Life After Being Diagnosed With Gestational Diabetes
Me at 25 Weeks
It is probably not news to you that somewhere between 24 and 28 weeks pregnant women undergo the glucose screening. Basically, you drink a cup of sugar water and then they test your blood to see if your body is producing enough insulin to handle the sugar. For women without diabetes, your pancreas is usually able to produce enough insulin to keep up with your sugar intake. However, during pregnancy, your pancreas has to work double time and it is not always up to the job. If you would like more information regarding the test, there are plenty of good websites, including this one.
When I went in for the screening I just had this gut feeling that it would come back positive. I wasn't super high but it was high enough to have to go to the next testing. I cried! Even though I had a feeling it was coming I was still distraught for the next 12 hours or so. Then I got a chance to talk to a friend about it (who also had GD) and she assured me that it would not be the end of the world. Here is my story that I hope will make you feel the same way.
Where are you at?
Where are you at?
Glucose Tolerance Test
If you test positive in your first glucose test, you get to go back for the second one. You will probably have to take at least a half day off of work because it takes over 3 hours. You will get your blood taken 4 times:
1st - When you arrive at the doctor. You will have been fasting so it is your fasting blood sugar level. The goal is for this level to be under 95. Then you get to drink the mix.
2nd - One hour later. Your goal is to be under 180.
3rd - One hour later (or 2 hours after your glucose drink). Your goal is to be under 155.
4th - One hour later/3 hours after your glucose mix. Your goal is to be under 140.
The testing was fairly easy all things considered. The nurses there are super professional and the blood draws were fast and painless. The room I spent most my time in was your average waiting room before you go in to the little room to see the doctor. I brought my laptop so I could watch a movie.
I found out the results about a day or two later. I was too high on the one hour and the two hour test. Apparently, 2+/4 = gestational diabetes (as long as you are not ever over 200 in which you are diagnosed with regular diabetes). Yay for me!
Learning to Live with GD
As soon as I got a positive result on the glucose screening I started my internet research, but everything I found was about the testing - not about what life was like after the diagnosis.
About a week after my positive result I had to take yet another half day off of work to attend a class where they teach you about Gestational Diabetes. I remember that most of the women at the meeting were similar to me (looked fairly healthy).
There was a dietitian and a nurse who taught the class. The nurse went into all the information about the blood sugar monitor, what you need and how to use it. The dietitian went into general eating rules but then sits down with you and helps you plan more personalized guidelines. The best things I learned: hot-dogs and deli turkey are not off the menu for pregnant women! At least some good news! I seriously went straight to Jimmy John's after the meeting.
My Daily Menu
What I was supposed to eat daily. Keep in mind I am 5'4'' and weighed about 135 lbs when I got pregnant. Of course, by this time I weighed a bit more :)
When considering your daily food intake you must keep in mind the four "food groups": Free items, fats, protein, and carbohydrates. Free items include a variety of things such as vegetables, jello, coffee, etc. and you can have as much of these items as you would like. Fats include things like bacon, nuts, and other items that you can eat because they won't affect your blood sugar but obviously they are not good to eat in large quantities. Protein is awesome because it actually helps to normalize your blood sugar, so it is important to eat them at the same time as carbohydrates. The amounts you see in my recommended diet are minimums (not that they should be doubled or anything). And I will get more to carbohydrates down below.
45g of carbs
1oz of protein
45g of carbs
3 oz protein
5 oz protein
So here is what my day usually looked like:
String cheese until I got sick of it. Then I would buy those little sausages that you can microwave but I got sick of those pretty quick too.
Glass of V8/Vfusion
Some other carb - I tried muffins, granola bars, and some other stuff but never really found something that I wanted to eat every day.
Piece of fruit
Usually snuck in some protein here (they told me I could cheat with as much protein as I wanted)
4oz of deli meat. They told me I could have it as long as it was fresh sliced at the store and had not sat in the fridge longer than 3 days.
potato chips (15g!)
piece of fruit
a cookie or a small serving of ice cream (see, you don't have to cut everything out!)
After doing some searching, I finally settled on this protein bar and a small glass of milk (I had to add this in at the end of my pregnancy because I wasn't gaining any weight on this diet. My doctor kept telling me that the sugar numbers were more important but I only gained 3 lbs. in my third trimester). Be careful about which protein bar you choose because a lot of them contain a ton of carbs.
rice or half a bun or pasta (p.s. alfredo sauce has a lot less carbs than tomato sauce)
something else sweet if I had enough carb count left over
string cheese (again!)
crackers of some sort
Official Definition of Carbohydrates
- Carbohydrate Counting - American Diabetes Association®
Carbohydrate counting, or carb counting, is a meal planning technique for managing your blood glucose levels.
The Truth About Carbohydrates
You may think 45g is a lot, and it really is, but if you sit down and think about everything that you eat that has carbohydrates you will start to wonder how your body is even able to handle that many under normal circumstances!
If you are anything like me, you probably thought milk and yogurt counted as proteins. WRONG! They are carbohydrates.
You probably thought corn and peas counted as vegetables. WRONG! They are carbohydrates.
You probably thought fruit was its own category. WRONG! They are carbohydrates.
And crazy other things too. Like a hot-dog bun actually has 30g of carbs. That is surprisingly what I LOVED about getting gestational diabetes. Not only did I have a new appreciation for how awesome my body normally functions, but I learned so much about what is in food and what it does to your body.
Anything with sugar - natural or not natural - is a carbohydrate and your body treats it the same. So weird! I mean, your body treats a cookie just like it treats an orange. Granted, an orange has a lot more good going for it, but it increases your blood sugar either way.
My Glucose Monitor
Testing My Sugars
When you develop GD you basically start living as a diabetic. There are two scenarios that can develop. One is that your body is able to handle the extra sugars just through a modified diet and added exercise. Two is that your body is unable to handle the extra sugars and you have to take insulin. Fortunately, I fell under the first scenario.
After the introductory meeting I got started using the glucose monitor to test my sugars four times a day: first thing in the morning, two hours after breakfast, two hours after lunch, and two hours after dinner. This was definitely the most annoying part of having GD. Everything is so scheduled.
First, I had to test my sugar before I had even eaten breakfast, when I was barely awake. Second, other testing times were not exactly convenient; I had to test my sugar two hours after breakfast, lunch, and dinner - the after breakfast one was in the middle of second period with my students. Third, you have to remember to bring your monitor with you everywhere you go. Fourth, you have to have all the materials that go along with the monitor - strips, needles, a pen to write down your numbers, and your number book. Fifth, you cannot eat within 2 hours of eating a meal and if you feel like going to bed an hour after dinner you can't because you have to wait two hours to test your blood sugar and then eat a bedtime snack.
At the Birth
Along with the change in diet and the blood sugar monitoring, I am sure you know that there are other concerns when a women has Gestational Diabetes - the biggest one being that the baby will grow too big. I am going to address the two that most affected me but a more complete list of complications can be found at this website.
Seeing as I gained only 3 lbs. in my third trimester, my doctor was not too worried about my baby being too big. With a couple weeks left to go she estimated my daughter's weight at 7 lbs. (right on target). However, my doctor did say that because of the GD it was important that I not go past my due date. She was going to induce me about a week early but since I wasn't measuring big she said I could go to my due date. Thankfully, my daughter came on her own about 4 days before I would have been induced.
The labor and delivery of my daughter was pretty much as textbook perfect as possible. However, a few hours after birth, she started experiencing low blood sugar levels (they were checking periodically because of the GD). Because of this, she had to go down to the NICU. I could write an entire hub about that heart wrenching experience, but I'll keep it short in saying that despite it being hard the hospital staff were able to take care of everything in just a couple days and she was released from the hospital only 12 hours after I was with no further complications. Praise God!
% of Women who are diagnosed with Gestational Diabetes
some say that it is as high as 18%
% Likelihood that those Women will be diagnosed with Diabetes after delivery
maybe because they had it before but were not diagnosed?
% Likelihood those Women will develop Diabetes in the next 10-20 years
maybe because they were leading unhealthy lives before pregnancy?
% Likelihood that those Women will develop Gestational Diabetes in a second pregnancy
compared with only 4% of women who did not have GD in their first pregnancy
the Next Baby
Since the rate of recurrence is so high, I know that I face a good chance of having GD again. And since no one seems to know what causes it, I'm not sure if it was due to poor eating choices early on in my pregnancy (hello entire chocolate bunny) or just my body not able to handle the extra work load.
I am not pregnant again yet, but of course it is something that is on my mind. Apparently, they recommend that any women who had GD in a prior pregnancy should start eating a "diabetic" diet when they start trying to get pregnant again.
Also, the glucose screening will be earlier in the pregnancy than it was for the first pregnancy. I have heard some doctors do it as early as 10 weeks but I spoke with my doctor who says she will do it around 20 weeks. Suffice to say, 10 weeks of having GD was hard enough, I'll pass on 20-30 weeks. Part of me thinks that if I test positive again, I'll just skip the blood testing part and do the diet part. I think I'll probably change my mind about that though when it comes down to it. I just remember at the end of my first pregnancy I was so uncomfortable pricking my finger (oddly I was fine earlier on) that my hands would shake.
If you just got diagnosed you are probably feeling like I felt when I first heard - that life was pretty much going to suck until the baby was born but it really wasn't all that bad and I now have a beautiful, happy, and healthy child so it was all totally worth it.
Pregnancy Numero Dos - Update!
Update (March 2016):
Well, after being pregnant a second time, I've come up with some interesting theories regarding Gestational Diabetes. I'm no doctor, but I was able to successfully avoid GD in my second pregnancy (!!!) so maybe I'm onto something. Now that I'm pregnant again (!!!x2) I have the opportunity to test my theory out again and see if it works.
Here is what I'm thinking: Gestation Diabetes is tied to the development of the placenta. Therefore, in my second pregnancy, I tried to be very good (as in, eat a diet that follows the one I did when I had gestational diabetes) during my first trimester. At 15 weeks, my doctor had me do the screening test because I had gestational diabetes in my first pregnancy and the results came back negative on that one (yay!). But, I had to take the screening again at 26-30 weeks. I tried to be conscientious of what I was eating but between 15 weeks and 26 weeks I was not super strict. At 26 weeks, I took the test and I came back positive - I scored 143 with the goal being below 140, so not too bad. Unfortunately, it meant I still had to do the three hour glucose tolerance test. Again. Blah. But.... my results came back negative on that test so yippee! No Gestation Diabetes in my second pregnancy!
Now we are in round three and I am again trying to be follow a healthy diet in my first trimester which is almost complete. The doctor told me that I did not have to do a gestational diabetes screening at 15 weeks which is a pro but I still have to wait until 26 weeks for it to be official. I'll let you know how it goes!
Fast Food Options
What I Can Eat (or will eat, I'm pretty picky)
Pretty much any sandwich on white bread and chips. This place is crazy low carb!
10 chicken nuggets or 6 chicken nuggets and a kid fry. There are actually a lot of options here though.
No mas burritos :( Burrito bowl with any meat but no beans (although, you can get beans if you don't get rice)
A burger or chicken sandwich. No fries! :(
Chicken nuggets and fries (if I share the fries). No lemonade :(
No go. The rice alone is twice my allowed count.
No information available online.
Kid's chicken strip meal
Kid's meal 6 chicken nuggets and fries or a double kid burger no fries
Anything that is wrapped in lettuce! Yum!
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.