I was well into my third pregnancy and trying desperately to keep the stress under control. After a miscarriage less than a year earlier, I was feeling like I’d been pregnant for over a year (which I almost was), and I was just looking forward to finally holding my baby. Then just before Christmas I was diagnosed with gestational diabetes. I was devastated.
A small percentage of women who get gestational diabetes have no risk factors. The official statistic is that between 2-12% of women will get gestational diabetes. I always thought that the odds of developing gestational diabetes was low for me since I have very little family history, and maintained a healthy weight and lifestyle. My doctor’s office didn’t handle the whole thing very well either. I received a phone call telling me that my blood sugar test results (3 hour glucose tolerance test) had come back elevated and that they were going to send me to Helwig. Now I didn’t know what Helwig was (as it turns out, it’s the diabetes and weight loss program run by the hospital. But everyone abbreviates the name, and for those of us who don’t work for the hospital, the term means nothing). I assumed that my care would be handled by the doctor. The nurse I spoke to wasn’t rude but she also wasn’t very helpful and seemed surprised that I had questions. She probably gave lots of women this news and thought nothing of it. But for me it was a huge blow and I was completely overwhelmed. The next few months were stressful as I tried to manage my condition and minimize the risk to my baby. But in the end, all was well and our boy was born 10 days late at a healthy 8 pounds, 9 ounces.
At the time, I was totally flipping out at the prospect of having to manage a medical condition that posed a risk to me and my child, but looking back it is easier to see the areas where I handled things well and those I could have done better with. Based on my own experience, I’d like to offer some advice and suggestions, many of them things I’d wish someone would have told me.
Don’t panic. I know this isn’t easy to hear. I allowed myself complete and total panic for a day or two when I went completely over the deep end mentally and emotionally. I can’t honestly say whether it was helpful or healthy but it was how I reacted. But eventually I was able to develop some perspective and try to focus on the goal. If I could follow the protocols, my son was likely to be born healthy, that was the ultimate goal. If I could keep my blood sugars properly regulated I still had a chance to have the birth experience I wanted.
Ask for actual numbers. One of the first things I asked for when the nurse called with my diagnosis was my actual test result numbers and what the normal range is expected to be. As it turns out, my two and three hour glucose numbers were elevated but my fasting and one hour levels were normal. While this technically still qualified me as a gestational diabetes patient, I discovered when I met with the nutritionist that this is a non-typical presentation. Most women present with high fasting glucose numbers. There is a debate whether numbers such as mine qualify as a “borderline” case, but doctor’s offices and hospitals treat it anyway. My nutritionist actually said she would like to do a study on women like me who have low or no risk factors and atypical presentation to see if perhaps it is the testing methods that are at fault.
If your doctor doesn’t refer you, find a dietician or nutritionist and meet with one quickly. I was diagnosed the day before leaving to visit family for the holidays and just a week before Christmas. I couldn’t get in to meet with the nutritionist until just two days before Christmas. In the meantime I was faced with traveling away from home without a real idea of what I should and shouldn’t eat. So I went crazy trying to do my own research before we left. But there was very little information available on the internet regarding diet, most of it said to consult your doctor. So I modified what I read regarding conventional diabetes. I avoided most sugars and carbohydrates. I was devastated at the thought of having to give up most of the foods I loved, but I was more concerned about all the potential risk factors to my child so I decided to suffer through it before I even met with a nutritionist. That was a big mistake. First, I probably wasn’t getting enough calories. I was hungry all the time and felt weak and sick to my stomach. Second, I cut out most carbohydrates when in fact carbs are necessary to maintain a healthy pregnancy. When I met with the nutritionist I was actually relieved. Sure, I was still bummed that I was going to have to watch what I was eating during the one time of year when I allow myself to splurge. But I was relieved to find out that I didn’t have to give up everything. In my case, I was put on a diet requiring a certain number of carbohydrates at each meal and a certain amount of protein, since the protein helped to slow the body’s absorption of carbohydrates. High fiber and low fat foods were encouraged and processed sugars discouraged but mostly it was a process of trial and error to discover what my body could tolerate. It was a more expensive way to eat, but it was also a healthier one and resulted in less pregnancy weight gain and quick weight loss after the fact.
Find a lifestyle you can live with
Initially I followed my diet religiously and exercised three times a day for 20-30 minutes each. But as my pregnancy progressed, I found it difficult to keep up with my ambitious plans, so I compromised. I settled for some form of physical activity or exercise as many days of the week as I could get. If I was going to cheat on my diet I figured out when was the best time for my body to have the minimum effect on my blood sugar, and was picky about my cheat items. I actually once took a bite of a dessert item and threw away the rest when it wasn’t very good. I wasn’t going to waste my carbs on something that wasn’t totally worth it.
Make you birth wishes clear
I knew that the hospital would treat me differently because of my condition so I wanted my birth wishes made clear up front. I didn’t want to be given certain kinds of drugs to induce labor (if necessary) because they could cause low blood sugar. I wanted to wait to cut the cord until it stopped pulsing, since that extra flow of blood would give the baby a little extra glucose so his levels didn’t drop too low. I asked to breast feed as soon as possible to make sure my son got immediate nutrition to prevent a sudden drop in blood sugar. Fortunately I had a very supportive doctor who reminded me of the things I wanted when I was too caught up in the moment to remember. Plus I had my very supportive husband and doula there to assist.
If you are choosing to breastfeed, find a lactation consultant at the first sign of trouble.
We did have a few issues with breastfeeding in the hospital and our son’s glucose levels did get too low. I found out months later when we faced some weight loss issues, and I finally saw a lactation consultant, that it is common for women with gestational diabetes to potentially have low milk supply. So if you are having issues, don’t wait. If I had called someone for help sooner, I would have saved myself months of being chained to a breast pump rebuilding my supply.
Try to keep eating healthy and continue to check your blood sugar post partum
I had planned to do this and didn’t do a great job of it. At first I ate whatever I wanted because I was pretty sure that I could. I continued to check my blood sugar for a while after the baby was born but I soon got tired of it. When my son was seven months old and I finally got around to getting my follow up blood work to make sure everything is OK. I recognize that I’m a total hypocrite in this area, but moms need to take care of themselves. Healthy diet and exercise are even more important for women recovering from gestational diabetes because we are now at higher risk of developing Type 2 diabetes later in life.
Gestational diabetes can be overwhelming, but it doesn’t have to consume your life or ruin your pregnancy and birth experience. If you developed gestational diabetes, how did you cope with it? What would you have done differently? Did you have the support your wanted and needed?