Being diagnosed with gestational diabetes was the thing that stressed me out the most during pregnancy. Well, after waiting for the results from our genetic testing. But by the time I was testing for gestational diabetes we already had those results and this diagnosis stuck around.
First off I am not a doctor, I am not a registered dietitian, and I am in no way giving medical advice. I am talking about my experience with gestational diabetes, what helped me, and what I learned. Please please please, if you take away nothing else from this post, let it be that you must talk with your Dr and/or a registered dietitian who has been trained and educated in dealing with gestational diabetes if you have any questions.
Second, being diagnosed with gestational diabetes is not the end of the world. Is it scary, yes, are there ramifications, yes, do you have to change things, yes, but ultimately you WANT to know if you have it. You WANT to make the changes because YOU need to be healthy AND baby needs to be healthy. It sucks when your carbohydrate intake has to drop (goodbye chips and queso) but it’s for a very important reason so you WANT to know if you have it so you can make the changes that need to be made. Does that make sense?
Third, this is NOT YOUR FAULT. This is the damn placenta’s fault. And if we’re placing blame here, the father’s genes play the dominant role in building/developing the placenta so it’s really HIS fault. I think he owes you a gestational diabetes gift in addition to a push present right?
The resources I used for my personal edification were my OB, my MFM Specialist, Leslee Flannery from Gestational Diabetes Nutrition, Dr. Rachel Paul from Best Body, and Michael Greger M.D. author of How Not to Die. HNTD is a fantastic read. I read it a few years ago and need to do a reread.
Diagnosis
Even before I was pregnant I had heard about the glucose test while pregnant but didn’t really have any clue what it was or what it meant. But I kept thinking oh pass/fail I can handle that. Then I got pregnant and started reading about it, about how most people pass it, and how even if you fail your 1 hour test you usually pass the 3 hour test. Well, not me.
To be diagnosed with GD I had failed the 1 hour glucose test (fast for 8 hours, drink the glucose drink, wait one hour, blood draw) and had to take another glucose test about a week later. You have to drink double the amount of the glucose drink (ugh) and then you have a total of five blood draws. So you go in having fasted for 8 hrs, they draw a fasted blood sample, you drink the glucose drink, wait one hour, blood draw, another hour, blood draw, final hour, and final blood draw.
After this diagnosis I had to go see a Maternal Fetal Medicine (MFM) Specialist. It took over a week for me to be able to get an appointment which freaked me out even more because I kept thinking if this is such an issue for baby and me why is this appointment not immediate?! And at that point I was thinking what do I need to do; I wanted to start doing something but I had no clue what to do. Turning to google was both helpful and a terrible terrible idea. A few days before my first MFM appointment I got an email from the office with an attachment that was super unhelpful. It was a bunch of photocopied articles and a typed page that said aim for x,y,z, but doesn’t tell you HOW to do that. It’s like they were pushing me into the arms of google!
The major takeaways from the attachment were you need to be tracking your food and your consumption of sugar and carbohydrates needs to decrease. My blood sugar was too high because the placenta was stealing all the insulin my body was producing to try to keep baby’s blood sugar normal. This means there can be negative repercussions for baby and for mom. Baby can get big from all the sugar and then end up having low blood sugar at birth because they’re pumped full of insulin; they can also have breathing problems and they’re predisposed to having diabetes (type 2) later in life. Mom might have to deliver early, a c section can be recommended usually due to the size of baby and baby getting too much insulin, and mom will also be predisposed to having insulin resistance or developing type 2 diabetes after she gives birth. There’s also usually a recommendation to deliver early to decrease the risk to baby. Thanks a lot placenta.
At this point, I felt like I was out of control and that was freaking me out. I fired up MyFitnessPal and tried tracking my carbs, trying to get them as low as I could which was both good and bad. I was able to see how many carbs I was eating without having to google ‘how many carbs are in raspberries’ every meal. BUT my consumption of carbs basically disappeared for three days and I was in the worst mood. I learned that you actually need carbs. Your brain runs on glucose and if you don’t have that your brain goes ‘fuzzy,’ or at least that’s my description of how I felt.
After my first MFM appointment, where they do a fetal measurements with a sonogram (that was good, hi baby), you learn how to prick your finger for the blood sugar testing. I still didn’t have a great handle on what exactly I was supposed to do between meals and overnight to get my numbers lower. The advice I kept getting was you’ll learn what foods make your numbers high by tracking. Umm what now? I want a meal plan, I want you to give me concrete things to do, parameters to stay between. I don’t want to trial and error WITH MY CHILD. I understand that each body is different and that even though one person might do well with a certain low carb snack another person’s body might not tolerate it as well but I needed some actual direction. I didn’t get that and I felt helpless. I remember sitting in the MFM office and hearing a big roaring in my ears. I knew my brain was overloaded and I apparently the questions I was asking weren’t the correct ones because I was not getting the information I needed.
My stress and anxiety levels were out of control for about three weeks. Which is so not helpful because stress increases cortisol which makes is more difficult to lower your blood sugar. Not a great cycle to be in! So I ended up doing a four hour deep dive into different diabetes meal plans, books on glucose levels, and friend sourced suggestions. I consolidated everything I found and came up with a plan. My plan was scratched out on a piece of paper that sat on our countertop but I made a prettier one you can see and if you want to download my gestational diabetes game plan you can below.
There were plenty of times where I needed to have some carbs. I kept calling it carb rage. I snapped at people, I cried, my brain was ‘fuzzy’ because my body needed carbs. I found this clean organic granola that was good, I counted out 10 wheat thins and made those suckers a meal; I had a handful of popcorn. But whenever I had this carb rage snack I made sure to have protein with it, usually the turkey pepperoni because that is basically all protein. This pasta and rice made me think I was eating carbs and as long as it’s in something (sauce etc) you’re going to like the texture and taste. I’m more of a volume eater so I love that you can eat the entire bag and it was only 4g of carbs!
I used the Blood Sugar Guide from Dr. Rachel Paul to get more food ideas. It’s important how you eat your food within your meals, veggies then protein then fat then finally carbs. You also want lots of fiber in your meals so you might need to have small additions. My additions were usually pumpkin seeds and slaw to salads or chia seeds and ground flax to my skyr (skyr is higher protein than greek/regular yogurt).
The goals I was given for testing numbers is:
Under 95 for fasting
Under 140 1 hour after meal or,
Under 120 2 hours after meal
Within a week of having a plan I was able to have consistent after meal numbers but no matter what I did my fasting numbers would not go down. The photo is of my log I had to turn in each week to the MFM Specialist Physician so he could review my week. After about two weeks of MFM appointments and my Dr seeing my log and notes and how I was able to control my numbers with food he suggested I start with insulin. There are two different ways to take the insulin: a pill or an injection. Injecting is the most “natural” way to get insulin because it’s how your body would produce it. The pill working similarly but obviously it’s a little different. Most people choose the pill because they don’t want to have to deal with the injections. I totally understand that, my personal preference would have been no injections but I ended up doing the injections because it was more “natural.” You can inject in the stomach or arms and I ended up having my husband inject me in my arms because I just couldn’t inject my stomach. I felt like I was injecting baby, I would not have been able to reach him, I objectively knew that but there was still a mental block. So I ended up having to do an injection each evening. My fasting numbers never got under control. I was never under 90, ever. We went up on the insulin amount every three days and it NEVER got under control. It happens. But it never jumped up so that’s good.
When I had to start taking insulin I felt like I had failed; like I had failed my baby. There were definitely tears on the drive home that day. There’s not much you can do to control your fasting numbers. My MFM talked to me about the fact that fasting numbers are the most difficult to control with food/exercise because the nature of fasting is there is no food or exercise during that time. It’s all cortisol controlled. While you can’t do anything overnight you can have a protein bedtime snack and the timing of when you take your insulin can be moved around. You can take a magnesium glycinate supplement, after confirming with your OB.
Baby was measuring big, they kept (educated) guessing 9 – 10 pounds and a big head. They were exactly correct. I ended up making the decision to have a c section. I had been preparing for a vaginal birth, had a class, doing exercises, drinking the tea, massage, breathing practice, the whole 9 yards. I had the birth plan/preferences all PRINTED OUT and COLOR CODED (you can eye roll it’s okay), I even threw a Robert Burns quote on there. Yall I was READY. Both my doctors were supportive and did not push either type of delivery on me, they just gave me the facts of baby’s health and size. The longer baby stayed in the more insulin and sugar he would get, the bigger he would get, the higher his blood sugar could be etc. I was really torn because I had this idea of what labor would look like in my head; I had the birth plan, I had the visualizations planned, I had the diffuser packed! But it took a few days after speaking with both my OB and my MFM for me to come to the realization that an elective c section was a better decision for myself and my son. Once I had made that decision and communicated it to my doctors they both (separately) told me they believed I would be happier with that decision and baby would be out of possible danger. We had my c section scheduled for 38.5 weeks. Then baby decided he knew better and my water broke on Mother’s Day. I texted my OB on the way (he’s amazing and I’m unapologetically high maintenance), and he came to the hospital to do the surgery. I ended up getting drugs because I was having some painful contractions since we had to wait about four hours since I had eaten around noon. After everything I am very thankful I had the c section and still believe it was the best decision for myself and baby.
After Delivery
In the hospital baby had to have his blood sugar checked every day. He was on the edge of the range the first test so they told me the pediatrician would make the call on keeping him at the hospital after looking at the next day tests. His blood sugar evened out, thank God, so we got to take him home when I was discharged. My blood sugar was still high both mornings we had in the hospital. My OB wasn’t concerned and told me I would need to have another glucose test 6-8 weeks after delivery. If you have gestational diabetes you’re more likely to develop insulin resistance or type 2 diabetes after delivery so you have to have that test to make sure you don’t need further testing.
Patience is not a virtue I possess and I still had all my blood sugar testing implements sooo I checked my blood sugar for a week each morning. In addition to the two mornings I was in the hospital my fasting numbers were high for two mornings at home. The next three they were going down so I stopped checking.
I took my postpartum glucose test at 7 weeks postpartum. Fasted blood draw, glucose drink (now the amount is between the 1 hour and 3 hour test amount), wait one hour, blood draw, wait another hour, then last blood draw. My results are above. They indicate I am insulin resistant but further testing for type 2 was not needed. Those damn fasting numbers… So what does that mean? It means that my body is not responding as it should to the insulin my body creates. It can’t efficiently use the glucose for energy or for storage so the glucose builds up in your blood. If your cells become too resistant to insulin, it leads to elevated blood glucose levels which can lead to type 2 diabetes.
I have to head that off before it becomes type 2. So I need to get my sh*t together and focus on my diet and exercise. One thing I learned from changing my diet during pregnancy is that about a week after my diagnosis I ended up losing weight (in my third trimester!). You have to be weighed at each weekly appointment so I was looking at my weight frequently; and once I hit 36 weeks I was looking at that number twice a week (once at OB and once at MFM). After that week of losing weight I didn’t gain weight for the next two weeks. Apparently my body responds very well to the low carb diet… the universe is hilarious that way. So I know what diet will be effective, I just need to make the lasting changes.
Things I Would Recommend
Get into a routine. I started trying to find recipes and wanted to make these delicious meals and it just got to be too much. You’re in the final trimester and you are exhausted. The routine was boring as hell and I wanted to put my face in the cake at my baby shower and eat all the cereal in the house but a simple routine makes it easier to have food in front of me faster so I didn’t grab the doritos. Ask your partner for help. I told TM it was going to be difficult for me to refuse carbs if I looked over and he had them on his plate. We agreed that if we were at home eating he would eat what I was eating. If we went out to eat or he was eating lunch at home without me then he could eat all the carbs he wanted. Don’t ask how many times that man door dashed mcdonalds. Set alarms for your tests. There were a few times I completely forgot to test because I was in the groove of work or running errands. Loop in your boss if you’re in the office or can’t take breaks easily. I had to let both my supervisor and the judge in my assigned courtroom know what was going on because while I could test at 2 hrs if we were busy at 1 hr, I couldn’t push it any further than that.
Keep your testing things (monitor, strips, pen, lancets, alcohol wipes, and hand wipes) in a small bag in your purse. Mine never left my work bag. Even when I had to get it out for my fasted test and my after dinner test, it went back in the work bag because I knew I would forget it. Give yourself grace. There are going to be meals where your numbers just don’t cooperate. It’s okay. Note what you ate and try to make a change. Going back to that routine I was talking about – I basically ate the same breakfast for five weeks because it worked. But there were some mornings where I was starving after eating all those eggs and I needed that PB toast. Also, NGL I had a (small) piece of that cake at my baby shower, I ate a cookie at work, and I had (five) french fries from TM’s bag from Five Guys. You’re going to have simple carbs and it’s OKAY.
Sleep. Water. Exercise. Calm. Your cortisol levels can effect your blood sugar levels… cool. You’re stressed about having GD, you’re stressed about getting everything ready for baby, you can’t sleep because you have to pee every three hours, the more water your drink the more you have to pee (which is already all the time), and walking to the car winds you now. Let me tell you, you just have to try. My mindset was, if I’m sleeping (or napping) or taking a walk I can’t be stressing at the same time.
Questions I Got on IG about Gestational Diabetes:
Do you have any tips to do before/during the testing to not fail it?
Yes and no. See what I wrote at the beginning in re: you want to know if you have it. Ultimately there was nothing I could have done to pass the test because of my levels but if your numbers are right on the make or break line here’s what I would say to do to give your body the best chance. Get sleep, do some yoga, destress, focus on protein, drink water, get some exercise. and take a short walk during the waiting hours. I wasn’t allowed to leave the dr’s office, their reasoning was if I passed out or something happened out of the office during the test they wouldn’t be able to help. I understand that but I was planning on taking a walk (because exercise helps) during one hour and then napping during the other hour. Each Dr is different so it will depend on your physician.
Did you have any previous signs or conditions that led to it? I heard it’s kinda random
I didn’t have any signs or conditions. It was out of the blue and it is random in that it’s the man’s genetic material that controls the placenta so he needs to be in good shape. But even then, as I understand it, you cannot predict if you will have it or not. My OB wasn’t concerned at all until the second glucose test results came back. And even then I wouldn’t say he was overly concerned/worried, it was more matter of fact – okay you have this we need to have more monitoring on you and baby.
Were there any symptoms you had that made you suspect your had gestational diabetes?
This is similar to above but slightly different because there could have been symptoms but I wasn’t looking for them. I wasn’t testing my blood sugar before I got pregnant or at the beginning of pregnancy. I don’t know if I would have been able to see my blood sugar rise immediately due to the placenta or when that would take place but I would have been able to see it at some point. I wish I had tested my blood sugar levels two years ago so I had an idea of my pre-pregnancy numbers.
Did all the finger sticking hurt?
Yes, but it wasn’t bad. It doesn’t feel good, you’re sticking your finger with a tiny needle but it’s still a needle! I got used to it but I still cringed each time. Don’t think about it, just do it. You have to charge the pen that spring releases the lancet (needle), like cocking a firearm. There were times I’d forget to ‘cock’ the pen and I’d hit the button but it didn’t release, obviously, and I’d cringe because I knew it was (supposed) to be coming.
How’s your postpartum transition back to non gestational diabetes living been?
I’m currently eating whatever I want but trying to just make better choices. But having a newborn wasn’t exactly conducive to my routine from pregnancy – mainly because we were/are making our way through prepared meals and meals brought by family/friends. We’ve door dashed more than we should be, but it hits 6pm and we both realize we’re hungry and the fridge is empty because I took a nap instead of going to the grocery store. I know that I will need to make the healthy switch permanent but that might have to wait until I go back to work. Only because then my husband will be on paternity leave and I will have more time to meal plan/grocery shop/cook. Maybe? I’m not quite sure how it makes sense to me that I will have more time to do those things when I’m adding in work but somehow it does?
Was it challenging to stick to a strict diet (if you were required to)?
YES! I literally wanted to eat all the carbs. I couldn’t walk through the break room at work because um DOUGHNUTS. I had to cut out coffee because milk has all the carbs and I can’t drink that stuff black. It sucked. I had to keep reminding myself this was for baby annnnnd then I had doughnuts in the hospital the day after he was born.
If you’re having another baby do you have to do anything differently?
Yes and no. I have a higher chance of having gestational diabetes in any subsequent pregnancies. Especially since I’m (now?) insulin resistant. I don’t know if I was insulin resistant before pregnancy so I don’t know if that contributed or not. See why I really wish I would have some idea about pre-pregnancy numbers? If I get pregnant again I will need to make sure my diet is focusing on keeping healthy blood sugar levels. I will probably keep my monitor/strips etc and start testing immediately after that positive pregnancy test so I can keep an eye on it. I would also make sure that I have the glucose test as soon as I am within the testing week window; my test this time was at the end of that suggested week range. Apparently you can’t just go straight to the long test, you still have to take and fail the 1 hour test. This is ridiculous to me but whatever.
Besides food are you making any changes because you had this diagnosis?
Yes. I’m starting to read the book Glucose Revolution and I’m thinking of getting a continuous glucose monitor so I can keep an eye on my numbers through out postpartum and so I can have that additional continuous information without having to prick my finger multiple times a day.
I hope if you’ve been diagnosed with gestational diabetes or you’re anxious about possibly having it, this gives you information to help decrease your stress. A gestational diabetes diagnosis is not the end of the world, if I got through it you can too! Email me if you have any questions, I am an open book!
PS one colleague reached out and said if anyone is going through this and your insurance sucks, Walmart has cheap meters, test strips, and lancets. She said her husband is type 1 and they went the Walmart way for a whole year because it was cheaper than copay!
