Thursday, June 26, 2014

Gestational Diabetes (Fun Stuff!)

(Warning, this is a long one!!)

I feel like I haven't talked about pregnancy #2 at all here, which is quite different from the first time around!  I feel bad for new baby, as if she's already getting neglected via second child syndrome and she's not even here yet!  The truth is, I think about her often, but it's just not the same with the second as it is with the first.  The important thing is that she is and will be tremendously loved, and that's all that really matters.

But I did want to write about one fun times part of this pregnancy so far:

A few weeks ago, I was bummed to find out I have gestational diabetes (found out at 30 weeks along).  Blergh.

Honestly, I was afraid from day 1 that I was going to have it.  With Harper, I failed the first screening test and had to take the longer (terrible) test, barely passing it.  Harper was born at 9lbs 3 ozs, so it's more than likely I did have it during that pregnancy, at least in some sense.  And since it tends to get worse with each pregnancy, I had low hopes this go round.  

However, that didn't stop me from being delusionally wishful.  I started this pregnancy on the heels of Whole30, weighing 20 full pounds less than I did before getting pregnant with Harper.  I was exercising frequently, whereas with Harper I was a grad student and did little more than sit in desks.  I had been eating so much better.  With Harper's pregnancy, I gained a total of 33 pounds, which wasn't bad considering she was over 9 of that!  I lost it all within a few weeks, save for a few lingering pounds that hung on (granted, I was the "same weight" but that looked totally different on a post-baby body than it did before.  Oh joys of pregnancy!).  This pregnancy, I'd only gained 19 pounds, which my doctor was very pleased with.  So knowing all of that, I thought - maybe I will trick the test this time!

Nope, didn't.  You can't trick genetic predisposition.  

At first, I felt guilty.  A little embarrassed   Yes, I was slightly overweight and yes, I didn't eat great during the first half of my pregnancy (but who can with near-constant morning sickness??).  

But I just kept thinking -- if every slightly overweight, not so great eater got gestational diabetes, there would be a lottttt more women with it.  Yes, the fact that I was slightly overweight, coupled with the fact that I'm over age 25 (the shame!) could have tipped the scales on me getting it.  But what my nutritionist explained to me was that what it boils down to is genetic predisposition.  I don't have a family history, but she explained that family can be carriers, and it can skip generations. It didn't matter that I ate too many carbs for weeks 1-20 or that I had a few pounds to lose.  The hormones in the placenta cause your body to be insulin resistant if you are predisposed to it. Simple as that.  

The issue with GD is that it can cause large babies, which can affect how they are birthed.  It also can cause their blood sugar levels to rise, which puts them at risk when they are born and for the rest of their lives.  But as long as I keep my numbers in line, hers will be too.

So, once I failed the long test I got to meet with a diabetes educator/nutritionist who was extremely helpful.  Tony went to the meeting too, since he's my chef and needed to know what to feed me.  :)  I was thinking it would be a low carb diet, but really, it isn't.  I actually get to eat a lot of carbs, just certain ones, at certain times, in small doses.

The basics are this:  I eat 6 times a day to keep my blood sugar levels consistent.  For my three meals I eat 45 grams of carbs, balanced with protein and healthy fats.  For my three snacks, I 
have 30 grams of carbs.  I have to take my blood sugar (stabbing myself 4 times a day is super fun) once in the morning for my fasting number, and then 2 hours after each meal.  I have to eat at certain times (every 2 1/2 - 3 hours), and I have to eat right before I go to sleep so my blood sugar remains stable overnight (if you don't have enough "fuel" overnight, your liver starts producing glucose which skyrockets your morning fasting levels).  

So, 45 grams of carbs equals about 3 slices of wheat bread.  That's a lot in a meal if you think about it that way!  Except good stuff, like say, a chocolate chip cookie, is roughly 60 grams of carbs.  And cereal, my go-to comfort food, is out.  So basically I just have to choose good carbs, making sure I get lots of fiber, protein, water, and fats to keep my numbers in range.

I've been doing great so far.  I've never once had a number that was out of range, which I'm really happy about!  It's important to try to keep your numbers diet-controlled.  Sometimes it's just not possible and you have to start insulin.  But I have high hopes and my doctor does too.  

I've been eating a lot of the same stuff, which only 2 weeks in has gotten kind of old.  I'm a little nervous to branch out when I know what I've been doing is working.  My day looks something like this:

- Breakfast:  Eggs and a whole wheat English muffin (I go lighter on carbs in the morning since it's a hard time to control your numbers)
- Snack:  Apple with peanut butter and a Wasa cracker (these were a great find - a good amt of carbs and they feel substantial to eat as opposed to Wheat Thins or something)
- Lunch:  A turkey wrap on a Flatout with cheese, hummus (a good source of healthy fat and carb), and veggies, and a serving of fruit (grapes and pineapple have been my faves)
- Snack: Cheese and crackers, a Southbeach protein bar with fruit, or whatever I can stomach.  I've had nachos on corn chips and popcorn with string cheese before too - so it's not like you can't have anything that feels like a cheat
- Dinner:  Not a crazy change here, I just have to watch and measure my portions and make sure I get enough, but not too much.  
- Snack:  A small fruit smoothie with yogurt and oat bran and a string cheese

Yeah, that's a lot of eating.  Sometimes I am SO not hungry, but I have to eat to keep on schedule.  And yes, there's a lot of cheese.  It's weird how stuff like peanut butter and cheese are good options for me.  They are "meat substitutes" that offer the protein I need when I just don't want actual meat.  

I have fit in a little bit of ice cream too. :)  It's not always easy, but it's doable.

Exercise helps keep your numbers low too, so we've been making sure to get in a nightly walk right after dinner.  Sometimes it's so stinking hot and I just don't want to - but my dinner numbers have been my highest ones, so I  know it's necessary.  

Many people have asked if I am feeling better.  I thought this was a weird question at first, but when I really thought about it, the answer is Yes, I'm feeling better. I didn't even know I was feeling bad!  But my nutritionist helped me see what low blood sugar really is.  I think I was having lots of low blood sugar swings.  I would all of the sudden get really weak and dizzy and tired.  I thought this was just pregnancy.  But I haven't had one of those episodes once since starting this diet.  I am eating a much more balanced diet, with more veggies and fruit.  I was walking before, but now I walk more regularly.  So, this is really a great thing for both baby and me - better food and better exercise.  I've even lost 2 pounds, making my total weight gain only 17 pounds.  (I know weight loss is NOT a goal in pregnancy, but it's reality and will help me be in better shape post-baby). 

The awesome part too - once my placenta is gone, my diabetes will be gone!  As long as I stay diet-controlled and not on medicine, I can eat whatever I want the minute she's out.   I will, however, have an increased risk of real deal diabetes later in life, since I clearly have a predisposition for it.  This is just good motivation to keep my weight down and continue exercising for the rest of my life.  I don't want bloody fingers forever!


I met with my doctor today and she was really pleased with my numbers.  I was glad to hear that she won't force NSTs or the like unless I have to get on meds.  The only thing that will be affected is how far they will let me go.  She told me they really prefer to induce at 39 weeks.  They will do ultrasounds to check the size of the baby to ensure she's not huge (although big babies don't really scare me!).  But even if she's not big, the doctor explained that GD babies tend to have bulky shoulders, risking them getting stuck, breaking bones, etc. during the delivery process.   Actually, with Harper I spent 2 hours pushing, and she was stuck for a while, requiring a vacuum assisted birth during the last few minutes.  She was absolutely fine during the process and her heart rate never dropped.  She was healthy and happy (ok, screaming) when she came out!  Her blood sugar numbers were great.  But then at our 2 month pediatrician visit, our doctor noticed a lump along her collarbone.  Turns out, Harper fractured her clavicle during birth, something which is subtle and not noticed generally until the bone begins to calcify around the spot, leaving a little lump.  It wasn't a big deal, but it's just proof to me that these types of issues are very real.  I don't want to risk something worse.  The doctor explained that one week can really make a difference in terms of her weight and the placenta's effect on my blood sugar.

Most of me hates the fact that I will get induced (unless I happen to go into labor early, but I doubt it).  I want to go into labor naturally when my body is ready.  However, I trust my doctor and the health of my baby comes first.  And when I think about it, it's not that crazy.  With Harper, my water broke naturally, but I didn't really progress.  My blood pressure started to go up so eventually they started me on Pitocin, which worked quickly and made it happen.  So, yes, I went into labor naturally, but I had a good taste of what would be done during an induction.  It's not the worst thing in the world.  

But the scary part - that's in 6.5 weeks!!  That number seems so small and having a real date makes it so real.  I have so much to do!


Also, can I just say how awesome Tony is?  I feel like I could say that every day, in every post.  He hit the ground running, helping me think of meal ideas (and executing many of them!), doing the math for me when I just was over it, and he makes sure to get dinner on the table at the time I need it.  He's even eating the same diet I am (for the most part) for solidarity.  I brought him cookies today because I felt bad he's been so deprived for no reason.  He's the best.  Such a true partner in life.

Anyway, if you read this far, congrats.  This was long and probably more than you ever cared to know about my blood sugar.  But I just wanted to share and whine just a little bit.  Luckily, even though it's a pain, I only have to do it for a few more weeks.  And then I will have a cuddly baby to hold.  So crazy to think we will have a newborn again.  The fun begins soon!

3 comments:

  1. Look at you go, Claire!!! You rock! I'm so impressed at how you've tackled this! Being induced... was so not bad. I was so scared going into it, but I really could not have asked for an easier labor (post-epidural! Yay, epidurals!) or delivery. And... to not have to go beyond 39 weeks in the middle of summer... that's kind of awesome. I felt like 39 weeks was the turning point for me of, "Yay! I'm pregnant! Babies!" to "OMG I AM SO HOT AND MISERABLE! GET THIS CHILD OUT OF ME!!"

    ReplyDelete
  2. Way to go! It sounds like you're doing awesome and have a great outlook on the rest of your pregnancy.

    ReplyDelete
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