Causes and Symptoms of Insulin Resistance During Pregnancy (Part 2 of 3, Who Am I?)

Valerie Berkowitz, MS, RD, CDE, CDN
Valerie Berkowitz, MS, RD, CDE, CDN

If you are curious about who I am, click here for part 1, as I will go right into the next part of my story – how I learned about insulin resistance during pregnancy.

In order to figure out my unexplained and substantial weight gain, my starting point of thought was “What is the underlying cause for this excessive weight gain during my pregnancy, and why was it so difficult to get it off?” If you looked at me, the simple answer is, “You eat too much!” but what was causing this necessity to eat every couple of hours?

Following the mantra of my book, “The Stubborn Fat Fix“, I had to scratch the surface and peel back a few layers to get to the reason of my perplexing issue.

My mind races back to Dr. Atkins’ voice as it resonates in my ear, “you will never have to worry about weight gain or diabetes, your pancreas is very efficient at covering the amount of carbs you eat.”  Past blood work from The Atkins Center showed slightly low insulin levels.

Then I think, “despite my weight gain all my clinical tests were normal!”

My doctors assured me not to worry, “you will lose the weight. Some people gain more than others.”

But something in the back of my mind tells me differently as I started to question the skin tag growing on my neck.

I had the tell-tale signs of insulin resistance:

Low Carb Pregnancy

  1. pregnancy itself (see potential causes of insulin resistance during pregnancy below)
  2. excessive weight gain
  3. skin tags
  4. post natal stubborn belly fat, in the past, if  I put on a few pounds, it was always on my thighs and butt
  5. weight loss (as a result of  both weight training and a long 2-3 year haul of low carbing)
  6. my last pregnancy, my body was all but through with me as it sent me another sign of the emergency state it was in…. acanthosis nigricans (dark patches on the knuckle of my big toe), I attributed these to cosmetic faults as a result of dehydration.  NOT, I was in denial!
  7. slightly elevated cholesterol  (after pregnancy)
  8. slightly elevated  liver enzymes (after pregnancy)

Nothing too alarming. All eight of these very important tell-tale signs were there but I never put them all together.

I always tell people to listen to their body. I translate body symptoms for others all the time. I connect the dots using various symptoms and lifestyle issues, and help improve weight issues and health conditions. I was in denial, but, in denial with all those health experts who assured me that this weight gain was “normal”.

I felt concerned. I typically am in control of my eating and thought, I am not pregnant forever.

My B-I-G mistake was not listening to my intuition. So I will repeat, “ALWAYS LISTEN TO YOUR BODY.” Although I was lucky, insulin resistance during pregnancy can affect the baby, and has health consequences above and beyond insulin resistance. I list these below.

Not one physician ever had a discussion with me about the potential hormonal induced insulin resistance that naturally happens with pregnancy. The practitioners main focus on prenatal care is to avoid gestational diabetes and protect the baby.

One year after giving birth, I board Jimmy Moore’s Low Carb Cruise 2012 and overhear Dr. Michael Fox talking about his insulin resistant patients, whose skin tags fall off once they lose the weight, and his observance of the appearance of acanthosis nigricans in his pregnant patients. I was hit with a left hook – all the symptoms I had – it was the arch-enemy of most of my patients, insulin resistance, rearing its ugly head at me.

Now I understand the why, thanks to this article:

Cellular Mechanisms for Insulin Resistance in Normal Pregnancy and Gestational Diabetes by Linda A. Barbour, et al. Diabetes Care, July 2007, vol. 30, Supplement 2 pages S112-S119.

Seven factors that are involved in causing insulin resistance during pregnancy:

  1. an increase in insulin secretion by approximately 225% that naturally occurs with pregnancy
  2. a decrease in insulin function by about 50%, that naturally occurs with pregnancy.
  3. human placental lactogen (hPL) increases up to 30-fold throughout pregnancy and induces insulin release from the pancreas in pregnancy
  4. human placental growth hormone (hPGH) important in fetal and maternal metabolism
  5. “adipokines” (include leptin, adiponectin, TNF-α, interleukin-6, resistin): factors released from fat tissue. Metabolic changes in fat tissue itself  could lead to underlying insulin resistance, increased nutrient availability, and subsequent transfer to the fetus. OMG, this is a big one. Babies are at risk. This could lead to childhood obesity.
  6. adiponectin: fat specific protein that is reduced with increased weight, and in individuals with heart disease and diabetes
  7. insulin signal pathway factors: IRS-1 protein (critical for regulation of glucose uptake) and is decreased in skeletal muscle by 30–50% in normal obese pregnant and GDM;  IRS-1 serine phosphorylation : a mechanism mediating insulin resistance; an increased p85 monomer and PI3 Kinase (an enzyme signaling pathway).

All this happened despite my following a low carb diet, because my hormones were being affected by the pregnancy.

If I was not following a low carb diet, I would have very likely been diagnosed with diabetes. If I were diagnosed with insulin resistance and had a physician like Dr. Fox, I would have been directed to cut down on my veggies to reduce my carb intake to less than the 100 grams I was eating. Maybe I would not have gained so much weight.

Now don’t let this happen to you – do not allow yourself to slip through the cracks. If you think there is something not right, and you are experiencing anything but good health, be your own super sleuth. Find out how next time.

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  1. This happened to me in my first pregnancy.I was gaining normally,then all off a sudden started gaining 10 pounds a month,for a total of 63 pounds.It was actually insulin resistance rearing its ugly head,but I didn’t know back then.For my next pregnancy I low carbed mostly and had the weight under control.Also breastfeeding is affected.I had milk but baby wasn’t gaining weight,known as low value milk.Once I dropped to Induction levels,and increased fat in my diet,breastfeeding became a success.Mothers Milk tea helped greatly too.

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