Written by: Alexandra Lotzgeselle
Boy, that’s not exactly a fun title, right? Most of the time, when you hear things about diabetes, it is in relationship to Type 2 or the applier named “Consumption Diabetes” where poor diet and lifestyle lead to the disease. At the start of my third trimester I went in for the normal 1-hour glucose test where I had to drink that not-so-tasty glucose drink and get my blood tested in an hour. I failed. However, I had gone to a party the night before and indulged in some delicious Snickerdoodle cookies, and had eaten a sandwich shortly before going into the test. As what gestational diabetes actually was had not been explained to me before the test, I assumed that a high intake in sugar was what lead to the fail. So I just chalked my failure up to the poor decisions I had made before and the last minute decision to go in and get the test over with.
When they scheduled be for my second test, the big 3-hour one, I “studied” a little harder. I had to fast for 8-hours before, and even before the fasting began I tried to eliminate as much sugar (either good or bad) as possible. [**Side note: not that there is any other way, but how horrible is it to be in your third trimester, have to fast for 8-hours, and then only be able to drink water for an additional 3 hours while taking the test??]. The results started coming in, and it wasn’t looking good. I failed 2 of the 4 blood sugar tests, which meant I would officially be diagnosed with gestational diabetes.
Needless to say, I was a wreck. I was thinking I put my baby at risk for some potentially horrible outcomes because I maybe had some ice cream here and there. I didn’t think I was going crazy with sweets- my weight gain was on the lower end of the increments they expect, I was eating really healthy sugars like fresh fruit and whole grains, and the doctors never gave me any indication I was doing anything wrong. A couple of days after I got the official diagnosis, a specialist called me to let me know the next steps. This was where I finally found comfort. I learned that gestational diabetes is not brought on because I was a horrible mom or making bad decisions. I had no control over my diagnosis. Hypothetically, had I been on a carb-free, no sugar diet, I would have still failed the test and been diagnosed with the disease. The medical community is still not certain what causes some women to have gestational diabetes and others not to. I discovered my grandmother had it with her last child, and that I have a cousin with Type 1 diabetes, so the doctor did say they expect some women have an inherent weakness due to their genetics.
A pregnant woman needs 2-3 times as much insulin as someone who is not pregnant. With women who suffer from gestational diabetes, or, GDM for short (this acronym is only used for women who specifically have gestational diabetes while not having suffered from diabetes prior to pregnancy), the placenta produces a high number of insulin blocking hormones that act as body guards to your insulin receptors. The hormones prevent your body from properly absorbing the insulin (which is carrying your bodies sugars), making the mother insulin-resistant, which in turn raises your blood sugar to levels that can negatively affect the growth of your baby. By sending more blood sugar into your blood stream, your baby’s pancreas has to work a lot harder to produce higher levels of insulin to get rid of the extra glucose, which creates more energy your baby then turns into fat. Larger babies mean more complications in-utero, during birth, and potentially later on in life as well. The increased creation of insulin by the baby can also lead them to have low blood sugar after birth (when they no longer need to over-produce to counteract your issue) and therefore are susceptible to lung issues. Before testing for GDM was standard, the nurse let me know it was safe to say that anyone with a baby over 9 pounds had GDM. Now with the blood-sugar test being more routine, it gives women the ability to manage their health and give their baby the best opportunity at an optimal outcome. The upside is, while I am now considered a high-risk pregnancy requiring more tests, meetings with doctors, and stricter watching by doctors, I have the ability to do everything I can to limit the possibility of my child having complications.
So what does my GDM diagnosis mean? Well, it means a lot of not very fun changes. My diet is now extremely limited and controlled. For instance, I cannot have any fruit or fruit products before 10am, (your blood sugar is naturally the highest between approximately 2am and 10am) and can only have very small amounts of fruit (say, ¾ of a cup of pineapple) with lunch or dinner. It means all my meals have to have high amounts of protein and good fat, and that I can have very little carbohydrates at all. Dinner has become mostly home-cooked meat like chicken or steak and vegetables, and lunches have become mostly leftovers. No more ice cream, no French fries, no more smoothies, no eating anything without first studying the nutrition labels. It also means, worst of all, that I have to test my blood sugar at least 4 times per day- once when I wake up (fasting) and once exactly 1-hour after I start each meal. You can imagine the complications that can arise with needing to prick your fingers and test your blood at a specific time. For instance, I don’t have the option of going on a date night where my husband and I eat dinner and then go to a movie right after. I would have to make sure I were able to find a place where I can bring out a needle and meter and test my blood exactly 60-minutes after my first bite of food. If ever my blood sugar is outside of the strict limits, I have to stop whatever I’m doing, drink a bunch of water, and do some exercise that gets my heart rate up. I would then have to re-test and continue until my sugar drops down to an appropriate level.
For the most part, I have been okay. Being in control of what I eat, while not very fun, means I normally know what to expect from my blood sugar. Unfortunately, my blood is not always at the right levels when I first wake up and have no control over it, so there is still a likelihood I will need to be put on a regulatory medication. I would be lying if I said I didn’t sort of expect something like this to happen- I was pretty lucky during the early stages of my pregnancy and skirted a lot of common problems like morning sickness, so I guess it wouldn’t be fair to get through it without any complications! While it’s disappointing to know that there are now mitigating factors that have control over what I can and cannot do during the rest of my pregnancy, put in the same position, who wouldn’t do whatever possible to help their unborn child have the best opportunity at eliminating serious risk-factors? Every time I think about how bad I want a Reese’s or a donut, I just think about the fact that my son is depending on me to help ensure he does not come out overweight or with lung complications. Plus, there are TONS of women going through way more difficult and demanding complications, so I really am lucky that I have an opportunity to help decrease my risks without drastic lifestyle changes like the bed-rest some women have to endure.
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