ability to expand, end up with too much extra pressure on the pancreas. I propose it also has something to do with muscle strength. If you are strong, your back is broad and your chest is pumped out. So if you are strong, even if you are fat, you still have more space in your chest cavity to accommodate the baby.

Why do some women with gestational diabetes remain diabetic after delivering the baby (most don't)? If my theory is correct, their duodenums stay in the strangulation position, perhaps because of extra weight gained during pregnancy, perhaps because the muscles that once held the chest out have weakened, perhaps because their duodenums just harden in place tightly around the pancreas. (Remember, folks, this is a theory. It's a theory that's not proven yet. And I'm not a doctor, not an expert, just a thinker.)

(Added January 3, 2009) A friendly acquaintance who is a biologist, albeit one not specializing in diabetes, tells me that diabetes is a symptom, not a disease. Let me explain what he means. When you have a cough, you should not say, "I have cough disease," because what is making you cough could be: the common cold, dust in the air, the flu, lung cancer, tuberculosis, something else, inhaling water while trying to drink and talk at the same time. So, let us extrapolate hard about diabetes, particularly gestational diabetes, if diabetes is a symptom. Let's say the cause of pregnancy-onset-diabetes is different than the cause of too-much-fat-onset-diabetes. You would have to assume that a non-pregnant woman who had diabetes who became pregnant could have two kinds of diabetes-causing diseases. Just because I have never heard of such a thing doesn't make it so, but isn't the burden of proof on the ones who propose this theory? Shouldn't there be a qualitative difference in the two diabetes's, like, say, the difference between smoker's cough and whooping cough?

If diabetes is a symptom of different diseases, shouldn't there be tests to determine which disease is causing the diabetes? For instance, if you had a cough, a test could show whether you had lung cancer or a virus. If you have head pain, a test could show whether someone shot a bullet into your head, or you had tense neck muscles, or you had a gigantic growth in your brain. Can we even speculatively name the different diseases that give rise to diabetes if diabetes is just a symptom, let alone test for which one is the cause?

If the pressure theory is correct, then pregnancy should make an already diabetic mother's diabetes worse, unless her diabetes is already as bad as it can get. In that case, her diabetes should remain in its extremely bad state. If hormones cause fat onset diabetes, and if a different set of hormones cause gestational diabetes, then it is possible that an already diabetic woman, upon getting pregnant, would not get any worse. It would be illogical that an already diabetic woman, upon getting pregnant, would automatically get gestational diabetes, if the cause of gestational diabetes is different than regular diabetes. That would be like saying that everybody with a cough caused by the common cold will automatically have more coughing caused by lung cancer if such a person takes up smoking. -- What I mean by all this is: if the causes of diabetes are really diverse, where is the research that shows its diversity? Where is the logic that shows it to be diverse?

If the mother is addicted to a drug, the baby will be born addicted to that drug. Hormones are like drugs, but produced by the body. If gestational diabetes is caused by hormones, or if regular diabetes is caused hormonally, shouldn't the baby of a diabetic mother be born with diabetes? If diabetes is caused by pressure, however, it makes sense that the baby would be born diabetes-free. Just because Mom's pancreas is tweaked in some way, doesn't mean baby's is. (Mommy's got enough guilt trips to worry about. Don't lay a "your baby's going to be born with diabetes" trip on her. It's not true. -- O.k., that's a straw man argument. Nobody's saying that.)