Popularly known as the ‘Keto’ diet, this is a low-carbohydrate, moderate-protein and high-fat diet that helps burn fat more easily. Our bodies run on either glucose or fat. A low carbohydrate intake sends the body into a metabolic state known as ketosis. This is where the liver produces ketones from fat. These ketones serve as a fuel source throughout the body. This means the fat from your body and from your diet is what is used as energy, hence this is the theory behind the weight loss seen with this diet. #### **What can I eat on the keto diet?** * Non-starchy vegetables, such as beans, broccoli, spinach and carrots. * Seafood * Plain Greek yoghurt * Meat and poultry * Coconut oil * Olive oil * Nuts and seeds * Berries * Butter and cream * Dark chocolate and cocoa powder #### **What can’t I eat on the keto diet?** * Cereal * Beer * Sweetened Yoghurt * Starchy vegetables (corn and sweet potato) * Low fat salad dressing * Beans and legumes * Gluten-free baked goods #### **What are some of the proposed benefits to the keto diet?** * Helps in improving [](https://nabtahealth.com/what-is-pcos/)[PCOS](https://nabtahealth.com/glossary/pcos/) symptoms. * Protects brain function. * Helps with excess weight loss. * Helps in reducing acne. * Helps reduce risk of all cancer types. * Helps in reducing seizures, especially for people diagnosed with epilepsy. * Contains neuroprotective benefits that protect and strengthen brain functions. #### **Are there any negatives to the keto diet?** * Some people tend to experience ‘Keto Flu’ that results in fatigue, gastrointestinal distress and lethargy. It tends to pass away after sometime. * [Diarrhoea](https://nabtahealth.com/glossary/diarrhoea/). This can occur as a result of lack of fibre in the diet and is common with low carb intake. * The risk of heart disease is a concern with such high fat diets. * Other problems associated with this diet are nutrient deficiency, [constipation](https://nabtahealth.com/glossary/constipation/), increased stress on the liver and kidneys and increased irritability. For further information on modern diets, click [here](https://nabtahealth.com/5-modern-diets-dissected/). Also try Nabta’s [Energy booster](https://nabtahealth.com/product/energy-multivitamin-daily-booster/). Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#87fee6ebebe6c7e9e6e5f3e6efe2e6ebf3efa9e4e8ea) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Cohen, J. “The Trendiest Diets Of 2018: Will They Work For You?” Forbes, 1 June 2018, [www.forbes.com/sites/jennifercohen/2018/06/01/the-trendiest-diets-of-2018-will-they-work-for-you/#55a137aa3aca](https://www.forbes.com/sites/jennifercohen/2018/06/01/the-trendiest-diets-of-2018-will-they-work-for-you/#55a137aa3aca). * Gibas, Madeline K., and Kelly J. Gibas. “Induced and Controlled Dietary Ketosis as a Regulator of Obesity and Metabolic Syndrome Pathologies.” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, vol. 11, Nov. 2017, pp. S385–S390., doi:10.1016/j.dsx.2017.03.022. * Gower, B A, and A M Goss. “A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes.” Journal of Nutrition, vol. 145, no. 1, Jan. 2015, pp. 177S–183S., doi:10.3945/jn.114.195065. * “Should You Try the Keto Diet?” Harvard Medical School, Oct. 2018, [www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet](http://www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet).
The protein in whole milk is much larger and more difficult to digest than the proteins in breast milk and formula (yes, even in cow’s milk formula). By 12 months of age, the great majority of babies are now capable of safely digesting that protein, and therefore you can make the switch to regular milk. Signs that your baby is not ready to switch include a dramatic change in stools that includes mucus or milk, as well as an upset baby. There are also toddler formulas on the market, but with rare exception, there is no medical need to graduate first to these products. They are expensive and unnecessary at this time. Powered by Bundoo®
Hormonal contraceptives are used to prevent pregnancy. When taken correctly, they are a highly effective form of birth control and have given women the opportunity to manage their family planning in a way they never could before. However, in today’s world, hormonally-driven contraceptives, such as the [oral contraceptive pill](https://nabtahealth.com/the-oral-contraceptive-pill/), are used to ‘treat’ a myriad of female health concerns, from irregular or heavy periods, to [acne](https://nabtahealth.com/why-do-i-get-acne-breakouts-before-my-period/) and [](https://nabtahealth.com/coping-with-pms/)[premenstrual syndrome](https://nabtahealth.com/glossary/premenstrual-syndrome/) (PMS). The question is how effective are they and should we be happy with a solution that merely masks the symptoms, rather than solving the underlying problem? #### **What are some of the conditions the pill is regularly prescribed for?** * [](https://nabtahealth.com/what-is-endometriosis/)[Endometriosis](https://nabtahealth.com/glossary/endometriosis/). [Endometriosis](https://nabtahealth.com/glossary/endometriosis/) occurs when the tissue that normally forms the lining of the [uterus](https://nabtahealth.com/glossary/uterus/) (the endometrium) grows elsewhere in the body. The two main [symptoms](https://nabtahealth.com/the-symptoms-of-endometriosis/) of [endometriosis](https://nabtahealth.com/glossary/endometriosis/) are pain and [infertility](https://nabtahealth.com/glossary/infertility/). Whilst the pill is never going to help resolve any difficulties women may be having conceiving; it does have widespread use in managing the [pain associated](https://nabtahealth.com/three-signs-you-might-have-endometriosis/) with the condition. In this case, the pill works by reducing the growth of endometrial tissue both within and outside the [uterus](https://nabtahealth.com/glossary/uterus/), which usually results in less pain. * [Polycystic Ovary Syndrome](https://nabtahealth.com/what-is-pcos/) ([PCOS](https://nabtahealth.com/glossary/pcos/)). [PCOS](https://nabtahealth.com/glossary/pcos/) is one of the most common conditions affecting women of reproductive age. It can prove challenging to both [diagnose](https://nabtahealth.com/problems-with-traditional-diagnosis-of-pcos/) and treat as it usually presents as a set of symptoms that can vary woman to woman, and even month to month in the same woman. The three defining features of the condition are [anovulation](https://nabtahealth.com/glossary/anovulation/), signs of [androgen excess](https://nabtahealth.com/male-hormones-in-women/) ([hyperandrogenism](https://nabtahealth.com/glossary/hyperandrogenism/)) and [polycystic](https://nabtahealth.com/do-polycystic-ovaries-equal-pcos/) [ovaries](https://nabtahealth.com/glossary/ovaries/); and two of these three need to be present for a diagnosis to be made. The pill is frequently prescribed to women struggling with the symptoms of [PCOS](https://nabtahealth.com/glossary/pcos/): * [Anovulation](https://nabtahealth.com/glossary/anovulation/)/irregular periods. The pill is often claimed to regulate abnormal menstrual cycles. However, the menstrual cycle is not actually being regulated because the monthly bleeds experienced are pill withdrawal bleeds, not normal menstruation, so regular, cyclical [ovulation](https://nabtahealth.com/glossary/ovulation/) is still not occurring. * Acne/[](https://nabtahealth.com/how-to-manage-facial-hair/)[hirsutism](https://nabtahealth.com/glossary/hirsutism/)/[](https://nabtahealth.com/coping-with-pcos-hair-loss/)[alopecia](https://nabtahealth.com/glossary/alopecia/) ([hyperandrogenism](https://nabtahealth.com/glossary/hyperandrogenism/)). The pill reduces the levels of [androgens](https://nabtahealth.com/glossary/androgen/) produced by the [ovaries](https://nabtahealth.com/glossary/ovaries/), which subsequently alleviates the physical signs of an androgen excess. * [](https://nabtahealth.com/a-simple-guide-to-fibroids/)[Fibroids](https://nabtahealth.com/glossary/fibroids/). [Fibroids](https://nabtahealth.com/glossary/fibroids/) are non-cancerous growths that can cause heavy periods and cramping. * [Menorrhagia](https://nabtahealth.com/glossary/menorrhagia/) (heavy periods). The synthetic version of the hormone [progesterone](https://nabtahealth.com/glossary/progesterone/), progestin, which is in the pill, thins the lining of the [uterus](https://nabtahealth.com/glossary/uterus/), resulting in lighter periods. Menstrual fluid volume is also reduced. * [Dysmenorrhoea](https://nabtahealth.com/glossary/dysmenorrhoea/) ([period pain](https://nabtahealth.com/natural-methods-to-alleviate-period-pain/)). The pill prevents [ovulation](https://nabtahealth.com/glossary/ovulation/), which normally triggers the release of [prostaglandins](https://nabtahealth.com/glossary/prostaglandins/). [Prostaglandins](https://nabtahealth.com/glossary/prostaglandins/) cause the [uterus](https://nabtahealth.com/glossary/uterus/) to contract during menstruation, causing cramps and discomfort. Without [prostaglandins](https://nabtahealth.com/glossary/prostaglandins/), period pain is significantly reduced. * PMS. Using the pill prevents [ovulation](https://nabtahealth.com/glossary/ovulation/) and inhibits the normal menstrual cycle. Although it might appear you are still having a monthly period, this is not the case and without the normal hormonal fluctuations seen during a typical cycle, the unwanted symptoms of PMS and [PMDD](https://nabtahealth.com/what-is-premenstrual-dysphoric-disorder/) can be significantly reduced. #### **What are the advantages to using hormonal contraceptives?** For those women not looking to conceive, taking hormonal contraceptives can bring welcome relief from otherwise relentless pain and discomfort. Heavy and/or chronically irregular periods are more than just an inconvenience; they can impede day-to-day life, impact mental health and even increase your risk of suffering from other medical complications, such as [anaemia](https://nabtahealth.com/glossary/anaemia/). Preventing [ovulation](https://nabtahealth.com/glossary/ovulation/) also reduces the risk of experiencing [pelvic inflammatory disease](https://nabtahealth.com/pelvic-inflammatory-disease-a-simple-guide/) and [ovarian cysts](https://nabtahealth.com/are-ovarian-cysts-the-same-thing-as-pcos/), which can be serious if they [rupture](https://nabtahealth.com/what-happens-when-an-ovarian-cyst-ruptures/). Women with unmanaged [PCOS](https://nabtahealth.com/glossary/pcos/) are at increased risk of developing [endometrial cancer](https://nabtahealth.com/a-guide-to-endometrial-cancer/) due to unopposed exposure of the [uterus](https://nabtahealth.com/glossary/uterus/) to [oestrogen](https://nabtahealth.com/glossary/oestrogen/). The pill can lower this risk. #### **What are the problems with using hormonal contraceptives to treat female-related healthcare issues?** The major problem with the pill having such widespread use in modern gynaecological medicine is that it does not rectify any of the underlying healthcare issues. It is a relatively ‘quick fix’ option that can give the illusion of symptom alleviation; when all it really does is mask the consequences of a condition. In all likelihood, once you stop taking the pill, your symptoms will return, in some cases more pronounced than before. Taking the pill for pain management, or to control the signs of androgen excess, is one thing and in these cases, perhaps it can provide some relief. However, for those women who are seeking help to manage their irregular cycles, perhaps with a view to improving fertility; hormonal contraceptives are not the optimal solution. The components of the pill are synthetic; artificial versions of the hormones they are attempting to replicate. Whilst it would be amazing if the pill contained some sort of stimulating agent that coaxed the body’s own endogenous hormones into behaving as they should; this simply does not happen. Menstrual cycles that appear regular with pill use are artificial and will not be maintained once treatment is ceased. #### **What is the alternative?** One alternative to symptom management is attempting to understand the root cause of your issue. [Obesity and](https://nabtahealth.com/how-are-obesity-and-pcos-connected/) [PCOS](https://nabtahealth.com/glossary/pcos/) are closely associated and lowering [](https://nabtahealth.com/what-is-body-mass-index-bmi/)[BMI](https://nabtahealth.com/glossary/bmi/) has been shown to improve the symptoms of [PCOS](https://nabtahealth.com/glossary/pcos/). In fact, many women will find that making [simple lifestyle adjustments](https://nabtahealth.com/is-it-possible-to-reverse-pcos/), such as losing weight, can help to restore fertility. A number of the conditions described above are exacerbated by high levels of endogenous [oestrogen](https://nabtahealth.com/glossary/oestrogen/); for example, high [oestrogen](https://nabtahealth.com/glossary/oestrogen/) contributes to the heavy periods and pelvic pain experienced by women with [endometriosis](https://nabtahealth.com/glossary/endometriosis/) and can trigger the growth of [fibroids](https://nabtahealth.com/glossary/fibroids/). By preventing [ovulation](https://nabtahealth.com/glossary/ovulation/), the pill reduces [oestrogen](https://nabtahealth.com/glossary/oestrogen/) production, but there are other more natural methods of reducing [oestrogen](https://nabtahealth.com/glossary/oestrogen/). Lowering body fat by exercising more, and limiting caffeine and alcohol intake can all help. Smoking can make period pain worse, so giving this up can also help significantly. A number of women rely on complementary medicine to manage their gynaecological health issues. Unfortunately, in most cases the data is limited on the effectiveness of such approaches. [Melatonin](https://nabtahealth.com/which-dietary-supplements-help-to-combat-insomnia/) might have some use in rectifying disrupted sleep; but other supplements, including fish oil, vitamins B1 and E, [zinc](https://nabtahealth.com/glossary/zinc/) sulphate, fenugreek and ginger have had negligible benefits in scientific studies. To conclude, the pill is an option for managing a number of gynaecological health issues. However, you should be wary about relying on it long-term and it might be worth speaking to your doctor about alternative solutions. Consider Nabta’s [Selfcare Essentials](https://nabtahealth.com/product/selfcare-essentials-for-him-and-her/) and try our [Women’s Health Test](https://nabtahealth.com/product/womens-health-test/). Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#6a130b06060b2a040b081e0b020f0b061e0244090507) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * “Noncontraceptive Benefits of Birth Control Pills.” _ReproductiveFacts.org_, American Society for Reproductive Medicine, [www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/noncontraceptive-benefits-of-birth-control-pills/](http://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/noncontraceptive-benefits-of-birth-control-pills/). * Pattanittum, Porjai, et al. “Dietary Supplements for [Dysmenorrhoea](https://nabtahealth.com/glossary/dysmenorrhoea/).” _Cochrane Database of Systematic Reviews_, vol. 3, no. 3, 22 Mar. 2016, doi:10.1002/14651858.cd002124.pub2. * Sachedin, Aalia, and Nicole Todd. “Dysmenorrhea, [Endometriosis](https://nabtahealth.com/glossary/endometriosis/) and Chronic Pelvic Pain in Adolescents.” _Journal of Clinical Research in Pediatric Endocrinology_, vol. 12, no. 1, 6 Feb. 2020, pp. 7–17., doi:10.4274/jcrpe.galenos.2019.2019.s0217. * “What Birth Control Method Is Right for You?” _Womenshealth.gov_, 14 Feb. 2019, [www.womenshealth.gov/a-z-topics/birth-control-methods](https://www.womenshealth.gov/a-z-topics/birth-control-methods). * “Which Birth Control Pills Can Help Reduce Acne?” _Institute for Quality and Efficiency in Health Care: Germany_, by Mona Nasser and Peter Sawicki, www.ncbi.nlm.nih.gov/books/NBK279209/.
* Type 1 diabetes is a chronic condition when the pancreas produces too little insulin. * We need the hormone insulin to be allow our body to turn sugar into energy. * Type 1 diabetes is not caused by lifestyle factors, unlike type 2 diabetes. * Type 1 diabetes is often diagnosed in childhood and has no cure. * Treatment of type 1 focuses on maintaining healthy blood sugar levels. Diabetes occurs when the body is unable to regulate its blood sugar levels. The three most widely known variants are type 1 diabetes, type 2 diabetes and [](https://nabtahealth.com/gestational-diabetes-8-things-you-should-know/)[gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/). This article explores type 1 diabetes in more detail. #### **What is type 1 diabetes?** Type 1 diabetes mellitus (T1DM) used to be known as insulin dependent or juvenile/child-onset diabetes. It is unknown why some people develop T1DM and, unlike the type 2 variant, poor lifestyle choices and an unhealthy diet do not increase your risk. T1DM is often diagnosed during childhood and is a lot less common than T2DM. The insulin deficiency seen in those with T1DM happens as a result of the immune system attacking and destroying the beta (insulin producing) cells in the pancreas. Insulin normally plays an essential role, transporting glucose from the bloodstream into the cells, where it is used for energy. Thus, without insulin, there is a build-up of sugar in the blood. High blood sugar levels ([hyperglycaemia](https://nabtahealth.com/glossary/hyperglycaemia/)) can be very dangerous and, left unmanaged, can cause permanent damage to the nerves and the blood vessels. #### **Symptoms of T**ype 1 Diabetes The symptoms of T1DM often come on suddenly and can be quite severe. Some of the most common are: * [Polydipsia](https://nabtahealth.com/glossary/polydipsia/) * [Polyuria](https://nabtahealth.com/glossary/polyuria/) * [Polyphagia](https://nabtahealth.com/glossary/polyphagia/) * Unexplained weight loss * Ketones in the urine * Fatigue * Irritability * Blurred vision * Frequent infections (particularly in the gums, skin and [vagina](https://nabtahealth.com/glossary/vagina/)). #### **Risk factors for the development of T1DM** Whilst the exact cause of T1DM remains unknown, there are some known risk factors: * Family history. You have an increased risk of developing T1DM if a parent or sibling has it. * Environmental factors. Sometimes a diagnosis of T1DM comes following exposure to a viral infection. * Geography. Some countries have a higher than average incidence of T1DM; examples include, Finland and Sweden. #### **Diagnosis of T1DM** Whilst increased thirst and insatiable hunger, accompanied by frequent urination are strongly indicative of diabetes, your doctor will probably want to confirm the diagnosis using a blood or urine test. An **A1C test** might be used to measure average blood sugar levels. It calculates the percentage of blood sugar attached to [haemoglobin](https://nabtahealth.com/glossary/haemoglobin/). Levels below 5.7% are considered normal; a reading of 6.5% or higher on two tests suggests diabetes. If results from the A1C test are inconsistent, a random blood sugar test, or fasting blood sugar test might be used to check whether blood sugar levels are higher than the normal range. Your doctor may also check for the presence of **[autoantibodies](https://nabtahealth.com/glossary/autoantibodies/)**. These bind to the beta cells of the pancreas and signal the immune system to attack and destroy the beta cells. [Autoantibodies](https://nabtahealth.com/glossary/autoantibodies/) can be detectable years before a diagnosis of diabetes is made, so if you are considered high risk, your doctor might want to monitor your levels over time. Urine samples are used to check for **ketones**. Ketones are produced by the liver when the body is unable to use glucose for energy and relies on fat instead. Having some ketones is not a problem, but having too many in the circulation can cause the blood to become acidic (ketoacidosis), which, left untreated, can be a very serious complication. #### **Complications** Long-term, poorly controlled diabetes is a significant health concern because the complications that develop gradually can be life-altering, or in severe cases life-threatening. * Cardiovascular disease. People with diabetes are 2 to 3 times more likely to experience heart disease or a stroke. * [Nephropathy](https://nabtahealth.com/glossary/nephropathy/). Approximately 25% of people with diabetes develop kidney disease, characterised by damage to the organs’ delicate filtering system. In severe cases, patients require [dialysis](https://nabtahealth.com/glossary/dialysis/) or transplant. * Damage to the blood vessels supplying the retinas can cause eye disease (retinopathy), resulting in [cataracts](https://nabtahealth.com/glossary/cataracts/), [glaucoma](https://nabtahealth.com/glossary/glaucoma/) or even blindness. Regular eye screening is recommended for all patients with T1DM. * Foot damage. Nerve damage or poor blood flow to the feet increases the risk of ulcers and infections. In severe cases, amputations become necessary. * Skin infections and [dry skin](https://nabtahealth.com/conditions-that-cause-dry-skin/). * Hearing impairment. * Depression, which can have a negative impact on how well you manage your condition. #### **Treating T1DM** T1DM cannot be cured. Daily insulin is required, either via injection or pump, but this manages the consequences of the condition, rather than treating the proposed cause. The cause is anticipated to be an immune system attack on the body and as knowledge regarding this increases, there is hope that, in the future, a cure that targets the deficient part of the immune system may be possible. In the meantime, management of the condition involves minimising the risk of serious complications. The optimal way of doing this is by keeping blood sugar levels within the target range. [Exercising](https://nabtahealth.com/ive-been-diagnosed-with-diabetes-how-can-exercise-help-improve-my-condition/) and eating a balanced diet can both help you to manage your diabetes. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#8af3ebe6e6ebcae4ebe8feebe2efebe6fee2a4e9e5e7) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * “Diabetes.” _Mayo Clinic_, Mayo Foundation for Medical Education and Research, 30 Oct. 2020, [www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444](http://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444). * “Diabetes.” _World Health Organization_, World Health Organization, 8 June 2020, [www.who.int/news-room/fact-sheets/detail/diabetes](http://www.who.int/news-room/fact-sheets/detail/diabetes). * Faye Riley. “Research Spotlight – Retraining the Immune System to Fight Type 1 Diabetes.” _Diabetes UK_, Diabetes UK, [www.diabetes.org.uk/research/research-round-up/research-spotlight/research-spotlight-a-vaccine-for-type-1-diabetes](http://www.diabetes.org.uk/research/research-round-up/research-spotlight/research-spotlight-a-vaccine-for-type-1-diabetes). * The Emerging Risk Factors Collaboration. “Diabetes Mellitus, [Fasting Blood Glucose](https://nabtahealth.com/glossary/fasting-blood-glucose/) Concentration, and Risk of Vascular Disease: a Collaborative Meta-Analysis of 102 Prospective Studies.” _The Lancet_, vol. 375, no. 9733, 26 June 2010, pp. 2215–2222., doi:10.1016/s0140-6736(10)60484-9. * “Type 1 Diabetes.” _NHS Choices_, NHS, [www.nhs.uk/conditions/type-1-diabetes/about-type-1-diabetes/](http://www.nhs.uk/conditions/type-1-diabetes/about-type-1-diabetes/). * “What Is Diabetes?” _National Institute of Diabetes and Digestive and Kidney Diseases_, U.S. Department of Health and Human Services, 1 Dec. 2016, [www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes](http://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes).
Acanthosis Nigricans (AN) is a skin condition, characterised by the formation of dry, dark patches. These patches appear most often under the armpits and at the back of the neck and feel velvet-like to the touch. They can also develop in the groin, behind the knees and elbows and under the breasts; or anywhere that the skin forms folds or creases. Sometimes the patches also develop small growths or become itchy, but often they are [asymptomatic](https://nabtahealth.com/glossary/asymptomatic/). They are not contagious and not harmful. However, if they appear suddenly, or are accompanied by other symptoms, such as unexplained weight loss, you should see your doctor. #### **What causes Acanthosis Nigricans?** Obese people seem more likely to develop AN. This is most likely because insulin signaling pathways are defective in both conditions. Further evidence for this comes from the fact that those with type 2 diabetes mellitus (T2DM) and [polycystic ovary syndrome](https://nabtahealth.com/what-is-pcos/) ([PCOS](https://nabtahealth.com/glossary/pcos/)) are at increased risk of developing AN patches. Both T2DM and [PCOS](https://nabtahealth.com/glossary/pcos/) are strongly associated with [](https://nabtahealth.com/what-is-insulin-resistance/)[insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/). In fact, it is thought that AN could potentially be a warning sign of pre-diabetes. Obesity driven AN is also known as pseudoacanthosis nigricans; perspiration and friction can exacerbate the condition, particularly in areas where the skin is in folds). Other endocrine conditions, such as [Cushing’s syndrome](https://nabtahealth.com/what-is-cushings-syndrome/) and thyroid conditions are also associated with the development of AN. Some **medications** can cause AN, including corticosteroids and the [oral contraceptive pill](https://nabtahealth.com/the-oral-contraceptive-pill/). In rare cases, AN can be a sign of **cancer**. This type of AN is known as the malignant form; it has a rapid onset, usually affecting people over the age of 40 (although in rare cases children have been affected too), and is often accompanied by other symptoms, such as sudden weight loss. Stomach cancer is the malignancy most commonly associated with AN (although it is still very rare); other cancer types that might manifest with AN patches are those of the colon and the liver, and the lymphomas. Another rare cause of AN is **familial inheritance**. The condition is passed on in an autosomal dominant fashion, meaning that only one of your parents needs to have it for you to also inherit it. This type of AN develops gradually, worsening during [](https://nabtahealth.com/what-is-puberty/)[puberty](https://nabtahealth.com/glossary/puberty/) and in adolescence, before stabilising and improving in adulthood. #### **How common is Acanthosis Nigricans?** AN is common and, with obesity rates rising globally, it is likely to affect more people. There are racial differences, with Native Americans and African Americans much more likely to develop AN patches than those of European descent. The prevalence of AN in healthy caucasians with a normal [](https://nabtahealth.com/what-is-body-mass-index-bmi/)[BMI](https://nabtahealth.com/glossary/bmi/) is thought to be less than 1%; however, the rate in Native Americans is between 30 and 70%, with higher rates seen in those with co-existing conditions and a high [BMI](https://nabtahealth.com/glossary/bmi/). More than 60% of children who are considered to be morbidly obese ([BMI](https://nabtahealth.com/glossary/bmi/) > 98th percentile) have AN, regardless of their race. As global obesity rates continue to increase, this clearly demonstrates why AN prevalence is going to rise, even amongst those populations/races not previously considered to be high risk. #### **How is Acanthosis Nigricans diagnosed and treated?** Diagnosis of AN is usually straight-forward; your doctor should be able to diagnose on sight. It may take longer to identify the underlying cause of your AN, particularly if there is no genetic component. There are limited options for specific treatment of the patches; most doctors will attempt to first of all establish and treat the cause of your AN. Over time this will result in skin improvements and the patches should start to fade. If obesity is thought to be the trigger, lifestyle changes should be implemented with a view to losing weight. If medications are causing the patches, your doctor will probably try different options, to find an approach that you are better able to tolerate. If your AN is found to have a malignant basis, you will be treated by an oncologist. One option that has generated some interest is the use of retinoids. These are [vitamin A](https://nabtahealth.com/glossary/vitamin-a/)\-like compounds, found to improve the appearance of skin affected by AN. Retinoids are used to treat a number of [skin complaints](https://nabtahealth.com/conditions-that-cause-dry-skin/), including [acne](https://nabtahealth.com/why-do-i-get-acne-breakouts-before-my-period/) and psoriasis, as they regulate cell growth, including the growth and differentiation of the cells that form the outer layer of the skin (the stratum corneum). Topical retinoids are likely to have fewer adverse effects than those taken orally. Other possible treatment options include: * [Vitamin D](https://nabtahealth.com/glossary/vitamin-d/) * Laser treatment * Melatonin * Metformin. For a comprehensive review of treatment options used in the management of AN, click here. #### **The outlook** In many cases, AN patches fade and disappear with time. Whilst, AN may cause cosmetic distress; in isolation, the patches are rarely harmful and are unlikely to manifest with any other symptoms. The condition can, however, serve a very valuable purpose, as it can be a warning sign or early indicator of a more severe underlying disease. Children with AN are more likely to become obese and/or experience [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/). Identifying that you might have a predisposition to unhealthy weight gain means you can take steps to alleviate it before it becomes a medical issue. Furthermore, AN that appears rapidly and without warning can be a sign of cancer. It goes without saying that the earlier cancer is diagnosed and treatment initiated, the better the overall prognosis. If you notice any unusual skin changes it is advisable to speak to your doctor as soon as possible. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#e099818c8c81a08e818294818885818c9488ce838f8d) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * “Acanthosis Nigricans.” _NHS Choices_, NHS, [www.nhs.uk/conditions/acanthosis-nigricans/](http://www.nhs.uk/conditions/acanthosis-nigricans/). * “Acanthosis Nigricans.” _NORD (National Organization for Rare Disorders)_, [rarediseases.org/rare-diseases/acanthosis-nigricans/](https://rarediseases.org/rare-diseases/acanthosis-nigricans/). * “Acanthosis Nigricans: Overview.” _American Academy of Dermatology_, [www.aad.org/public/diseases/a-z/acanthosis-nigricans-overview](http://www.aad.org/public/diseases/a-z/acanthosis-nigricans-overview). * Brickman, Wendy J., et al. “Acanthosis Nigricans: A Common Finding in Overweight Youth.” _Pediatric Dermatology_, vol. 24, no. 6, 2007, pp. 601–606., doi:10.1111/j.1525-1470.2007.00547.x. * Higgins, Steven P et al. “Acanthosis nigricans: a practical approach to evaluation and management.” _Dermatology online journal_ vol. 14,9 2. 15 Sep. 2008. * Phiske, Meghanamadhukar. “An Approach to Acanthosis Nigricans.” _Indian Dermatology Online Journal_, vol. 5, no. 3, July-Sept 2014, pp. 239–249., doi:10.4103/2229-5178.137765. * Yosipovitch, Gil, et al. “Obesity and the Skin: Skin Physiology and Skin Manifestations of Obesity.” _Journal of the American Academy of Dermatology_, vol. 56, no. 6, June 2007, pp. 901–916., doi:10.1016/j.jaad.2006.12.004.
The best way of managing the symptoms of [Polycystic Ovary Syndrome](https://nabtahealth.com/what-is-pcos/) is through making careful, well thought out, changes to both lifestyle and diet. Medications are often used to treat the condition: the [oral contraceptive pill](https://nabtahealth.com/the-oral-contraceptive-pill/) is commonly prescribed to manage the symptoms of excess [androgens](https://nabtahealth.com/glossary/androgen/). [Metformin](https://nabtahealth.com/i-have-pcos-should-i-take-metformin/), an anti-diabetic drug, is widely used to manage [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/) (even though studies on its effectiveness are contradictory); and clomiphene citrate is regularly used to induce [ovulation](https://nabtahealth.com/glossary/ovulation/) in those who are infertile. Short-term relief from symptoms is one thing, but it is far better to identify and eradicate the cause of [PCOS](https://nabtahealth.com/glossary/pcos/), with a view to providing [permanent symptomatic relief](https://nabtahealth.com/is-it-possible-to-reverse-pcos/). With such a multi-factorial condition, there is never going to be a simple solution. However, adopting a healthier lifestyle and a more nutritionally balanced diet has been shown to improve many of the symptoms, including [](https://nabtahealth.com/what-is-insulin-resistance/)[insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/) and [](https://nabtahealth.com/causes-of-female-infertility-failure-to-ovulate/)[infertility](https://nabtahealth.com/glossary/infertility/). #### **Why lose weight?** A loss of weight has been shown to improve fertility and increase live birth rates in women with [PCOS](https://nabtahealth.com/glossary/pcos/). In one study, 80% of women experiencing [anovulation](https://nabtahealth.com/glossary/anovulation/) and [infertility](https://nabtahealth.com/glossary/infertility/) started having regular menstrual cycles after losing 5% of their body weight. Furthermore, 40% of these women went on to fall pregnant. Dr. Majeda Al-Azemi, a consultant and professor of Obstetrics and Gynaecology at Kuwait University, estimates that over 50% of [PCOS](https://nabtahealth.com/glossary/pcos/) cases can be reversed by weight loss alone, demonstrating the huge potential of adopting a healthy diet, not only for providing symptomatic relief, but also in alleviating the need to take long-term medication. Those who may have a genetic predisposition to the condition, such as those with a family history, can take preventative steps to minimise the impact, through maintaining a [healthy](https://nabtahealth.com/what-is-body-mass-index-bmi/) [BMI](https://nabtahealth.com/glossary/bmi/) and a balanced diet. #### **How eating the right food can help** To have [PCOS](https://nabtahealth.com/glossary/pcos/) is to exist in a state of chronic, low-grade [inflammation](https://nabtahealth.com/glossary/inflammation/). Thus, adopting an anti-inflammatory diet can help alleviate symptoms. Avoiding processed food, tobacco, excess alcohol and minimising sugar intake (very, very important for the management of [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/)) are all steps that are recommended. Other factors that can help include: * Avoiding exposure to harmful environmental irritants, including [endocrine disruptors](https://nabtahealth.com/glossary/endocrine-disruptors/). * Supplementing your diet with magnesium, which is anti-inflammatory, but also naturally lowers insulin levels. * Consulting a naturopathic doctor, who can advise on which herbal or natural medications may work on a case-by-case basis. Adopting a good, well balanced diet not only lowers [BMI](https://nabtahealth.com/glossary/bmi/) and improves body composition, but also promotes hormonal balance, improves menstrual regularity, increases spontaneous pregnancy rates, lowers blood pressure, and reduces blood glucose levels. The longer term risk of developing associated conditions and health complications, such as type 2 diabetes, are also reduced. Women who are insulin resistant are at a higher risk of developing [](https://nabtahealth.com/gestational-diabetes-8-things-you-should-know/)[gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/), which can [lead](https://nabtahealth.com/glossary/lead/) to complications such as [](https://nabtahealth.com/complications-during-pregnancy-polyhydramnios/)[polyhydramnios](https://nabtahealth.com/glossary/polyhydramnios/), [pre-eclampsia](https://nabtahealth.com/what-is-preeclampsia/), premature delivery and large birth weight, as well as increasing the risk of foetal mortality (fortunately this is very rare). Thus, a healthier diet can reduce the risk of any of these unwanted [pregnancy complications](https://nabtahealth.com/pcos-and-pregnancy/). #### **Conclusion** [PCOS](https://nabtahealth.com/glossary/pcos/) is a syndrome, with a range of associated symptoms. Not all symptoms will affect every patient. The best management of the condition comes from having a better understanding of your own body. Making lifestyle changes will not only improve your [PCOS](https://nabtahealth.com/glossary/pcos/) symptoms, but also your general health and wellbeing. To learn more about [PCOS](https://nabtahealth.com/glossary/pcos/) click [here](https://nabtahealth.com/five-things-your-doctor-probably-wont-tell-you-about-pcos/) and try [](https://nabtahealth.com/product/pcos-selfcare-pack/)[PCOS](https://nabtahealth.com/glossary/pcos/) pack for a healthier lifestyle. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#e79e868b8b86a789868593868f82868b938fc984888a) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Crosignani, P G, et al. “Overweight and Obese Anovulatory Patients with Polycystic [Ovaries](https://nabtahealth.com/glossary/ovaries/): Parallel Improvements in Anthropometric Indices, Ovarian Physiology and Fertility Rate Induced by Diet.” _Human Reproduction_, vol. 18, no. 9, Sept. 2003, pp. 1928–1932. * El Hayak, S, et al. “Poly Cystic Ovarian Syndrome: An Updated Overview.” _Frontiers in Physiology_, vol. 7, 5 Apr. 2016, p. 124., doi:10.3389/fphys.2016.00124. * Norman, R J, et al. “The Role of Lifestyle Modification in Polycystic Ovary Syndrome.” _Trends in Endocrinology and [Metabolism](https://nabtahealth.com/glossary/metabolism/)_, vol. 13, no. 6, Aug. 2002, pp. 251–257. * _Overview: [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/)_. NHS, [www.nhs.uk/conditions/gestational-diabetes/](http://www.nhs.uk/conditions/gestational-diabetes/). Page last reviewed: 05/08/2016 * Patel, S. “Polycystic Ovary Syndrome ([PCOS](https://nabtahealth.com/glossary/pcos/)), an Inflammatory, Systemic, Lifestyle Endocrinopathy.” _The Journal of Steroid Biochemistry and Molecular Biology_, vol. 182, Sept. 2018, pp. 27–36., doi:10.1016/j.jsbmb.2018.04.008. * Salama, A A, et al. “Anti-Inflammatory Dietary Combo in Overweight and Obese Women with Polycystic Ovary Syndrome.” _North American Journal of Medical Sciences_, vol. 7, no. 7, July 2015, pp. 310–316., doi:10.4103/1947-2714.161246. * Shokrpou, M, and Z Asemi. “The Effects of Magnesium and [Vitamin E](https://nabtahealth.com/glossary/vitamin-e/) Co-Supplementation on Hormonal Status and Biomarkers of [Inflammation](https://nabtahealth.com/glossary/inflammation/) and Oxidative Stress in Women with Polycystic Ovary Syndrome.” _Biological Trace Element Research_, 18 Dec. 2018, doi 10.1007/s12011-018-1602-9. * Tata, B, et al. “Elevated Prenatal Anti-Müllerian Hormone Reprograms the Fetus and Induces Polycystic Ovary Syndrome in Adulthood.” _Nature Medicine_, vol. 24, no. 6, June 2018, pp. 834–846., doi:10.1038/s41591-018-0035-5.
The greatest risk for a baby that is exposed to [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus affect the newborn (GDM) in utero is [**large birth weight**](https://nabtahealth.com/articles/how-your-weight-can-affect-your-pregnancy/), which is known medically as [](https://www.mayoclinic.org/diseases-conditions/fetal-macrosomia/symptoms-causes)[macrosomia](https://nabtahealth.com/glossary/macrosomia/). #### [Macrosomia](https://nabtahealth.com/glossary/macrosomia/) This refers to babies who weigh over 4 KG or are above the 90th centile. Quite apart from the [difficulties for the mother](../i-have-gestational-diabetes-what-are-the-risks-to-me) in delivering such a large baby, [macrosomia](https://nabtahealth.com/glossary/macrosomia/) can have serious health consequences for the neonate, including an increased risk of [**birth injury**](https://nabtahealth.com/articles/5-types-of-vaginal-tears-from-giving-birth-and-what-they-mean/) and, fortunately only in exceptional cases, early [neonatal](https://nabtahealth.com/glossary/neonatal/) death. #### Other risks There is a slightly increased risk of **[foetal malformations](https://nabtahealth.com/glossary/foetal-malformations/)**. However, this is thought to be primarily due to undiagnosed type 2 diabetes, rather than GDM itself. GDM-induced malformations occur when the condition has been diagnosed early on in pregnancy. Most women are not diagnosed until after 24 weeks and thus, the risk of their babies developing malformations is negligible. GDM does increase the likelihood of interventional approaches such as [induced labour](../https://nabtahealth.com/induction-of-labour/) and [C-section](https://nabtahealth.com/is-caesarean-considered-a-better-choice/), each of which has its own complications. Furthermore, if these intervention techniques are implemented before 37 weeks, the birth will be classed as [**premature**](https://nabtahealth.com/articles/anemia-in-premature-infants/) and the baby may require further monitoring and additional care. Whilst studies are yet to find a direct link between maternal GDM and infant respiratory distress, babies that are more than 4 KG at birth have an increased risk of **respiratory distress**. A major problem in managing this situation is that premature birth and [C-section](https://nabtahealth.com/articles/is-performing-a-c-section-better-than-inducing-labour/) delivery are additional risk factors for respiratory distress. Therefore, even if you take steps to avoid [macrosomia](https://nabtahealth.com/glossary/macrosomia/) and its associated issues, your baby might still need additional medical support at birth. #### Later health problems In addition to the risk of complications during pregnancy and delivery, having untreated GDM can predispose your child to **health problems later in life**. These include impaired glucose tolerance, high blood pressure and obesity, which in combination increase the chances of them developing type 2 diabetes themselves. GDM is not the only risk factor for these conditions; genetics and lifestyle exposure almost certainly play an important role too. [Breastfeeding](https://nabtahealth.com/benefits-of-breastfeeding/) is one way of counteracting some of these negative effects, as it has been shown to improve glucose tolerance and lower the risk of childhood obesity. It has also been suggested that GDM in the mother can increase the likelihood of the child having **attention deficiencies and delayed language** as they reach middle childhood, around the age of 7. The offspring of less educated women are more affected, suggesting a concurrent environmental or genetic element. Recent studies have revealed that babies born to mothers with [GDM](https://nabtahealth.com/articles/i-have-gestational-diabetes-what-are-the-risks-to-me/) have different bacteria present in their gut. This is known as an **altered [microbiome](https://nabtahealth.com/glossary/microbiome/) profile**. It is thought that the presence of specific bacteria in the gut of a neonate helps with the maturation of their immune system. Thus, a disruption in this [homeostasis](https://nabtahealth.com/glossary/homeostasis/) can have long term effects on the child’s ability to overcome infections and put them at increased risk of [metabolic disease](https://nabtahealth.com/glossary/metabolic-disease/) later in life. Most of these adverse effects can be significantly reduced by successful management of the mother’s GDM; further highlighting the importance of [identifying](../how-is-gestational-diabetes-diagnosed) and treating the condition as soon as possible. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#9ee7fff2f2ffdef0fffceafff6fbfff2eaf6b0fdf1f3) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Bener, A, et al. “Prevalence of [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) and Associated Maternal and [Neonatal](https://nabtahealth.com/glossary/neonatal/) Complications in a Fast-Developing Community: Global Comparisons.” _International Journal of Women’s Health_, vol. 3, 2011, pp. 367–373., doi:10.2147/IJWH.S26094. * Dionne, G, et al. “[Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Hinders Language Development in Offspring.” _Pediatrics_, vol. 122, no. 5, Nov. 2008, pp. e1073–1079., doi:10.1542/peds.2007-3028. * Groof, Z, et al. “Prevalence, Risk Factors, and Fetomaternal Outcomes of [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus in Kuwait: A Cross-Sectional Study.” _Journal of Diabetes Research_, vol. 2019, no. 9136250, 3 Mar. 2019, doi:10.1155/2019/9136250. * Mitanchez, D. “Foetal and [Neonatal](https://nabtahealth.com/glossary/neonatal/) Complications in [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/): [Perinatal](https://nabtahealth.com/glossary/perinatal/) Mortality, Congenital Malformations, [Macrosomia](https://nabtahealth.com/glossary/macrosomia/), Shoulder Dystocia, Birth Injuries, [Neonatal](https://nabtahealth.com/glossary/neonatal/) Complications.” _Diabetes & [Metabolism](https://nabtahealth.com/glossary/metabolism/)_, vol. 36, no. 6, ser. 2, Dec. 2010, pp. 617–627. 2, doi:10.1016/j.diabet.2010.11.013. * Mitanchez, D, et al. “Infants Born to Mothers with [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus: Mild [Neonatal](https://nabtahealth.com/glossary/neonatal/) Effects, a Long-Term Threat to Global Health.” _The Journal of Pediatrics_, vol. 164, no. 3, Mar. 2014, pp. 445–450., doi:10.1016/j.jpeds.2013.10.076. * Su, M, et al. “Diversified Gut Microbiota in Newborns of Mothers with [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus.” _PloS One_, vol. 13, no. 10, 17 Oct. 2018, p. e0205695., doi:10.1371/journal.pone.0205695.
Ethnicity is at risk for [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus (GDM) is a glucose intolerance that develops during pregnancy; which, if left untreated, can have long-term health implications for both the [mother](../i-have-gestational-diabetes-what-are-the-risks-to-me) and her [baby](../i-have-gestational-diabetes-what-are-the-risks-to-my-unborn-baby). Worldwide, the prevalence of GDM is increasing, paralleling the rise in cases of type 2 diabetes. Obesity is a major [risk factor](../how-can-i-reduce-my-risk-of-developing-gestational-diabetes) for the development of both [GDM](https://nabtahealth.com/articles/how-is-gestational-diabetes-diagnosed/) and type 2 diabetes, with over 70% of women with GDM having a [Body Mass Index](https://nabtahealth.com/what-is-body-mass-index-bmi/) ([BMI](https://nabtahealth.com/glossary/bmi/)) of over 25. These women have a 50% chance (at least) of developing type 2 diabetes in the decade that follows their [GDM diagnosis](https://nabtahealth.com/articles/how-is-gestational-diabetes-diagnosed/). Addressing obesity is key to reducing the growing number of women being diagnosed with GDM. Ethnicity: a significant risk factor ------------------------------------ However, obesity is not the only factor that increases a [woman’s risk of developing GDM](https://nabtahealth.com/articles/i-have-gestational-diabetes-what-are-the-risks-to-me/); with one of the greatest non-modifiable risk factors thought to be ethnicity. Ethnicity is defined as “belonging to a social group that has a common national or cultural tradition” (Oxford English Dictionary), and the differences in prevalence rates of GDM across different ethnicities are quite striking. **Women from the Middle East have amongst the highest rates of GDM**, at up to 20%; whilst the risks in part of Europe are almost negligible, for example, the risk of developing GDM in Sweden is only 0.4-1.5%. Which populations are at highest risk? -------------------------------------- One large scale study looked at Kuwait in detail. It identified that 12.6% of pregnancies were affected by GDM. This figure increased to 18% when only women aged over 35 were considered (age is another major risk factor for GDM diagnosis). Prevalence rates across neighbouring countries are not dissimilar; Bahrain (10%), Saudi Arabia (15.4%), Qatar (16.3%) and UAE (20.6%). In the Kuwait study it was actually found that Kuwaiti women were at lower risk of GDM than non-Kuwaiti women living in Kuwait (10.2% vs 16.5%). This is probably due to a high proportion of Asian women living in the region. South Asian women have a 7-fold greater risk of developing GDM than women from the US or Australia. Their risk is significantly greater than the risk for women from other Asian sub-populations, including South East Asia and East Asia. The problem with cross-country comparisons ------------------------------------------ There are, however, problems with comparing across different countries, primarily because there is a distinct lack of universally accepted diagnostic criteria and screening approaches. Furthermore, the management of the condition should vary according to ethnicity, and the potential maternal and [perinatal](https://nabtahealth.com/glossary/perinatal/) outcomes will differ depending on where in the world you are. For a start, [BMI](https://nabtahealth.com/glossary/bmi/) is widely used as a screening tool and it can be highly successful at identifying those women at greatest risk in some parts of the world. It will potentially successfully identify over 90% of African-American women with the condition. However, in Asia, its use is questionable, as many women with the condition have a healthy, or even low [BMI](https://nabtahealth.com/glossary/bmi/). Perhaps in this part of the world, the best option is for all women to undergo diagnostic screening. Where obesity is identified as a concurrent risk, it is important to assess the normal diet and eating habits of a particular cultural group. In parts of Asia the diet is very rice-heavy; in the Middle East it is usual to have a large meal mid-afternoon, a small breakfast and a very late dinner. Therefore, carbohydrate intake and timing can vary substantially in different parts of the world, regardless of GDM prevalence. The impact of fasting during the holy month of Ramadan also needs to be taken into account, as many diabetics will still wish to fast. As a final note, extra care should be taken of migrants living in a foreign country. They may struggle to manage their condition if all their health care is provided in a language that they are unfamiliar with. These women are at greater risk of additional complications if their GDM remains untreated. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#2158404d4d40614f404355404944404d55490f424e4c) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Bener, A, et al. “Prevalence of [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) and Associated Maternal and [Neonatal](https://nabtahealth.com/glossary/neonatal/) Complications in a Fast-Developing Community: Global Comparisons.” _International Journal of Women’s Health_, vol. 3, 2011, pp. 367–373., doi:10.2147/IJWH.S26094. * Fadl, H E, et al. “Maternal and [Neonatal](https://nabtahealth.com/glossary/neonatal/) Outcomes and Time Trends of [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus in Sweden from 1991 to 2003.” _Diabetic Medicine_, vol. 27, no. 4, Apr. 2010, pp. 436–441., doi:10.1111/j.1464-5491.2010.02978.x. * Groof, Z, et al. “Prevalence, Risk Factors, and Fetomaternal Outcomes of [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus in Kuwait: A Cross-Sectional Study.” _Journal of Diabetes Research_, vol. 2019, no. 9136250, 3 Mar. 2019, doi:10.1155/2019/9136250. * Yuen, L, and V W Wong. “[Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus: Challenges for Different Ethnic Groups.” _World Journal of Diabetes_, vol. 6, no. 8, 25 July 2015, pp. 1024–1032., doi:10.4239/wjd.v6.i8.1024.
There is no definitive rule with regards to how often you should see a doctor if you have [endometriosis](https://nabtahealth.com/glossary/endometriosis/). The main thing is to find a _sympathetic doctor_ who will take the time to listen to any concerns you might have. [Endometriosis](https://nabtahealth.com/glossary/endometriosis/) can be [difficult to diagnose](https://nabtahealth.com/how-is-endometriosis-diagnosed/) and often the [symptoms](../the-symptoms-of-endometriosis) will closely resemble those of other conditions, such as [irritable bowel syndrome](https://nabtahealth.com/glossary/irritable-bowel-syndrome/) ([IBS](https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome)). For this reason you may initially be referred to a [gastroenterologist](https://nabtahealth.com/glossary/gastroenterologist/) rather than a [](https://nabtahealth.com/articles/top-10-gynaecologists/)[gynaecologist](https://nabtahealth.com/glossary/gynaecologist/). In fact, even once diagnosed, the best approach may well be to consult a multidisciplinary team of experts, depending on the specific symptoms you are experiencing. #### Looking after your emotional health It is also important to consider that [endometriosis](https://nabtahealth.com/glossary/endometriosis/) can have a large impact on your emotional wellbeing, and thus you need to manage more than just the physical symptoms of the condition. Chronic pain can be psychologically draining, as can putting on a ‘brave face’ in front of friends and family. It is not unusual for [](https://nabtahealth.com/articles/what-medications-are-recommended-for-endometriosis/)[endometriosis](https://nabtahealth.com/glossary/endometriosis/) patients to report feeling isolated and alone and the condition has a strong association with depression. It is important to consult your doctor before these feelings start to overwhelm you. Your doctor should also be able to put you in contact with local support groups, where you will have the opportunity to talk to other women who are in the same position. #### Personalised treatment approach The wide ranging clinical presentation of [](https://nabtahealth.com/articles/how-is-endometriosis-diagnosed/)[endometriosis](https://nabtahealth.com/glossary/endometriosis/) means that every patient ideally needs to have a [personalised treatment plan](https://nabtahealth.com/), tailored to their own requirements. This can take time to optimise, so in the early days after diagnosis, it might be necessary to see the doctor on a regular basis. As symptoms improve, the frequency of visits should subside. Nabta is reshaping [women’s healthcare](https://nabtahealth.com). We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Try Nabta’s [Cycle Monitoring with OvuSense](https://nabtahealth.com/product/cycle-monitoring-with-ovusense/) and understand your cycle and health. Get in [touch](/cdn-cgi/l/email-protection#dca5bdb0b0bd9cb2bdbea8bdb4b9bdb0a8b4f2bfb3b1) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * _[Endometriosis](https://nabtahealth.com/glossary/endometriosis/) FAQs_. [Endometriosis](https://nabtahealth.com/glossary/endometriosis/) UK, [https://www.](https://www.endometriosis-uk.org/endometriosis-faqs)[endometriosis](https://nabtahealth.com/glossary/endometriosis/)\-uk.org/[endometriosis](https://nabtahealth.com/glossary/endometriosis/)\-faqs. * _Overview: [Endometriosis](https://nabtahealth.com/glossary/endometriosis/)_. NHS, [www.nhs.uk/conditions/](http://www.nhs.uk/conditions/endometriosis/)[endometriosis](https://nabtahealth.com/glossary/endometriosis/)/. Page last reviewed: 18/01/2019.
* [Gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) is a temporary condition that happens when your body cannot product enough insulin needed to control blood sugar levels during pregnancy. * [Gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) can occur at any stage of pregnancy, but is more common in the second or third trimester. * Often women do not have symptoms and only find out they have [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) when blood sugar levels are tested. * Treatment includes [reducing your sugar intake](https://nabtahealth.com/diabetes-diet-and-hydration/). In some cases, women will need to take insulin. Most women will give birth to healthy babies. Receiving a diagnosis of [](https://nabtahealth.com/gestational-diabetes-8-things-you-should-know/)[gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) during pregnancy can be upsetting. Knowing that it is not only your own health, but also that of your unborn child that could be affected by your diagnosis can seem overwhelming and scary. The good news, however, is that the condition is often managed by careful monitoring and through making sensible changes to the diet. #### **The link between [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) and type 2 diabetes** What [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) should do is to serve as a warning. Women who receive a positive diagnosis during pregnancy are up to seven times more likely to develop type 2 diabetes mellitus (T2DM) later in life. T2DM is a chronic condition that often requires long-term medication and increases your risk of heart disease, stroke and nerve damage. As the global incidence of [obesity](https://nabtahealth.com/what-is-body-mass-index-bmi/) and [](https://nabtahealth.com/what-is-insulin-resistance/)[insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/) increases, rates of T2DM are also going to rise, putting more strain on health services around the world. So, how can you reduce your risk? Aside from adopting a generally healthier lifestyle, there is one other important thing that can lower the risk of T2DM: breastfeeding. Breastfeeding has many benefits for both the [mother](https://nabtahealth.com/benefits-of-breastfeeding-for-the-mother/) and the [child](https://nabtahealth.com/benefits-of-breastfeeding/); and, whilst not all women find it easy, it is imperative that time and effort go into supporting and helping new mothers at this stage. Initial studies, over a two year time period, suggested that women who had received a diagnosis of [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) and exclusively breastfed, were about half as likely to develop T2DM compared to those in the same position who did not breastfeed. Longer term studies are needed to determine how long the benefits of breastfeeding are maintained for, but these results are promising. #### **How does breastfeeding help reduce the risk of developing T2DM?** Breastfeeding improves glucose tolerance by increasing insulin sensitivity, meaning the body can manage fluctuating blood sugar levels more easily. Breastfeeding also promotes energy expenditure. The net consequences of these two factors are improved metabolic function and reduced risk of diabetes. #### **An added complexity** [Gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) is more common in women who are overweight or obese because they are probably already insulin resistant. Unfortunately, overweight women typically struggle more with breastfeeding. [Gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) is associated with a greater risk of pregnancy complications, such as [premature labour](https://nabtahealth.com/glossary/premature-labour/), [](https://nabtahealth.com/is-caesarean-considered-a-better-choice/)[caesarean](https://nabtahealth.com/glossary/caesarean/) delivery and [macrosomia](https://nabtahealth.com/glossary/macrosomia/). These can all hinder attempts to initiate breastfeeding, particularly if the child requires medical assistance after birth. #### **Why is it so important to overcome these problems?** As well as having a positive effect on the mother’s mid- to long-term health, breastfeeding can also benefit the newborn. Babies born to mothers with [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) often experience fluctuating blood glucose levels themselves and their initial insulin production can be erratic. Frequent breastfeeding is a very effective way of normalising blood sugar levels. Evidence also suggests that breastfed babies are at lower risk of developing obesity and diabetes later in life. The take-home message has to be that breastfeeding is beneficial for all women, but particularly for those who have received a diagnosis of [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) during their pregnancy. Children born to mothers who have had [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) may already have an increased susceptibility to developing obesity or T2DM because of their genetics or environmental influences. Breastfeeding is the first step you can take to help lower this risk Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#e198808d8d80a18f808395808984808d9589cf828e8c) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * “Breastfeeding May Help Prevent Type 2 Diabetes after [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/).” _National Institutes of Health_, U.S. Department of Health and Human Services, 7 Dec. 2016, [www.nih.gov/news-events/nih-research-matters/breastfeeding-may-help-prevent-type-2-diabetes-after-gestational-diabetes](http://www.nih.gov/news-events/nih-research-matters/breastfeeding-may-help-prevent-type-2-diabetes-after-gestational-diabetes). * Gunderson, Erica P., et al. “[Lactation](https://nabtahealth.com/glossary/lactation/) and Progression to Type 2 Diabetes Mellitus After [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus.” _Annals of Internal Medicine_, vol. 163, no. 12, 15 Dec. 2015, pp. 889–898., doi:10.7326/m15-0807. * Much, Daniela, et al. “Beneficial Effects of Breastfeeding in Women with [Gestational Diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) Mellitus.” _Molecular [Metabolism](https://nabtahealth.com/glossary/metabolism/)_, vol. 3, no. 3, June 2014, pp. 284–292., doi:10.1016/j.molmet.2014.01.002. * “Overview: Diabetes in Pregnancy: Management from Preconception to the Postnatal Period: Guidance.” _NICE_, 25 Feb. 2015, [www.nice.org.uk/guidance/ng3](http://www.nice.org.uk/guidance/ng3).
A craving is a sudden feeling or urge to consume a specific type of food. Cravings are an unusual phenomenon and mostly affect women throughout pregnancy and during menstruation. Sometimes food cravings are for common foodstuffs like cake, apples, and chocolate, but sometimes, less often, they result in a desire to eat a type of food you normally do not like, or combine a weird combination of different ingredients. There are specific causes of food cravings: • **Hormonal changes.** During pregnancy, hormonal changes can [lead](https://nabtahealth.com/glossary/lead/) to an intensified sense of smell that can affect your food choices. • [](https://nabtahealth.com/coping-with-pms/)**[Premenstrual syndrome](https://nabtahealth.com/glossary/premenstrual-syndrome/)** **(PMS).** You can have many signs and symptoms, including fatigue, mood swings, irritability, tender breasts, depression, and food cravings. • **Stress.** Increased stress can raise your levels of [cortisol](https://nabtahealth.com/glossary/cortisol/), which leads to cravings, hunger, and bad (unhealthy) eating behaviours. • [**Lack of sleep**](https://nabtahealth.com/i-cant-sleep-what-causes-insomnia-and-how-can-you-improve-your-sleep-quality/)**.** Poor quality of sleep can interfere with the hormones that are responsible for regulating the feeling of hunger. Usually, this happens in the evenings because that is a time for unusual eating patterns to develop. • **A nutrient-poor diet.** Proteins and fibre support one to feel full all the time. However, a diet with low levels of these nutrients can cause you to feel hungry. • **Poor hydration.** Taking in too few fluids can make you feel hungry or even start cravings for particular foods in some people. • **Lack of** **physical activity.** Walking more, or an increase in physical activities, can help reduce food cravings. However, with less physical activity, you will experience more cravings. Those giving up smoking often experience very strong cravings. You cannot avoid all triggers, however, learning how to handle them can make it easier to manage them. With smoking, when you experience a craving, it is very useful to have in place a strategy to handle that urge to smoke. #### **Hints and tips for defeating unwanted cravings** There are ways you can handle any cravings you might be having. It might be hard initially, but persevere and some of these might work well for you. • Consume a stable diet that contains lean meat, which is a source of protein, vegetables, fruits, legumes, reduced-fat dairy foods, and whole grains. When you follow a balanced diet during pregnancy you know that your baby is getting all of the nutrition they require. • Physical activity is another option. Jogging or walking are a good way of getting some exercise in. • Try to eat frequently to avoid blood sugar drops, which might cause food cravings. Dividing food into small and fulfilling meals can help. • Try to get enough rest; ensure you look for a comfortable area, that will help you to fall asleep and stay asleep. • Attend self-help classes or talks to help you manage your unwanted thought processes. • Emphasis on lower-calorie foods. Select low-fat options, instead of full fat varieties. • Generate more healthy treats like chewing gum in case of smoking cravings, or perhaps some fruit when you crave a sweet treat. Deciding to defeat your cravings is a personal decision, and takes discipline to accomplish. Try Nabta’s [SLIM pack](https://nabtahealth.com/product/slim-multivitamin-healthy-digestion/) for a healthy digestion. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#7801191414193816191a0c19101d19140c10561b1715) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources** * “1st Trimester Pregnancy: What to Expect.” _Mayo Clinic_, Mayo Foundation for Medical Education and Research, 26 Feb. 2020, [www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/](http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20047208)[art](https://nabtahealth.com/glossary/art/)\-20047208. * “[Premenstrual Syndrome](https://nabtahealth.com/glossary/premenstrual-syndrome/) (PMS).” _Mayo Clinic_, Mayo Foundation for Medical Education and Research, 7 Feb. 2020, [www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780](http://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780). * “Prepare for Cravings.” _Centers for Disease Control and Prevention_, Centers for Disease Control and Prevention, 8 Apr. 2020, [www.cdc.gov/tobacco/campaign/tips/quit-smoking/guide/cravings.html](https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/guide/cravings.html).
Many people have heard of [Polycystic Ovary Syndrome](https://nabtahealth.com/what-is-pcos/) ([PCOS](https://nabtahealth.com/glossary/pcos/)), but not everyone understands what the condition is and [how it is diagnosed](https://nabtahealth.com/problems-with-traditional-diagnosis-of-pcos/). The truth is, it can be very difficult, even for specialists in the field, to diagnose it and many women wait over two years to receive a positive diagnosis. #### **Guidelines for diagnosis** In 2003 the Rotterdam Consensus Workshop was established to redefine the optimum diagnostic criteria for [PCOS](https://nabtahealth.com/glossary/pcos/), which had not been reviewed in detail since the National Institute of Health (NIH) established guidelines for diagnosis in 1990. The outcome of the Rotterdam consensus was the identification of three clinical symptoms, experienced by many women with [PCOS](https://nabtahealth.com/glossary/pcos/): * [Hyperandrogenism](https://nabtahealth.com/glossary/hyperandrogenism/) (an [excess of male hormones](https://nabtahealth.com/male-hormones-in-women/)) * Menstrual cycle irregularity/[anovulation](https://nabtahealth.com/glossary/anovulation/) * Polycystic [ovaries](https://nabtahealth.com/glossary/ovaries/). The consortium concluded that **a patient should present with at least two of these symptoms before a positive [PCOS](https://nabtahealth.com/glossary/pcos/) diagnosis could be made**. Since this consensus, both the NIH and the Androgen Excess Society have adopted very similar criteria, requiring two clinical signs for a [PCOS](https://nabtahealth.com/glossary/pcos/) diagnosis. The review panels held subsequently have recognised a number of other common features of [PCOS](https://nabtahealth.com/glossary/pcos/), including [](https://nabtahealth.com/what-is-insulin-resistance/)[insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/), [obesity](https://nabtahealth.com/what-is-body-mass-index-bmi/) and elevated levels of luteinising hormone in the serum. Although their presence is often considered intrinsic to [PCOS](https://nabtahealth.com/glossary/pcos/), none are yet recommended for use in its diagnosis. #### **[Insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/)** Women with [PCOS](https://nabtahealth.com/glossary/pcos/) are considered to be at greater risk of developing [](https://nabtahealth.com/what-is-the-connection-between-insulin-resistance-and-pcos/)[insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/). However, whether the [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/) results in, or is a consequence of, their [PCOS](https://nabtahealth.com/glossary/pcos/) remains unclear. Insulin sensitivity does appear to contribute to many of the other symptoms of the condition; including [hyperandrogenism](https://nabtahealth.com/glossary/hyperandrogenism/), [irregular menstruation](https://nabtahealth.com/why-are-my-periods-irregular/), [obesity](https://nabtahealth.com/how-are-obesity-and-pcos-connected/) and a predisposition to other metabolic conditions. Treating [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/) has also been shown to improve the symptoms of [PCOS](https://nabtahealth.com/glossary/pcos/), providing further evidence that a deficiency in insulin signalling may be key to the pathogenesis of the condition in a large number of women. To date though, the three defining features of [PCOS](https://nabtahealth.com/glossary/pcos/) remain those outlined by the Rotterdam consensus. Without two of these being present, a diagnosis of [PCOS](https://nabtahealth.com/glossary/pcos/) will not be made. To learn more about [PCOS](https://nabtahealth.com/glossary/pcos/) click [here](https://nabtahealth.com/five-things-your-doctor-probably-wont-tell-you-about-pcos/). Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#a8d1c9c4c4c9e8c6c9cadcc9c0cdc9c4dcc086cbc7c5) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Azziz, R, et al. “Positions Statement: Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: an Androgen Excess Society Guideline.” _The Journal of Clinical Endocrinology and [Metabolism](https://nabtahealth.com/glossary/metabolism/)_, vol. 91, no. 11, Nov. 2006, pp. 4237–4245., doi:10.1210/jc.2006-0178. * El Hayak, S, et al. “Poly Cystic Ovarian Syndrome: An Updated Overview.” _Frontiers in Physiology_, vol. 7, 5 Apr. 2016, p. 124., doi:10.3389/fphys.2016.00124. * “How Do Health Care Providers Diagnose [PCOS](https://nabtahealth.com/glossary/pcos/)?” _National Institute of Health_, www.nichd.nih.gov/health/topics/[pcos](https://nabtahealth.com/glossary/pcos/)/conditioninfo/diagnose. Last Reviewed Date 31/1/2017. * Marshall, J C, and A Dunaif. “Should All Women with [PCOS](https://nabtahealth.com/glossary/pcos/) Be Treated for [Insulin Resistance](https://nabtahealth.com/glossary/insulin-resistance/)?” _Fertility and Sterility_, vol. 97, no. 1, Jan. 2012, pp. 18–22., doi:10.1016/j.fertnstert.2011.11.036. * Polak, K, et al. “New Markers of [Insulin Resistance](https://nabtahealth.com/glossary/insulin-resistance/) in Polycystic Ovary Syndrome.” _Journal of Endocrinological Investigation_, vol. 40, no. 1, Jan. 2017, pp. 1–8., doi:10.1007/s40618-016-0523-8. * Rotterdam ESHRE/ASRM-Sponsored [PCOS](https://nabtahealth.com/glossary/pcos/) Consensus Workshop Group. “Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome.” _Fertility and Sterility_, vol. 81, no. 1, Jan. 2004, pp. 19–25.
