Gestational Diabetes FAQ
I am not claiming to be a Gestational Diabetes expert, but I was diagnosed with Gestational Diabetes around week 32 of my pregnancy. It has been a learning process, especially since it isn't frequently talked about. So I have decided to share my experiences and what I have learned here to help future mamas as they go through the same thing as me. Again, I am not a doctor, a nurse, or a medical professional. I am just a mama to be that wants to create open dialogue for future sugar mamas!
Here are a few questions that I either researched, asked my doctor, or people asked me after I was diagnosed with Gestational Diabetes. And I thought this would be a great place to start!
What is Gestational Diabetes?
Gestational Diabetes is something that occurs in 7-8% of pregnancies. It is characterized by insulin resistance and carbohydrate intolerance during your pregnancy. It doesn't matter how fit you are or how well you eat - because during pregnancy your placenta decides if you will have gestational diabetes due to a hormone it releases. That hormone is called the human placental lactogen and it can result in elevated blood glucose levels. Which in turn causes gestational diabetes.
Who is at risk for Gestational Diabetes?
There are lots of factors that can weigh into potential risk factors - here are a few that my doctor's office told me: family history of diabetes, being overweight or obese, older than 25, gestational diabetes in previous pregnancies, previously giving birth to a baby over 9 lbs or stillbirth. In my case, it was something I was prepared for - not only do I have some family history and I am over 25 - but I also have PCOS and was on metformin to help my glucose levels for years and only went off it because my symptoms were not as strong after years of use and it wasn't something that doctors kept prescribing for PCOS.
What are the symptoms?
There weren't any symptoms that made me take the test. Generally gestational diabetes shows up in the third trimester, which is why they have you do the glucose test between 24-28 weeks. You will start with a 1 hour glucose test and a blood draw. If you pass, you are good to go. But if you don't - depending on your numbers you will either go straight to a specialist or take a three hour test. The standard range is 60-135 and I was at 154. That isn't a huge variance, so they had me do the three hour test. During the three hour test you go in fasting - you start with a resting blood draw, then you drink 100 mg of the sugar drink, and then you get your blood drawn at hour 1, hour 2, and hour 3. If you fail two or more of those ranges then they will put you in the Gestational Diabetes category. However, as far as symptoms - I did notice that things like ice cream that did not make me sick previously made me sick to my stomach as I entered my third trimester. So while I was waiting for my diagnoses I was pretty sure I had it because I could no longer enjoy a bowl or ice cream or too many Texas Roadhouse rolls like before. I would get so sick to my stomach and just have to lay down after. Which was a serious bummer.
What are possible side effects of Gestational Diabetes?
If you don't work to manage your Gestational Diabetes there are a few side effects you will want to be prepared for. The very first thing is large sized babies - specifically in the chest and shoulder area. That can lead to delivery complications because if baby's shoulder are too broad delivery will be more difficult. Also, once the baby is here it could be difficult for the baby to regulate their blood sugar the first handful of days after birth. And then outside of complications with baby, there is an increased risk of Type 2 diabetes for the mother. There is a 35-60% increased risk in the next 10-20 years according to 2011 CDC data and women with gestational diabetes are 7 times more likely to develop Type 2 diabetes than women who have no had gestational diabetes. All the better reason to learn how to manage your blood sugar levels during pregnancy and make some lifestyle changes for the future.
What are the best ways to manage Gestational Diabetes?
The very first thing is meal planning. Less carbs and less sugars - your doctor's office will give you an idea of how many carbs you should be planning into your meals. I eat about every two hours and have a max amount of carbs for each one - but every body is different. My schedule is: Breakfast with 30 grams of carbs, a snack with 15 grams of carbs, lunch with 45 grams of carbs, a snack with 15 grams of carbs, dinner with 45 grams of carbs, and then again a snack with 15 grams of carbs. After that drinking lots of water, making sure to exercise for at least 30 minutes a day - walking, yoga, swimming, whatever you body can handle, of course monitoring your blood glucose levels, and if none of that works your doctor will be able to put you on medication like insulin as needed.
How do you monitor your blood glucose levels?
I have a monitor that I use four times a day. There are a few different thought processes as to when you need to monitor/check your blood. So I will tell you what I do, but of course - do whatever is told to you because everyone is different and you want to make sure you are following what your doctor says. I check mine in the morning when I wake up for a resting/fasting number, and then two hours after I start every meal. They made sure I was watching when I START eating, not when I finish. So if I start eating breakfast at 8am and finish at 8:30am, I will test at 10am - two hours after I started. My doctor wants my resting number in the morning to be under 90 - I will be honest, this one has been the most stressful and hard for me because I am rarely in range. They put me on a medication to help, and sometimes I am under and mostly I have not been, so we are trying different dosages and techniques to figure it out. The hard things is since I am sleeping it isn't something I can help manage with meal planning. My body just does tricky things while I sleep. For all my meals they want me under 120 - this has not been a problem. Over the first month I was able to figure out what spiked my blood sugar and cut those things out - even if they were on my "approved carbs" list in the right about of grams. So for me - things like hot dogs, tater tots, mashed potatoes, ketchup, even the tiniest bit of ice cream are a no. But some women can have those no problem. You just have to watch your levels and figure out what is a yes and a no for you.
Do you have to monitor your baby?
My doctor is adding in some non stress tests through the last month or so of my pregnancy to help monitor my babe's movements. But something I do is make sure to count my baby's movements. After I eat I generally like to sit for a little and make sure I am getting at least four movements within the hour. Counting baby's kicks and movements during active hours to make sure there isn't any big change is the easiest way to monitor.
What advice do you have?
My best piece of advice is to realize that Gestational Diabetes is not your fault or something you can control. When I first found out, I cried and cried because what if I had done something wrong to hurt my baby. What had I done to make this happen. But after talking to my doctor and my OBGYN brother, I realized - it isn't my fault. It is this dang placenta and the hormone is produces. That isn't on me. But what is on me, is to make sure I am doing everything I can now to ensure my baby is healthy and strong. By testing my levels, eating right, drinking water, and all of that. You don't have to feel guilty for having gestational diabetes. You just have to do what is right by your baby, and let's be honest - for your own health, once your realize it is now a part of your pregnancy.
Gestational Diabetes has a red mark on it, because for real it isn't ideal and it sort of sucks. But that is why I felt so strongly I should talk about it. And share my experience. Because the red mark isn't due to something you did prior to or during your pregnancy. The body is an interesting thing and it will do what it wants! No matter how hard you try to be above board and make sure things don't happen. I have so many friends with kids - some with two or three - that know nothing about Gestational Diabetes, because it isn't openly discussed. So if you are reading this because you have Gestational Diabetes like me, don't be ashamed or sad or hard on yourself. You have me and 7-8% of other pregnancies as your support group. It is better to be prepared, to be educated, and to learn as much as you can. And your experiences will help some future sugar mama in the future as she experiences Gestational Diabetes.