A STAGGERING statistic reported by the Bermuda Diabetes Association (BDA) was that a quarter of all residents pregnant last year developed gestational diabetes.

A condition caused by several factors, it serves as a warning to women at risk for Type 2 Diabetes, and can have severe implications for a child including premature birth and respiratory problems and places them at risk for obesity later in life.

To combat that, the BDA plans to launch an educational programme for at-risk women and health professionals which will teach weight control before, during and after pregnancy, and also how to recognise the symptoms of diabetes and the best forms of treatment.

S is true in the rest of the world, the number of diabetics on the island is increasing. According to the BDA, some 8,000 residents have the disease, the majority of whom are afflicted by Type 2 Diabetes, an hereditary condition exacerbated by poor diet and insufficient exercise.

Of growing concern, however, is gestational diabetes. Usually detected in week 28 of a pregnancy, it indicates that a woman is likely to develop Type 2 Diabetes unless significant changes are made in diet and exercise.

"Not all women get gestational diabetes," past BDA president Debbie Jones explained. "But women are at risk of getting diabetes if they've got a family member with diabetes, if they've put on weight, if they haven't been exercising and the older the mum is, the greater the risk.

"But that is changing. We never used to see gestational diabetes in our young mums but we're now seeing it quite a lot because they've started that pregnancy being overweight."

She said the problem might be observed in how a body regulates insulin. Many women increase their intake of fruits and fruit juices during pregnancy unaware of the impact doing so will have on their blood sugar levels.

"You have enough insulin to take care of the food you eat. As the baby grows, the placenta grows, and that placenta starts to consume some of the insulin.

"So there's less insulin available as baby gets bigger. The screening is usually done at 28 weeks and the reason is because that's usually when the placenta is at a certain size that it will make a difference.

"Women are then asked about their eating habits. There are lots of women who think that if they are pregnant they should be eating tons and tons of fresh fruit. They might start breakfast with a big glass of juice and a big bowl of fruit ? that's too much sugar.

"In some cases all we need to do is to change the way they're eating, to encourage them to eat less fresh fruit and drink water instead of the fruit juices that they might be drinking during the day."

In such cases it becomes essential to monitor a woman's blood sugar levels. A daily log is kept which is presented to healthcare professionals once a week. Those who record a blood sugar level of more than 120, two hours after a meal, on repeated occasions, are started on insulin.

"They have to check their blood sugars six times every day ? before they eat breakfast in the morning and then two hours after each meal and then at bed ? which is a lot.

"A normal blood sugar range is 70 to 130, but when you're pregnant we want that fasting blood sugar to be between 65 and 90. (Where necessary) we teach them how to use that insulin and between us and the physician we adjust that insulin as the pregnancy increases. So we work very, very closely with the mums' doctors."

Their aim is to prevent the baby from becoming too fat and to remove its risk of becoming obese later in life.

"When the mum's blood sugars are high, that sugar goes into the blood and goes into the baby. The organs are already formed so there's no harm to the baby at all, but the baby will respond to those high sugars by putting out more insulin of its own and it will take that excess sugar from mum and convert it into fat.

"The baby will put on weight and the danger is it could (decide it's) ready to be delivered (at) only seven and a half months (because it's) the size of a nine month old and it could have respiratory problems or other problems associated with being big.

"A second problem which is now coming to light is that the higher the baby's blood sugar is, the more fat the baby puts on as a foetus. That puts that child at risk for obesity later on in life." Just as essential are regular urine checks for ketones, which occur when a diet does not contain sufficient carbohydrate to provide the body with sugar for energy.

"If the body is not getting enough nourishment the cells in the body will start to burn fat, and that turns into ketones," Mrs. Jones explained.

"It's very good if you're a marathon runner and you need extra energy, but we're not sure what it does to the baby. It's not proven yet, but there's some suggestion that continual ketones in a mum's urine could have an effect on the baby's IQ."

She said the idea came from studies conducted on children born to malnourished women. Many developed ketones during pregnancy because they didn't have an ample diet.

"Sometimes we find that mums get so worried about their blood sugars that they'll only eat tiny, tiny bits. They'll check their blood sugar at night, it'll be higher than they would like it to be and they think, 'Oh my gosh, if I have a snack now it's only going to be higher in the morning'.

"That's not true and, it means they're not having enough nourishment overnight. And so in order to feed the baby the mum releases ketones which isn't healthy."

The best way to ensure a healthy pregnancy and a healthy child is to incorporate a healthy diet and regular exercise into one's life from birth, she insisted.

"Meal planning and exercise are important from the day you're born. You need to eat healthy, drink water and do some form of physical activity every single day for the rest of your life.

"We recognise it isn't something that a person was meant to do alone. And if they were, it's not working and that's why the community has to be involved.

"We have to take steps to make sure that there is access to water as opposed to sweet drinks, that there's a place to walk and be physically active without being in danger of being run over by a vehicle. It's a whole community effort."

Such efforts could slow the progression of gestational diabetes on the island, she added.

Of the 800 women who gave birth on the island last year, the BDA tracked "a sizeable amount" with the disease ? more than 110 ? many of whom were placed on insulin.

As such, the organisation is wildly appreciative of PartnerRe's decision to contribute the proceeds from its ninth annual 5K Run & Walk to efforts to fight female diabetes on the island.

The BDA plans to launch an educational programme to combat the problem, aimed at both at-risk women and health professionals who treat them.

"I think now the doctors are now routinely ordering the test at 28 weeks because diabetes is such a huge problem around the world. There are so many people who are doing so little exercise and eating foods on the run.

"Some of them have busy jobs, they have more than one job, they have a family to look after ? they have all sorts of different commitments to meet and taking time for themselves is the last thing on their agenda.

"We really enjoy our gestational mums. It's a real pleasure to be working with women who want to take care of themselves not just for themselves, but for their unborn babies.

"They're willing to test themselves as much as we're asking them to do, they're willing to make changes to their meal plan and they're willing to take insulin if they have to.

"I think the message we want to get out there is that mums, teenagers and young girls, as they start to get older, they have to start thinking about being healthy because it will impact on their pregnancy."

HE added: "The healthier they are, the fitter they are, the better pregnancy they will have. But it's around the world. It's not just here. And as diabetes is increasing, gestational diabetes is increasing.

"Raising awareness of it is the best way to make people think about it and because of that we really appreciate being chosen as the beneficiary of this year's PartnerRe 5K.

"We encourage women of all ages to come out and support us. It's not just a walk. They're putting this whole fun aspect into it. There will be women walking, women running, women running competitively, women walking not competitively.

"Mothers and daughters, girls from schools, relay teams, gestational mums ? they have really put together a real women's kind of day and there's tons of prizes they're giving out.

"They've got a healthy breakfast that's going to be happening afterwards and there's blood sugar testing before and after the race. It just sounded so wonderful and I think they're wonderful for the kind of work they're doing, to be so community active in putting something like this on.

"Each year they choose a different charity and this year, we were the lucky charity."