I didn't know much about GD except that I didn't want it. I had to
switch my Ob/Gyn when we moved from Buffalo to CT, and at my first
appointment with the new Ob/Gyn, they gave me the slip for the infamous
Glucose Tolerance Test. Of course, I googled my way through the
information on the test from fasting a full day before to sitting
completely still during the test. The most important advice was from a
mom saying that there is no sense in trying to "trick" the test, one way
or another.
Research shows that you are at an increased risk for GD if you have a
strong family history of diabetes, you are non-white, you are
overweight, or are older than 25 years old. I have one family member
with diabetes, but otherwise I considered myself to have a healthy diet
and was keeping up with walking while pregnant. When I found out that I
tested slightly higher than the threshold set by my Ob/Gyn, I was
crushed. They gave me another slip to go for the three-hour glucose
test.
When I found out that I tested slightly high again, I was devastated. I
felt guilty that I wasn't giving my perfect baby boy a healthy place to
grow. I felt like I let him down. Most of all, I felt overwhelmed. I
was to attend the Diabetes clinic to learn about my diagnosis (this is
where I watched my educational GD movie.)
Basically, the placenta and hormone madness of pregnancy interfere with
the insulin's ability to process sugars. If the baby gets too much
sugar, they are at risk for health problems, including a difficult birth
and high birth weight. My Ob/Gyn took this very seriously and was not
going to negotiate my treatment. I was given a glucose monitor and
finger pricks and was to check my sugars four times per day for 2 weeks
and report them to the clinic. I was given a strict diet and was
instructed on how to count my carb intake. At the time, I couldn't
imagine how I would do this during the workday.
When I reported my sugars for the first week, the nutritionist told me
that she thought I needed to start insulin. What? Why? My fasting
numbers (the morning numbers, the sugar levels you report after not
eating for the entire night) were the high numbers. These were the
levels that could not be controlled by diet and exercise alone.
My first reaction was to stop all carb intake, but this is not
recommended as the baby needs carbs for proper growth and development.
I asked if I could wake up at 2 am and walk on the treadmill...would
that help? She said it might but that she would personally make sure
that I would not do that.
The nurse showed me how to inject insulin. I assumed I would just use
my thigh or arm. No, you stick it in your belly. I started to cry, and
told her that that's where my baby was, as if I were carrying my baby
differently than any other pregnant woman. She reassured me that the
baby couldn't feel anything. It was not painful for me either, you just
avoid the stretch mark areas and use a new area each time. I did my
injection before bed, but some people have to do them before meals as
well.
The kicker is that when you start insulin (at least in my Ob/Gyn
practice), you have to come for Non-stress tests (NSTs) twice per week.
This is when they strap a monitor to your stomach and record the baby's
heart rate as they move. Of course if that baby is sleeping or
inactive at that time, these can take a long time! I brought cold water
and a clementine to speed things up. Otherwise they manually jiggle
him around a bit or bang something loud to encourage movement, which I
enjoyed much less. I also had an ultrasound once per week to check the
fluid levels and make sure Luke wasn't being affected in any way.
I did not know much about diabetes. I give people with diabetes who are
working to control their sugar a lot of credit. The counting of foods,
the blood sugar pricking, that is not easy. The silver lining? Luke
could not so much as make a funny face without the doctor recording it.
They had everything measured, monitored and tracked. Nothing
was going to go unseen with all of these appointments. I also got to
meet many wonderful people in the diabetes clinic that educated me, and
was able to meet every doctor in the practice so that whoever delivered
me was going to be a very familiar face. Luke was not affected by the
GD. He was a perfect size and the delivery was (fairly) uneventful. I
also lost my pregnancy weight quickly since I was on such a strict diet.
I had to repeat the glucose test 12 weeks postpartum. The funny part
was how my perspective changed. Pre-Luke, I brought books with me and
played with my phone during the testing. Post-Luke, I enjoyed sitting
and having a few hours of me time, even if it involved blood work and a
terrible sugary drink. I am so thankful that my postpartum blood work
came back normal. This is the case for many people with GD. I am at a
higher risk for GD for subsequent pregnancies and diabetes later in
life, but if there is a next time, I'll be armed with much more
information.
I can share more about my actual diet if you are interested. For now I would say:
1. Be prepared when going out for meals. One time I had a salad with tuna on top with no dressing and my sugar level SPIKED. There must have been sugar in the tuna, something I did not anticipate, so explain your needs to the server.
2. Try out Diabetes Lifestyle bread from Stop&Shop. It has about the same amount of carbs as certain breads but must be processed differently in the body since it didn't cause a sugar spike. I felt like it took too much experimentation to find foods that worked for me so I stuck with a routine diet and reminded myself that it was temporary (hopefully).
3. I was SO AGAINST insulin injection even though I didn't know anything about it. It felt like a medication that I didn't want my baby exposed to. I felt like starting insulin meant that I had failed, that I tried to control everything with diet and exercise but couldn't. In reality, do your best and then do what you gotta do. I regret wasting any time or thought in self pity; this is for the baby! Even when the nurse told me I had to start insulin, I said I needed to call my dad and check with him first. I explained the appointment to him and he said "yes, take it, do what they say." And I did. I needed someone I trusted to "okay" the whole thing. Not all medical professionals understand gestational diabetes to the same extent, and the thresholds for treatment seem to vary as well. Make sure you trust your Ob/Gyn's judgement as this could become very serious if not treated. Be aware that starting insulin does not mean you can relax and stop checking your sugars. The placenta/hormone madness changes throughout the pregnancy as do the insulin needs. Towards the end of my pregnancy, I dropped my insulin dose a few units each week because my sugar was getting too low (as directed by the Ob/Gyn). Make sure you know the signs of low sugar and that you have an emergency dose of sugar (like juice) with you.
4. Since I had just started my new job, I could only think about how I would check my sugars at work, how I would have my 15g of carbs spaced throughout the day while seeing patients, and how I would fit in my 2+ appointments per week. I had to cut down to part time, and I had to speak to HR and my co-workers about taking time during the day to check sugars and eat my snacks. I was so blessed to have an understanding employer and I realize not all offices make such accommodations for their employees. My advice on this would be get everything in writing from your doctor and stay in open communication with HR/co-workers. If your job cannot make accommodations, then you have have to make it work another way. It's temporary (again, hopefully), and your baby's health depends on your compliance.
Please feel free to leave any GD questions or insight! I was hesitant to share my experience but feel that it is worth it to be open if I can help even one person.
This website is helpful:
http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html
and I did not have this book but it seems informative:
http://www.shopdiabetes.org/559-Diabetes-And-Pregnancy.aspx?loc=WhatisGestationalDiabetes
***This is all written from experience only, I am not qualified to give medical advice on GD. Ask your Ob/Gyn before doing anything!***
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| This is my blog editor, Luke. |
This post was reposted with permission by the original author, Lindsay Gill, momma to Luke. Please read more about Lindsay at her blog, Wedding Rings to Teething Rings.
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