31 May 2011

Luck of the Draw: You've got Gestational Diabetes!

Guess who gets to be on a low-carb diet for the next 3 months or so?  :: thumbs in shoulders :: This girl!

Guess who gets to give up dessert for the next 3 months or so?  :: sobs :: ... this girl...

Okay, I'm being dramatic. I know.   I didn't actually sob when I found out.  But I did have an emotional roller coaster of a day.

Turns out around the beginning of the thrid trimester, it's entirely customary to test all preggo's for something known as Gestational Diabetes (GD).  At the time our mommies were giving birth to us, this particular test was not being done.  The hubs and I are confident that his mom had GD, since the guy was born weighing more than 12 pounds.  << Yes, she delivered naturally, with nothing to numb the pain.  Did I mention she powered her way through labor and delivery with the support of her husband and a midwife in a small village in Bolivia?  She wasn't even in a hospital!  There was no trained doctor attending to her... WOW! >>  My mom is not sure whether or not she might have also had GD, but it's possible because we were all 3 fairly big babies requiring an epesiotomy with each delivery.  As she likes to say, she huffed and puffed and blew us out. Ha!

Here's how we found out that I'm one of about 200,000 women in the US every year who develop gestational diabetes during their pregnancy .

Thursday: At 27 1/2 weeks gestation, we show up for the 1-Hour Glucola test which required me to fast since midnight, drink a super sweet and very cold orange drink, then sit and wait an hour while my body did its thing to process all the sugar.  After an hour I followed the nurse to have my finger pricked to read my blood sugar level.

These were the words out of her mouth. "You failed the test."

Pardon me for getting on a soapbox here, but this is another one of those DO NOT EVERY UNDER ANY CIRCUMSTANCE SAY THIS TO A PREGNANT WOMAN statements: "You failed."  It's bad enough for any non-knocked-up person to be told that they've failed, but when you say this to a pregnant woman you might as well go ahead and assume she can NOT be held accountable for her actions. << I had a brief fantasy where I turned into a monster, ripped her head off, chewed it up, spit it out, and then went right back to being sweet and gentle preggo Jess.  I blame the violent fantasy entirely on the raging progesterone that has hijacked my body. >> The initial fury at the news delivered from this inexperienced nurse passed, and I became simultaneously hopeful that there had been some mistake, saddened by the thought that something was wrong with me, and scared that something could be wrong with our son.

We then go to see the nurse practitioner, and she assures us the test results from today only tell us that we have to do the 3-hour test to get an accurate look.  At this point it's not definite that I have GD. So we schedule the 3-hour test for the next day.

Friday: We arrive and I have a pre-sweet-drink finger prick to measure my fasting sugar levels. They're GREAT. The doc wants that initial number to be 110 or below, and mine was 87.  Drink the drink and wait an hour for finger prick #2. Ideal number would be 190 or below, and mine was 212. :-(  The nurse, a different one from the day before, gently and sweetly tells us, "Your number is a little higher than what we're looking for." << In contrast to the reaction I'd had the day before, I took this news in stride... I think.  The hubs might tell you differently, but do me the favor of not asking him. >> We go back to the holding area to wait for finger prick #3. Here's the deal- I could have failed 1 out of 4 of the finger pricks and still "passed" the test.  So if my numbers for finger sticks #3 and #4 were below the desired levels, then we would have avoided the GD diagnosis.  Turns out the #3 test read 175, when they were hoping for 165.  So we wait to see the doc.  It's official according to the doc: I've got Gestational Diabetes.  The Dr's office will make a referral to a local Diabetes clinic, and they'll call us to make an appointment to come in and learn what's next. We'll do this in the next few days.

So what is Gestational Diabetes, exactly?
The National Institute of Health has the following information.
Normally, your stomach and intestines digest the carbohydrate in your food into a sugar called glucose. Glucose is your body’s main source of energy. After digestion, the glucose moves into your blood to give your body energy.  To get the glucose out of your blood and into the cells of your body, your pancreas makes a hormone called insulin.  If you have diabetes, either your body doesn’t make enough insulin, or your cells can’t use it the way they should.  Instead, the glucose builds up in your blood, causing diabetes, or high blood sugar. Gestational diabetes happens in about 5 percent of all pregnancies, or about 200,000 cases a year in the United States.
How is gestational diabetes treated?
Many women with gestational diabetes have healthy pregnancies and healthy babies because they follow a treatment plan from their health care provider.  Each woman should have a specific plan designed just for her needs, but there are some general ways to stay healthy with gestational diabetes:
  • Know your blood sugar and keep it under control – By testing how much sugar is in your blood, it is easier to keep it in a healthy range.  Women usually need to test a drop of their blood several times a day to find out their blood sugar level.
  • Eat a healthy diet – Your health care provider can make a plan with the best diet for you.  Usually controlling carbohydrates is an important part of a healthy diet for women with gestational diabetes because carbohydrates affect blood sugar. 
  • Get regular, moderate physical activity – Exercise can help control blood sugar levels.  Your health care provider can tell you the best activities and right amount for you.
  • Keep a healthy weight – The amount of weight gain that is healthy for you will depend on how much you weighed before pregnancy. It is important to track both your overall weight gain and weekly rate of gain.
  • Keep daily records of your diet, physical activity, and glucose level – Women with gestational diabetes should write down their blood sugar numbers, physical activity, and everything they eat and drink in a daily record book.  This can help track how well the treatment is working and what, if anything, needs to be changed. 
What happens after the baby is born?
For most women, blood sugar levels go back to normal quickly after the baby is born.
Additionally, I digitally sauntered on over to the U.S. Food and Drug Administration's website and found some very good, NOT ALARMIST, material about Gestational Diabetes.  Here's a snip of what the US FDA website said about GD, in case you're confused, concerned, worried, freaking out on my behalf, etc.
Why is gestational diabetes a problem?
For you:

• Your risk of developing type 2 diabetes is increased.
• You are more likely to have a large baby (a condition known
as macrosomia). This may cause discomfort during the last
few months of pregnancy.
• Having a large baby may lead to a cesarean section
(C-section). If you had a C-section, it may take longer for you
to recover after the birth.
For your baby:
• Large babies are more likely to suffer from birth trauma.
• Soon after delivery, your baby may have low blood sugar.
This can be treated with early feedings and should not result
in any long-term consequences after birth.
What can I do during pregnancy if I have gestational
Go to all of your • prenatal visits.
• Follow your health care providers’ recommendations for
controlling your blood sugar. This can help reduce your risk
of having a large baby.
• Stay physically active.
• Make healthy food choices.
• Ask your health care provider to see a dietician or a diabetes
In order to avoid a total melt down while attempting to be proactive and become informed over the Memorial Day weekend, I decided to research carb content in some of my favorite foods.  As far as my preferred fruits and veggies, I learned that lemons, limes, avocados, and strawberries will be A.O.K., and there is a huge long list of veggies that will be just fine for low-carb requirements.  

In closing, you should know that if you're planning to come for a baby-viewing visit at any point postpartum, I may just have to charge you an entry fee of fresh bread, pizza, pastries, macaroni and cheese, cookies, or something else of the carb and/or sweet variety.  And in the meantime, if you have any sugar-free, low-carb recipes you love, send them my way!

1 comment: