5.08.2012

Gestational Diabetes - My Story and Recipes

This is a little bit of a departure from my normal blog posts. However, I thought sharing my experience with gestational diabetes would be good to raise awareness and let other pregnant gals hear a first hand account.  I hope you keep reading and that you learn something.  The recipes, ideas and meal suggestions are healthy for anyone diabetic or not.

Gestational Diabetes Basics - FoyUpdate.blogspot.com

Heading into my third trimester gestational diabetes was not on my radar.  It blindsided me.  I didn't expect to be diagnosed. I've been very proactive about my health. I've focused on eating well, maintaining a good weight and getting exercise. I only had two of the risk factors: I'm over 25 and I do have history of type II diabetes from both my maternal grandfather and paternal grandmother.  Although they both were diagnosed  late in life and already had other health problems so it just didn't seem relevant.  When I failed the first 1-hour non-fasting glucose test I figured it was a fluke and I would pass the longer 3-hour fasting glucose test.  I didn't.

For the 1-hour glucose test, anything over 130mg/dL (or 140mg/dL depending on your doctor) is high enough to warrant the three-hour test.  If your blood sugar is over 200mg/dL they don't even bother with the 3-hour test and confirm a diagnosis of gestational diabetes.   Usually pregnant women are tested between 24 and 28 weeks.  At week 28 my blood sugar tested at 138 mg/dL.

What is considered elevated blood glucose levels vary by doctor and practice.   From what I've read, I go to a fairly conservative practice. Below you can see the American Diabetes Association scores to diagnose gestational diabetes verses the practice I go to and then what my scores were.

Gestational Diabetes Basics - FoyUpdate.blogspot.com
Blood Glucose Tolerance Test Results for the 3-hour Fasting Glucose Test
(Information from Spring 2012)

The 3-hour fasting glucose test involves not eating for 12 hours, then having blood drawn.  That's the first fasting score.  Then you drink a very sugary liquid that has a specific amount of glucose in it.  Blood is drawn three more times at one hour intervals to see how your body is metabolizing sugar.  In order to be diagnosed with gestational diabetes you need to test high on two of the four blood draws.  I failed the 1-hour and although I didn't quite fail the 2-hour it was close enough.

At first I was mad, I felt let down by all my carefully planned meals and the changes I had already made to my diet before pregnancy: cutting way back on processed foods, growing and preserving my own vegetables, eating fresh and simple food. And then there were the changes I'd made for pregnancy.  I had increased my protein to over 60 grams a day, added foods high in omega three fatty acids three times a week and only bought hormone free, pastured meat and dairy.  I also felt unjustly diagnosed because only one test was actually high enough to fail.

Then I got over it.  If monitoring and regulating my blood sugar with diet and exercise would equal a healthier baby and a better pregnancy/birth experience than this was good.  It took about a week of reading up on gestational diabetes and several teary appointments with the midwives for me to not feel like I had somehow failed myself and my unborn kid.  I realized all the changes I made were still good and even mitigated some of the problems with having high blood sugar.  It wasn't something I had done, I couldn't have prevented it.

What is Gestational Diabetes?

I started reading about what having gestational diabetes means.  Gestational diabetes (GD) is caused by hormones put into the mother's blood stream by the baby's placenta that create insulin resistance.  As the placenta increases in size so does the amount of hormone produced.  The mother may need up to three times as much insulin to regulate her blood sugar during her last trimester.  If her pancreas can't increase insulin to meet the demands of her body glucose builds up in her blood stream resulting in GD.  Generally the placenta doesn't produce enough hormone to effect insulin levels until the third trimester.  Most testing is done between 24-28 weeks.

Here's a comparison of what a normal pregnant body does verses someone who has gestational diabetes.

Gestational Diabetes Chart - FoyUpdate.blogspot.com
This chart is from the pamphlet given to me at the hospital called: Gestational Diabetes Basics Second Edition

Since gestational diabetes becomes an issue in the third trimester it doesn't affect the development of the fetus.  There are no birth defects connected to GD.

A normal pregnant woman's blood glucose levels never go above 120 mg/dL, nor do they dip under 70 mg/dL. With GD blood sugar may go as high as 200-300 mg/dL.  Here's a comparison of how a normal, pre-diabetic and diabetic's blood glucose levels look like after eating.  Gestational diabetes is similar to being diabetic or pre-diabetic.

Gestational Diabetes Insulin Chart - FoyUpdate.blogspot.com

Although insulin does not cross the placenta, glucose does.  The extra blood glucose goes through the placenta, giving the baby high blood sugar levels. This causes the baby's body to make extra insulin to get rid of the excess blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.  This means the baby is bigger.  I've read in a couple places that mother's who have given birth to babies over nine pounds are very likely to have had undiagnosed GD.  Having previous big babies is another one of the GD risk factors.

In extreme cases, untreated, exceptionally high blood sugar can cause still births.

Most women with gestational diabetes won't experience any symptoms, so the only way to know is to get tested.  Anymore it is a standard part of prenatal care. As for the cause, it's mostly genetic.  Partially the genetics of the mother and partially of the father, as the placenta that is producing the hormone is a combination of the parents just like the baby.  The only things that the mother can control to help prevent or minimize GD is to keep her weight, blood pressure and cholesterol in a healthy range.  Also not smoking, but you already knew you weren't supposed to do that while pregnant.

Gestational diabetes is fairly common, the American Diabetes Association reports that 18% of pregnant American women develop GD.  Once you've had GD you have a 20-50% chance of getting type II diabetes within 5-10 years. But you only have a one in three chance of developing GD in a subsequent pregnancy.  I thought that was interesting.  I'm not doomed to have GD the next time around.  Although I will do a yearly diabetes screening since I now have a such a high chance of developing diabetes.

What Happened After Being Diagnosed with Gestational Diabetes

After being diagnosed I signed up for the gestational diabetes class at the local hospital.  It was one time deal that took three hours.  A licensed dietitian who specializes in diabetes taught the class.  It was me and two other newly diagnosed pregnant ladies.  The other two were also first time moms.  One poor gal was only there because she couldn't stomach the glucose drink and they couldn't do the blood tests so her doctor figured better safe than sorry.

Our teacher lead us through what GD is and then explained that most GD can be controlled simply by eating carbohydrates in small amounts spaced out over the day.  We got a basic meal plan to follow:
Breakfast: 30g carbohydrates
Snack: 15g carbohydrates
Lunch: 30-25g carbohydrates
Snack: 15g carbohydrates
Dinner: 45g carbohydrates
Snack: 15g carbohydrates
In order to get enough calories through out the day we get to eat every 2-4 hours and at each sitting never more than 45g of carbohydrates.  Also, distributed through out the day should be at least 25g of fiber, 60g of protein and 60g of fat.  Total calorie intake should be around 1,700. This plan varies by practice and your specific needs. This is what I was given.

In addition to eating in this special manner we were also encouraged to exercise by taking a walk for at least a half hour each day.

We were then treated to a long section of the dietitian holding up foods to demonstrate what  a reasonable serving of carbohydrates were in different things from peas to rice to oranges.  Luckily this wasn't surprising to me as I've measured my portions for years.  I could tell it was new to the other moms in the class. I would guess they were going to have to change the way they ate more drastically than I was.

Next we got a Gestational Diabetes Record Book to keep track of what foods we eat each day.  I already had a food diary where I recorded my protein intake.  I adjusted it to also track carbohydrate, fats and fiber.

Gestational Diabetes Blood Meter - FoyUpdate.blogspot.com
My blood glucose meter.  I prick my finger
 with the gray  thing, then insert a blue strip into
the meter and  touch it to the drop of blood.  Ten
seconds later my blood sugar level pops up.  
We then got blood glucose meters and were ask to take readings four times a day; once before eating in the morning and then an hour after each meal.  We were warned if we couldn't keep our blood levels between 70-95 mg/dL in the morning and under 130 mg/dL an hour after meals we would be put on medication.

Then we were let out into the world to figure out how to fit this new "treatment" into our lives.

At first pricking my finger to take blood glucose levels made me a bit queasy, but now it is normal.  And I like getting the instant feed back of how I am doing. Tip: if you get unexpected numbers wash your hands and test again. Sometimes I just didn't get my finger clean enough.  I also found the almond scented soap I was using gave me artificially high readings.  I switched to an unscented and haven't had any further issues.

Eating by this new plan I am almost never hungry.  I have found that I naturally eat just a little more than 1,700 calories.  Before being diagnosed I was gaining about a half pound a week in my second trimester.  I had gained 25 pounds which was the high end of where my midwife suggested I gain for the whole pregnancy.  I was told my weight gain would probably plateau once I started following the GD plan and it did.   In the first week of eating for gestational diabetes I lost about an 8/10ths of a pound and then gained no weight for the next three.  Just in the last couple weeks I have gained a half pound back.  To me that's a sign this is working.  My baby isn't making the extra blood sugar into surplus fat.

What if Diet and Exercise aren't Enough?  Medications for Gestational Diabetes

*Update* I'm adding this section in January 2013 because so many folks have asked about medications.  I didn't need medication so this is just my research on the topic.  If you have personal experience please fill in your knowledge in the comments below.

If you test really high (How high is that?  I'm not sure.) you might be put on medication right away.  Or if diet and exercise don't adequately control your blood sugar.  Some 20-25% of women who have been diagnosed with GD will require medication to control their blood sugar.

Group Health recommends initiation of pharmacological treatment if, during the previous week, the patient’s average readings are:

  • Fasting glucose greater than 90 mg/dL, or 
  • 1-hour post meal glucose greater than 120 mg/dL

Usually the first thing your doctor will try is a pill form of insulin called NPH.  Often the starting dose is 0.2 units/kg are taken before bed.

NPH stands for neutral protamine Hagedorn. Also called N insulin.  On average, NPH insulin starts to lower blood glucose within 1 to 2 hours after injection. It has its strongest effect 6 to 10 hours after injection but keeps working about 10 hours after injection. It is considered a moderate (as opposed to fast or slow) acting insulin.  Hopefully this will bring your fasting levels down to below 90mg/dL consistently.

You will probably be asked to continue monitoring blood sugar as how much insulin your body can make and how much your body needs will change as your baby gets bigger.

There are other non-insulin drugs but as of 2011, the ADA and ACOG do not endorse the use of oral anti-hyperglycemic agents during pregnancy.  Such medication has not been approved by the FDA for treatment of GD. Doctors reserve other non-insulin treatments such as Metformin or Glyburide for women who cannot control blood glucose levels with diet and exercise and cannot or refuse to take insulin. If these meds are used, you should know that these drugs cross the placenta and may have unknown risks to the fetus.   (Here's my reference for this section: Group Health GD Guidelines for Health Providers)

What I am Eating with Gestational Diabetes


Gestational Diabetes Fruit and Cottage Cheese - FoyUpdate.blogspot.com
A half cup of cottage cheese with an
orange or strawberries for breakfast.
I am now 36 weeks pregnant and I am doing well managing my gestational diabetes.  It took me a couple weeks to figure out what works for my body, everyone is a little different.  Luckily the midwives understand that there is a learning curve and gave me a pass on the couple times I have spiked my blood sugar.

Breakfast

Breakfast was the hardest to figure out.  Toast, a cup of milk or one pancake would put my blood sugar 10mg/dL over the limit.  After some experimentation I found I could eat only 15 grams of carbohydrates first thing in the morning.  A half cup cottage cheese with a cup of fruit has been my go to food.  This gets me protein and fiber along with just enough carbs.  My blood sugar is consistently right on target in the 100-110 mg/dL range one hour later.

I've also been eating breakfast cookies, substituting more nuts for the dried fruit.  These are handy to eat when on the go as well.  They have been my take along snacks many times. Each cookie has 26g of carbohydrates.
Gestational Diabetes Breakfast Cookies - FoyUpdate.blogspot.com
Breakfast Cookies

Snacks

My snacking didn't change much from what I was eating before.  Usually it's a protein plus a starch or fruit.

  • Cucumbers or bell peppers with homemade yogurt ranch dip
  • Small apple with string cheese
  • 1/4 cup salsa with 1/4 cup cottage cheese and 10 tortilla chips
  • 10 pretzels with 2 tablespoons peanut or almond butter
  • Hard boiled egg
  • 1/4 cup mixed raw nuts
  • 1/4 cup of hummus with veggies
  • 2 squares of dark chocolate
  • 2/3 of a fruit smoothie (I can't eat them first thing in the morning.  They've got too many carbs, but they make a great snack and I freeze the rest for later.)
Lunch

Often I eat leftovers from dinner for lunch.  I also keep Ezekiel wraps (sprouted grain tortillas) on hand and fill them with grilled chicken, veggies, mayo, mustard and some cheese.  I also do a Waldorf salad inspired wrap of chicken, sliced apple, balsamic vinegar mayo, lettuce and toasted pecans.  

Dinner

I am continuing to work on different ideas for dinner.  This is when I am most at risk for eating too many carbs and having a high blood sugar reading.  Things that are working so far:
Gestational Diabetes Burger - FoyUpdate.blogspot.com
Cheese burger with grilled asparagus

Dessert

This is a hard one.  I really don't get to eat dessert anymore.  Luckily I haven't had sugar/ice-cream/doughnut cravings because those foods all have a lot of carbs. I decided I didn't want to use artificial sweeteners which makes options limited.  It seems like all diabetic desserts involve some form of Equal, NutraSweet or other non-saccharide sweetener.  I've been eating half servings of fancy dark chocolate after my evening walk as my dessert.

For the record I thought maybe I could handle a mini-blizzard which has about 45g of carbs.  Nope.  Even after a walk my blood sugar was elevated.

Exercise 

At first I was dubious about how much of a difference exercise would make to gestational diabetes.  But, I am a believer now.  I make sure to get a half-hour walk in each day, even the days my hips hurt or my ankles are swollen.  Walks are particularly useful if I take my blood sugar and it's too high or if I know I ate too much, I can use exercise as a preemptive strike.  

Tonight, after a dinner I didn't measure out particularly well,  my blood sugar was 168 mg/dL.  Yikes!  I'm still learning I guess.  I immediately went for a brisk half-hour walk and when I got back my blood sugar was at a very acceptable 114 mg/dL.  

Exercise works because muscles need extra energy in the form of glucose when active.  With moderate exercise our muscles take up glucose at almost 20 times the normal resting rate which lowers blood sugar levels quickly.  (For more information click here.)

What Does Gestational Diabetes Mean for Labor and Delivery?

This will depend on your doctor or midwife.  I've read that some doctors insist on a Cesarean birth, but I think that's kind of old school these days.  I am going to a birth center and seeing a group of five nurse practitioners and nurse midwives.  The biggest draws for me are they have a very private birth facility where you have one midwife and nurse who stay with you the whole time and there is the option for water birth.  Also there are no drugs available. I think if I know there is no epidural I won't feel tempted when the going gets rough.  If needed, the hospital is five minutes away.  The midwives have admitting privileges and one of the practice's five OBGYNs is on call.  I like that it is all one cohesive unit and if I decide at any point in the next couple of weeks I'd rather be at a hospital for the birth, they will arrange for that.   

Back to the original question.  As long as I control my blood sugar levels I can give birth at the birth center.  Some doctors do extra ultra sounds and non-stress tests to make sure the baby is okay.  These tests check amniotic fluid level (too much can sometimes be a problem with GD and the baby won't go head down), measure fetus size and make sure the baby's heart is responding normally.  The practice I go to doesn't do those tests.  They just asked me to make sure the baby moves well each day.  So far so good.   They also measure the size of the uterus externally and as long as I am within 3 cm of where I am supposed to be they consider all to be well.  Also, so far so good.  

Gestational Diabetes During Labor

Depending on where you go you might be put on an IV drip of glucose to maintain blood sugar.  Where I'm going they will just have me check my blood sugar every two hours.  And if I need to I can eat something to keep my blood sugar up.  They suggest something with protein.  I am thinking mixed nuts, string cheese and fruit smoothies will be my take along snacks.  Although how hungry does one get during labor?  My fasting levels have always been good, so I shouldn't need any intervention.  

What if the baby is too big?

One of the risks of gestational diabetes is a bigger baby that can't be birthed vaginally.  In my case, the midwives consider labor to be the test of whether or not the baby is too big.  If labor doesn't progress, I'll get moved to the hospital and then they can do a Cesarean or whatever is needed.  Hopefully by keeping my blood sugar in the target ranges the baby's weight will be normal.  

What happens after birth?

After it is born the baby is immediately put to the breast.  Breast milk is one of the best ways to make sure the baby does not become hypoglycemic.  Remember the baby wasn't making the extra blood sugar, its mom was.  Once born, the baby may still be over producing insulin and blood sugar levels could drop too low causing hypoglycemia.  Sometime in the first hour the baby gets a heel prick and its blood is tested.  In almost all cases they are fine and their bodies adjust to make the right amount of insulin.  In rare cases, usually if the baby can't or won't be nursed, they give the baby a bottle of glucose water to bring up blood sugar.  

Once the placenta is delivered the mom is no longer getting the hormones that made her insulin resistant.  Within a couple days she will return to her normal non-diabetic state.  Moms should keep checking their blood glucose after birth until their doctor/midwife okays things.  There is the chance that the mother will have developed type II diabetes and not go back to normal.   

Conclusions

I'm looking forward to not pricking my finger four times a day.  Just four more weeks until my due date!

I have a lot more sympathy for folks living with diabetes.  Our industrialized culture eats sugary, refined carbohydrates in large quantities at most meals.  It would be challenging to maintain blood sugar long term without feeling left out.  

I have learned that eating for level blood glucose is very healthy even if you don't have diabetes.  I plan to keep eating small snacks, more protein and smaller quantities of carbohydrates.  However, I won't hold myself to quite such rigid standards.  I'll eat the crusts of my pizza and have ice-cream every now and then.  

Another thing I learned is that I was afraid of fat.  I'd been trained for so long by Weight Watchers and all the other diet preaching out there that low fat and low calorie foods are healthiest.  Fat is healthy too and should make up about 30% of a diet.  Just like protein, fat takes longer to break down (actually even longer than protein) into blood sugar and thus you feel fuller longer and it won't raise blood sugar unduly.  

Gestational Diabetes Carb, Fat and Protein Blood Sugar Chart - FoyUpdate.blogspot.com
This chart shows how carbohydrates, proteins and fats affect blood sugar over time.  Carbohydrates have the most dramatic peak between 30 minutes and an hour, proteins a more moderate peak in 2-4 hours and fats a low peak in 8-12 hours.  This chart is from: http://www.tudiabetes.org/forum/topics/583967:Topic:178783

I've been choosing fats that have been processed very little; namely olive oil, butter, and chicken, beef or pork fat that I render at home.  No more fat-free dressings or skimping on the butter for me.

I'd like to end with a message to any pregnant gals who read this because they have been diagnosed with gestational diabetes. Being diagnosed is a good thing.  Even though it is extra time and work to control your blood sugar it is worth it for your health and your baby's.  It's alright to be confused and upset by the sudden changes you'll need to make.  Look at it as an opportunity to learn more about how to live a healthy, happy life.

If you've had experiences with diabetes feel free to share your story in the comments.  It's nice to know I'm not alone!

*Update* June 20, 2012  

Our little girl was born on June 3rd, just three days before her due date!  She was born vaginally, weighing in at a  reasonable eight pounds.  I was relieved that I was able to keep her weight under nine pounds by controlling my gestational diabetes with diet and exercise.

The baby had no problems with her blood sugar levels. She was normal right from the start. 

During early labor I ate hummus with veggies, string cheese and a fruit smoothie.   In the last hour I had several cups of cranberry juice and a couple tablespoons of honey because I was so worn down from the long labor and they wanted to give me some quick energy.  

My blood sugar is also back to normal.  I did a couple checks one-hour after eating more than 45 grams of carbs and I was consistently below 120 mg/dL.  I celebrated by eating a bowl of chocolate peanut butter ice-cream.  

*Update* March 24, 2014

I am 28 weeks into my second pregnancy and just got the results for my 1-hour glucose test.  With a score of 138mg/dL I have just barely failed.  The midwives want to schedule a 3-hour test, however I have been self tracking and I have seen my blood sugar spike to 170mg/dL after a dinner of pasta and 160mg/dL after a bowl of cereal.  I need to dig out my old tracking notebook and start the four blood sugar tests a day again.  The new challenge this time will be finding foods my toddler likes and that are low-carb.  It will be good for her too.

Since my first pregnancy Pinterest has come into being.  Here's my Gestational Diabetes Recipe board.  I'll also probably write another GD blog post.  I'll link to it here once it is up.

This post is part of the Simple Lives Thursday Blog Hop

95 comments:

  1. Anonymous5/08/2012

    Foy! I heart your blog, miss you tons and hope your pregnancy is progressing well despite the diabetes. My grandmother also developed gestational diabetes while pregnant with my twin aunts and was a great home preservation goddess. All the best to you, doll!

    Melissa Thompson

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  2. There are so many facts about gestational diabetes I was completely in the dark about. Thank you for sharing your story and for all your research.

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  3. Fabulous information, thank you for sharing your experience with us. Best of luck with baby!

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  4. This is super interesting to read. I am in my second trimester now and go for my gestational diabetes test in another couple of weeks. Thanks for sharing all this information!

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  5. Thanks for sharing so much of your research on GD Foy. My sister developed it in her last pregnancy. She had to control so much of the carbohydrates as well. One thing I gave her which helped so much was coconut palm sugar to use in her coffee and if she needed to sweeten anything else. Also, one thing she found out... this is wierd... after she would eat, she would get down on all fours and hang her belly for about 5-10 minutes. This kept her blood sugar level down. Wierd, I know. But maybe worth a try especially after breakfast or dinner.

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  6. Great post! My good friend had GD and I also was borderline when I was pregnant. The good news is that if you manage it, which you are doing, it should not be a problem later after the baby is born. Good luck to you -- it sounds like you're doing well though. You're right -- it's shocking and upsetting when you find out about it, but it is good to be diagnosed so you can deal with it. SO important...

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  7. Very informative. I do say that I was surprised to read the title of this post b/c I know you live a healthy lifestyle and are uber food conscious. Good luck to you and all the best. (My sister was boarder line with her first pregnancy and she was a healthy eater and exerciser too.)

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  8. Anonymous5/14/2012

    I am at 32 weeks, and just got home from a teary 2 1/2 hr meeting with a diatician. Her: "you can't eat this...you can't eat that..." Me: "But I'm 7 1/2 months pregnant and I'm HUNGRY!" This news has been a bit of a shocker. (This is my 2nd baby & I had no issue with my first pregnancy.) More than anything, I appreciate your more positive spin on it all, and your ability to put it more into perspective. And to say maybe you CAN eat this...try it...
    Thanks, Kate in the Bronx, NY

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    Replies
    1. Hi Kate,

      Glad you found this post and it was useful!

      I remember I was starving the first week after I was diagnosed with gestational diabetes because I was scared to eat anything! No one told me I was allowed a learning curve and that it was okay if my blood sugar was over every now and then. I was afraid to show the midwives my first set of numbers because I thought they would put me on insulin and tell me I had to have a hospital birth because I had elevated blood sugar several times. However, they were very understanding and gave suggestions as to what I could do to help keep my blood sugar levels in range.

      I look back at my meal plan for that first week and it is loaded with salads, frittatas and fish with vegetables. Not a single starch to be found. Don’t be afraid to try starches. I tried carb heavy foods like bread, rice and beans in portions with about 30 grams of carbs to see how my body reacted. I found I pretty much can’t have white rice, wheat bread is okay and beans are good.

      A couple good online resources you might find useful include the Spark People Recipe Calculator (http://recipes.sparkpeople.com/recipe-calculator.asp). You can enter the ingredients in a recipe and the number of servings and it will make a nutrition facts label just like what is printed on processed foods at the grocery store. Many of my recipes on this blog include this information.

      I also use My Fitness Pal (http://www.myfitnesspal.com/) both as an ap on my iphone and on the computer to look up the nutritional content of foods. They also have a lot of chain restaurant meal information so if you’re eating out you don’t have to guess. It’s free and it has a ton features for tracking calories and other food nutrients including carbs/protein/fat/fiber. I’m sure I don’t use it to its full potential.

      Good luck! I hope you find your groove and figure out what to eat to so you’re not hungry and feel healthy.


      Foy

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  9. Anonymous5/15/2012

    I really appreciate your response, and the very helpful links. It's so easy to feel criticized/judged, esp when it comes to food...but I think that having gestational diabetes really is less about "eating healthy" and more about counting and eating exactly the right things. I am not overweight, & I've always eaten healthy, but my insulin response was not suppressed either! So this morning, I'm blaming the hormones from the placenta...not my own lifestyle...and I'm forging ahead. 2 more months to go... xo, kate

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  10. Anonymous5/15/2012

    p.s. I grew up in Southern IN, and my husband up North (in Hammond). Before we met, he was in peace corps (in West Africa). So I guess we have a lot in common!!! Our baby's due July 12th! Blessings to you through June, Kate

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    1. How funny is that! If you ever find your way near North Manchester we should meet up!

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  11. Thanks for this. I just got my diagnosis this week and am doing some pre testing before I meet with my doctor because my Grandpa had an extra meter. Anyway... it has been nice to read something readable (and not so medical) and get some good food and snack ideas. I'm 27 weeks, so just getting started... I had GD with my last pregnancy also, but it was not diagnosed until very late and was borderline so my doctor just said not to worry about it. So this time, we know early. Anyway. Thanks for sharing!

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    1. Good luck with your testing and finding what foods work for you!

      The weeks right after the diagnosis were the worst for me. I had a lot of preconceived notions to straighten out. And finding foods that worked for me took effort.

      I'd love it if you came back later and leave a comment about how it is going and what foods have become a staple of your diet!

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  12. Anonymous7/07/2012

    Thanks for sharing your story. I was diagnosed this week and am utterly devastated. I will definitely keep your recipes on file as I learn what I can tolerate. I meet with my dietician on Monday for some more suggestions. Again, thanks for sharing--this whole process is overwhelming and it was nice to read something so personal.

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    1. It gets better. The scariest part is not knowing. Please come back and share what helps you manage your GD.

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  13. Andrea7/26/2012

    Thank you for this lovely post. I was just diagnosed with GD and your blog has been such a help.

    Congrats on your baby girl.

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    1. Glad you found this post and it was helpful. Gestational diabetes is scariest when you don't know much about it. I hope your finding your way through.

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  14. Anonymous7/26/2012

    Excellent and very informative!Thank you for making such an effort to share this info- has been an encouragement.

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  15. I want to add my thanks to the list! I just found out this morning that I have been referred to an endocronologist to talk about GD - which I guess means I failed glucose screening test #2! I do have two of the risk factors - I am 36 and overweight - but none of the others, so while it is not a total surprise, I am still disappointed and feeling those guilty feelings that you mentioned.

    However, I am confident that I can manage this with diet and exercise in the next 10 weeks before my DD arrives. I really appreciate your positive attitude, and your comments that a diagnosis is a good thing because it gives us a chance to do the right thing for us and our babies. And the recipes/food ideas you listed are very helpful! Like you, I have always been told that high calorie/high fat is bad, so most of the foods you mention here sound heavenly to me! Thanks to your comments, I am actually looking forward to going to the grocery store tonight, instead of dreading it. Thank you, and congratulations on your little girl!

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    1. Hi Courtney, glad you found your way here! One of the best unplanned side effects of having GD was that I rearranged how I think about buying groceries. I used to think of dark chocolate, avocados, red peppers,and cheese as luxury items because they were expensive. I should only buy them in small amounts. After being diagnosed I couldn't buy my normal treats I decided to buy lots of the luxury healthy foods I could have. Now instead of buying m&ms or chips as my special treats I buy string cheese, mixed nuts and sea salt dark chocolate.

      Enjoy your grocery trip! And remember to be kind to yourself as you learn how to manage your blood sugar.

      Foy

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  16. Anonymous8/06/2012

    I can't thank you enough for your post. You sound exactly like me! I was slightly concerned when I went for my 1 hour screening test simply because I have such a sweet tooth. I was worried that the chocolate I had been eating now and then during my pregnancy would cause me to get GD. So sure enough when I failed the 1 hour, I was beyond devastated. I cried for days. And then I got mad - really mad. And was determined to "beat" the stupid 3 hour test. My appt was at 8 a.m. and they did the initial draw right away. But they didn't give me the glucose drink until 8:05 and I didn't finish it until almost 8:15. So when they called me back at 9:00 on the dot for my second draw I tried to tell them that it hadn't been an hour. They insisted that it was "close enough". It made me nervous but I was still hopeful that I would pass. I didn't. By ONE stinkin point. Cut off was 180 and I was at 181. All of those emotions I felt after the one hour were multiplied by 10 after failing the 3 hour by one point. When the nurse called to tell me that I failed I tried to tell her that they drew my blood too early but she refused to listen and said that they "knew what they were doing". I'm still a little upset about it, but I also feel the way you did above - if there is a chance that I have this and monitoring my blood sugar will help to keep my baby healthy then so be it. Heck I'd cut off a limb if that would help him to be healthy!

    Something else you mentioned above really hit home.. that it's very possible that women who have had babies weighing more than 9 lbs have undiagnosed GD. I have 3 nieces - all of whom were over 9 lbs. So I'm wondering if it really does run in the family and somehow my sisters just weren't diagnosed?

    I have always eaten healthy (despite my sweet tooth!) and exercised a lot. In fact - I was a marathon runner before I got pregnant and I certainly was not overweight. I stopped running as soon as I found out I was pregnant and switched to the elliptical but I was/am still exercising 4-5 days/week for 45 minutes. I'm at a normal weight and measuring right on for this pregnancy. And the only risk factor that I have for GD is being over 25.

    It's only been a few days since my diagnosis but right away I did all kinds of research on it and started following a GD diet. And just like you said above - I am starving! Today is not so bad, but I was so afraid to eat anything at a picnic that I went to over the weekend that I ended up not eating much at all. I'm meeting with a dietician on Wed and I'm really hoping that she can help me.

    I wish I could say that I don't blame myself but there's still a small part of me that wishes I had done something differently and avoided this. I feel ashamed to have diabetes. I know this is the wrong way to think but when I think of diabetes I think of someone who is overweight, doesn't exercise, and sits around eating cake all day. Wow - what a wake up call. I will certainly never think that again!

    I'm still very embarrassed by the diagnosis though and haven't told anyone except my husband. But now my sister is pregnant again too and I'm starting to think that it would be selfish if I didn't tell her - especially since her 1st child was over 9 lbs.

    Anyway, sorry this ended up being so long! I just couldn't resist sending a comment because we have so many similarities in our stories.

    Congratulations on having a healthy baby!! And I'm SO glad to hear that your diabetes disappeared after the baby was born. I'm very nervous about that too but trying not to think too far ahead. I guess I'll cross that bridge when the baby comes at the end of October.

    Thanks again.

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    1. I think there is a lot of shame wrapped up in diabetes. You're right as a society we think of it as a fat people disease that could be cured if folks would just lose the weight and get healthy. That's not the case for Type 1 diabetes or GD. However, once you it's mostly genetic disposition makes it feel less like it was something you could have prevented. We can help educate others about what GD is so that there isn't a stigma and pregnant gals feel comfortable getting the treatment they need.

      I still wasn't convinced after the tests that I was gestational diabetic, especially when my family doctor said with my scores he wouldn't have diagnosed me. But once I got my blood meter and started recording my blood sugar I realized I was. My blood sugar was elevated after meals, not severely, but I could see it for myself. Later in pregnancy I could even feel when I had spiked.

      You should let your family know that you have GD and are controlling it with diet and exercise. Having a sibling or parent with any form of diabetes is considered risk factor to both type II and GD. They have very similar genetics to you.

      In the last couple years the CDC & ADA have seen an increase in birth weights. They are recommending that the scores to diagnose GD become less lenient and doctors have become more aware of it.

      At my six week postpartum visit I was only 8lbs more than when I got pregnant. My midwife's comment was, "at least four of those are in your boobs!" I fully credit being diagnosed and changing my diet with keeping my weight in check during the last trimester. I was getting to the point where I was uncomfortable and pregnant and everyone told me I was eating for two so I ate whatever sounded good. Being forced on to a diabetic diet definitely helped me have a healthier pregnancy. In the end I am grateful was diagnosed.

      Delete
  17. Anonymous8/09/2012

    Thank you for sharing your story. I felt so guilty when I was diagnosed, but I was able to face it and I am managing to control my blood sugar with diet only. I am on my 32nd week and so far my baby girl is very active. I am convinced that for the rest of my life I need to exercise and be careful with my diet so I don't end up diabetic for life. Measuring the blood sugar 2 hours after a meal is very important, I was not being very consistent there, sometimes measuring 2,5 hours later because of work, and I realized my baby's health is more important, so I am now being better. I encourage every mom who was diagnosed with GD to be diligent and follow the diet, a healthy baby is worth any effort.

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  18. I just found out the other day that I have Gestational Diabetes, I am really glad that I found this blog post cause I too have had the same guilty feelings and after reading that other readers have had the same feelings it helps me know that I am not alone. Thanks for this blog post! I have been frustrated the last few days not sure if I follow the labels or follow the meal plan carb choices because they seem so standard.Knowing that it does get easier helps out a lot! Congrats on your Baby Girl! I am also having a girl she is due in November!

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    1. Congratulations on your little girl! GD is confusing and it's hard because from the moment you are diagnosed there is pressure to keep your blood sugar in range from then on. No one is perfect and no one's body responds exactly the same. There is a learning curve and if you keep trying you will find what works for you and your body.

      I found setting iphone alarms for each snack time was a great way to remind myself to eat when I was out and about. Eating 6 or 7 times a day was not how I normally eat!

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  19. I have type 2 diabetes. I'm not fat, I am fit. I exercise daily, lift weights and run. I'm fed up with peoplesaying T2DM is about being fat.

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  20. I am so happy to have read your blog post! I just found out on Thursday that I have gd. Honestly, it was a HUGE shocker. I'm 22, feel like I eat healthy, am not overweight, and my baby is not measuring big or anything like that. I don't know of anyone who has diabetes in my family, except an older and extremely overweight person. I literally have zero risk factors, and I was so utterly shocked during my appointment that I left without getting an answer to any of my questions. Now I must wait to be able to see the specialist, and I've been left for the last four days with the sole advice of my doctor to go off of - only eat 3 servings of carbs a day (whatever that means), don't drink caffeine (haven't in years), and don't eat white bread (don't anyways). Anyways, I've been following some diets I saw online in the mean time, and your post has really made me feel better!! You've also noted some interesting facts I didn't know about - like that breastfeeding helps with the risk of the baby developing a sugar condition - I will DEFINITELY be asking my dr. about this!

    Thanks for sharing your story! You've made many people feel much better. :)

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    1. I should clarify that it's not that the baby is at risk for having a permanent condition of hypoglycemia. The baby could be low on blood sugar when born and it is just a matter of how quickly his or her body adjust to regulating it's own sugar levels. Breast milk, or really colostrum at this point, will help bring up baby's blood sugar swiftly. I just didn't want you to think your baby would have hypoglycemia forever. Did I explain that well?

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  21. Anonymous9/11/2012

    I am so glad I found this post. I am 27 weeks pregnant was just diagnosed yesterday after flunking my 1 hour test. I cried my way through appointments with the doctor, nurse, and nutritionist because of feeling ashamed and worried. I have no risk factors other than being over 25 and it seemed like the doctors and nurses were just as surprised as I was. I have been setting my alarm to remind me to eat and test my blood and I go back in a week to see if I'll need medication. I'm really hoping to manage of this with diet and exercise but my numbers were quite high. I have always thought of myself as a healthy eater and I've tried to remain active through the pregnancy, so it's hard not to blame myself. Reading this post, and all the comments, really helped me gain perspective. Thank you so much for sharing your story!

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  22. Anonymous9/19/2012

    Thank you for sharing this info! Much more than I got from my obgyn or books. I feel much better now going into my 3hr glucose test. Still hope I don't have GD, but no longer afraid if I do. Very well written!

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  23. Anonymous9/21/2012

    Thank you so much for taking the time to put all this information together. This is, by far, the most useful info I have found on GD so far - and reassuring. I'm pregnant with my 3rd child, have no risk factors other than being older than 25, and was shocked to be diagnosed this time around! It's always good to know you're not alone!!

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    1. You're welcome. Taking the time to write up this information was a great tool for me to feel in control of the gestational diabetes. Once I had it all written down I knew it would be useful to others. I'm glad you found your way here. :)

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  24. Anonymous9/29/2012

    thank you for sharing all of this with us. i have a question about something u did not mention, KETONES, did your dr make u check for ketones??? no matter what i eat am always having traces of ketones in my urine in the morning :(

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    1. You are right, I should have written something about ketones. Ketones are an acid by product of your body not having enough carbohydrates and switching to breaking down stored fat for energy. Too many ketones in the bloodstream can lead to a serious problem called ketoacidosis. There have been studies linking ketones to problems with brain development in fetus.

      Depending on your doctor you may be asked to test each morning for ketones in your urine. Overnight is when your body is most likely to run out of carbs. My doctor only recommended I test if my blood readings were high multiple times in a row or if I got sick.

      If you do have ketones in your urine you might be asked to eat a midnight snack so your body has enough carbohydrates to make it through the night.

      I personally found eating a piece of string cheese right before I went to bed was a good way to prevent ketones.

      I have a good friend who had what she called the cheese alarm. She would set an alarm to go off at midnight to wake her up so she could eat her cheese and then go right back to sleep. During her pregnancy she actually kept a cooler with string cheese by her bed. If you don't like cheese some other high protein food like turkey or nuts would also suffice.

      I didn't have any problems with ketones so I know less about theme. If anyone has any other information to share. Please do!

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    2. Anonymous9/30/2012

      i am in my week 34, till now i have been able to manage m glucose levels with diet and exercise, my dr asked me to check for ketones because in my last urine test i had traces of ketones so now i have to check it daily.

      since my BG levels are fine there is 2 reasons left for the ketones presence, its either a low carb diet or dehydration.

      my dr increased my carbs, honestly i cannot eat anymore, but still i have ketones in my urine.

      one very important thing that i learned today, is that the color of urine indicates how dehydrated a person is, there is even a color chart!!! when my urine was dark yellow ketones were present, but when i drank enough water my urine is clear with no ketones :D

      so after all, i think it was about dehydration, thought that i should share this with all of you. a piece of advice for pregnant women: drink 3 L of water daily, you r after all drinking for 2.

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    3. Good information! My midwives harped on drinking enough water, but I was never really clear on why.

      Delete
  25. Anonymous10/01/2012

    Thanks so much for sharing your experience with GD during pregnancy. I wondered if you had any thoughts or tips on fasting numbers in the morning. My numbers throughout the day are great...2 hours post meal between 90 and 110 generally. My morning fasting number seems to be high at times and inconsistent. I am trying to eat a half packet of instant oatmeal with whey protein added right before bed. Or find something else that works. I have done lots of research online but am interested in what worked for you. Glad to hear your little one was born healthy and complication free. Keeping my fingers crossed for the same outcome with our little girl who will be here in December.

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    1. Anonymous10/03/2012

      I dont have a bedtime snack, i hate eating just before bed, but my fasting numbers are fine, always in the 80s, and that is because of a 30 min walk that i do daily after dinner. whenever i skip the walk i get high fasting number. try to make it a daily routine, and you will have better fasting levels in 2 or 3 days :) hope it will work for you as it is workin for me. good luck :)

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    2. Anonymous10/03/2012

      Thanks for your feedback. :) I actually go the the gym and walk on the treadmill and or the track after dinner almost every night. I will keep researching!
      Great blog for support of GD!

      Delete
  26. Thanks so much for this. I am 31 weeks along with my 3rd boy and somehow this time I "failed" the test! It's been hard because you really feel like you are to blame for both the diagnosis and also if the glucose is high after a certain meal.

    I learned more from your post than I did talking to the registered dietician at the Diabetes clinic I had to go to.

    I appreciate the snack and meal suggestions as well as the ways to control glucose if a certain reading is consistently high. The dietician told me that I should have 2-3 servings of carbs (30-45g) at my meals and 1-2 at my snacks. This is way more carbs than I have been having for the whole pregnancy! It seems so anti-intuitive to me.

    The only good news is, my diet is more balanced and I am not hungry. Pretty much ever.

    9 weeks left and then I will be enjoying my bowl of ice cream!

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    1. I'm so glad this post has been helpful to you. I too was frustrated with the information out there. I found the GD class to be not that helpful either! Guess we'll have to band together and get the information out there.

      It's important not to feel like you did something wrong and to understand what's causing the problem so you can make the diet and treatment into your life in an effective way.

      Sounds like you are well on your way. Happy eating and hope you have a good delivery!

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  27. Thanks for this blog post. I had borderline GD. One correction, though, you CAN be diagnosed with GD in the first trimester and there are some birth defects associated with early GD. I am thin with no family history of GD, but was diagnosed at 10 weeks. Many medical practices have started testing women at 10 weeks if they meet any of the higher risk criteria. I met two criteria, 1) over 25 yo and 2) Grandmother with type II. I had to follow the diet almost my whole pregnancy. The good news: baby was born perfectly healthy at 7 lb 14oz.

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    1. Good points! I hadn't heard about 10 week testing, but it makes sense. GD is getting on the radar and doctors are looking for it more actively, especially if you have risk factors.

      I was told I'd get tested in the 2nd trimester my next pregnancy. And if it was negative, I'd get tested again during the normal window.

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  28. I wondered if you had any thoughts or tips on fasting numbers in the morning. My numbers throughout the day are great...2 hours post meal between 90 and 110 generally. My morning fasting number seems to be high at times and inconsistent.
    gestational-diabetes-diet-plan

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    1. I love this blog post, thank you! I"m also wondering about fasting numbers. I just got diagnosed w/ GD b/c my fasting number was 4 points too high! All my glucose levels were fine.
      Really though - thank you for this post. I haven't stopped crying in 2 days b/c of the GD diagnosis. I meet w/ the dietician tmrw, and feel more informed for our meeting b/c of you!

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    2. I think that is one of the most traumatic parts of being diagnosed with GD. You get tested and diagnosed with out learning anything about what GD is and how it will effect you and your baby.

      The most important thing you should know is that it is that Gestational Diabetes can be controlled either with diet and exercise or with medication AND that it won't cause birth defects.

      I hope the rest of your pregnancy is less eventful!

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  29. This article was awesome! I wish i had found it when i first was diagnosed with g.d. i literally cried because i was eating a cupcake a week when they told me i had to cut it out! Maybe it was the hormones...but basically we have similar heath history and i also thought i would be fine. Got diagnosed at 25 weeks and plan on delivering next week. I found this article trying to figure out why my sugars are "normal" at this stage in my pregnancy. But great information regardless!

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  30. Also, congratulations on your baby! All natural? I'm trying to go that route as well!

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  31. This article was awesome! I wish i had found it when i first was diagnosed with g.d. i literally cried because i was eating a cupcake a week when they told me i had to cut it out! Maybe it was the hormones...but basically we have similar heath history and i also thought i would be fine. Got diagnosed at 25 weeks and plan on delivering next week. I found this article trying to figure out why my sugars are "normal" at this stage in my pregnancy. But great information regardless!

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  32. Happy New Year! Thanks so much for putting this info out for the newly broken hearted moms who just found out they've failed the test. I am going in for my second test on wednesday after getting the bad news on New Years Eve that I have failed the one hour test. I honestly don't know how to feel right now. I was upset at how my last day of 2012 ended with the news. I felt 2012 still wanted to eat me alive until the r912 end. I am scared but I will research and find answers and look into forums for advice and I'm so glad it has brought me here. I like to be my own advocate and find answers. I dont want to wait on the doctors advice only. After reading this, I no longer feel scare because you gave me hope. I will go in on wednesday with a positive attitude and patiently wait for the out come. thanks in advance and wish me the best! Again Happy New Year!

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  33. Thank you for this post - I share a lot of the same experiences as you. I was completely blindesided and didn't believe that I actually had it until I monitored for a week or so. I'm 34 weeks pregnant now and working on my fasting numbers, which are typically in the mid-90s. The doctors are recommending starting me on Metformin, which I don't feel comfortable with. I also appreciate your recipes - always looking for yummy meals as sometimes I feel a little deprived.

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    1. Hey Krista,

      Thanks for commenting!

      I have a good friend who had gestational diabetes too and had trouble with fasting numbers. Her blood sugar would get low enough during the night that her body would switch to ketosis and she would have elevated blood sugar and protein (ketones) in her urine in the morning.

      Her doctor recommend having a high protein snack six hours before waking. She had what she called the "cheese alarm". She would wake up at midnight and eat a piece of string cheese and go back to bed. This kept her morning reading between 70-90.

      I don't know if it would work in your situation but it might be worth a shot.

      Best of luck to you and your little one!

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  34. Thank you for your informative blog. I ran across it when searching for healthy meals during pregnancy. Then found we live in the same county when reading some of the posts:)

    I was borderline gd with my first two pregnancies and now I'm 24 weeks with my third. I've been researching gd because I have had a few days of dizziness and almost passing out. Do you know if this is associated with gd ? I have my test in a few weeks and needed some ideas for what to and what not to eat.

    Thanks!

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    1. Often ladies won't experience symptoms with GD. Although you could notice being thirsty more than normal, increased urination or blurred vision. I haven't heard of dizziness as part of GD, but I'm no doctor.

      I'd say talk with your doctor about what's going on. Maybe they can move your test up if he thinks that's a potential problem.

      Hope you feel better!

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  35. Im 17 weeks pregnant with my third child i had gd with my other two pregnancy and was on insulin my little girl was born at 36 weeks at 10pound 4 and my son delivered by c section 38 weeks 11 pound found out im having another little girl :) even tho i have had gd with both pregnancies I still feel down that it is all probably going to start again on tje next few weeks would love to try a natural birth again just a bit nervous as you can imagine with the size of my last too baby's has anyone went through a similar situation would love to hear your experience and how it went

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    1. it is a hard set of emotions and information to process. My reading of the medical literature suggests that these issues are not as simple or black and white as some doctors make them out to be. I think the guidelines and diet are really helpful in creating a great basis for a healthy pregnancy (as my midwives say ... "all pregnant women should eat like this") but it is important for women to not make themselves crazy or feel bad that they are not fitting a "normal" type. There is a huge range of diversity in human beings and in pregnancy and labour.

      Im 35 weeks now waiting for the arrival of my second baby. My first child, a son was born almost three years ago. He was a wonderful vaginal delivery at 41 weeks and three days and weighed 11 pounds. I tested negative for gd in that pregnancy, put on a reasonable 25-30 lbs and when he arrived late and big they tested his blood sugars after delivery and he was fine. He was not a "fat" baby but just overall larger - he literally filled the bassinet from end to end and side to side with his long legs and arms. He was in the 97% for height and head size, only 90th for weight. Three years on and he is still incredibly tall for his age (over 90th percentile) and quite trim but big boned. My mother and sisters all make large babies - over 9 lbs if they arrive on their due dates so my son being bigger when he was so late was not strange in my mind. I come from a family of tall, larger people - it makes sense for my baby to be at that end of the curve. 9 lbs as "too big" needs to be in the context of the overall size - length, head size, femur size - of the baby.

      I'm older and started this second pregnancy heavier which I knew increased my risk of being gd positive this time but I was surprised and disheartened to get the result. Before being tested at the end of the second trimester I had gained only 6 lbs in the first two trimesters due to careful watching on my own of my diet and increasing exercise as I didn't want to put on a lot of weight in this pregnancy. Over the last 7 weeks seeing the gd clinic I have actually lost 4 lbs. I've done a "perfect" job of controlling my blood sugars to quote my endocrinologist but the daytime was not my challenge, it was only ever the fasting overnight number. I tried loads of things to do to get the morning number down but as the clinicians told me, if overnight is a challenge for you it is more likely that you will end up needing insulin. Your body tends to ramp up hormone production during the night is what they told me, so don't beat yourself up about this number because it is largely outside your control. I started on nph overnight at around 32 weeks and have had no problem with my morning numbers since. The nurse at the clinic told me that I would likely, based on what usually happens, start to need more insulin and daytime insulin etc. This interestingly has not happened - I have only ever needed overnight insulin and in week 34 we've actually started to decrease the amount I need overnight. My endocrinologist expects to discharge me from his monitoring in week 37 if things continue as well as they have been.

      Interestingly the ultrasounds for this baby show it to be very much like my first - 97% percentile again, even with these super controlled sugars and low to no weight gain. While some doctors would say anything over 9 lbs is too big, others would say its really important to understand your individual situation, family history, your own size. There is a big difference between a 5 ft woman with a small pelvis trying to deliver a 9 lb baby and a woman who is 5 ft 10 trying to. My midwives were never concerned that I would be able to push out my son because they could tell that I had the pelvic space to do it. I'm definitely not worried about doing it this time.

      If you pushed out a baby over 10 lbs once before I think its reasonable to talk to your care team about options. Best of luck on the road ahead - I hope it goes well.

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    2. Thanks for sharing the details of your experience Allison!

      You are right family history matters as do your previous pregnancies.

      You sound a lot like me. I had charts of weight and log books for nutrition, exercise and blood sugar levels! I look forward to comparing my next pregnancy to this one.

      Your midwife is right, all pregnant (and dare I say it all people) ought to eat this way. That's my struggle now. Eating and living in a way to reduce my future chances of diabetes and other chronic illnesses.

      Best of luck to you and your family.

      Delete
  36. Great blog for those of us going through the emotions of just getting diagnosed. Especially those of us that live very healthy lives... I too was mad when I found out, what did I do all the planning and healthy lifestyle living for if this is what I would be rewarded with. I was furious at the lack of information that was given to me by the LAB TECH (I didn't even get to talk to a doctor) and I sit here 2 days later waiting for the education specialist to call and set up an appointment with me. I've dug in started doing my own research only to find that the diet they will likely have me follow is so close to my actual real diet it's almost scarey- having to omit the cake and ice cream will be difficult but it's def doable (also a runner, use to watching what I eat during training has set me up wonderfully for this). I see 2 problems for me- one being breakfast and 2 being the middle of the night wakings in which I am starving and NEED something to eat- hopefully whenever I do get to see my education specialist they can help me with those two areas.

    I find it interesting that everyone else was given the FULL test. My fasting numbers were perfect (78, needed to be under 90) and my one hours post drink was 202 (needed to be under 180) so they STOPPED my test... I have no idea what my sugars would have done after that- now I wish I did.

    Thanks for providing such an informative piece on this subject for those of us just sitting around waiting for the experts to call- it really does help!!

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    1. I didn't include in my post above that it took almost two weeks for me to get into see a dietitian. That's part of why I was able to put this post together. I was doing the research myself just like you!

      Since you are already eating well probably the biggest change will be timing what you eat. With a little planning it is doable.

      Breakfast was difficult for me too. You will have to figure out what works for you. Having the glucose meter is such a big help in getting that instant feed back. My midwife told me many women find that they can't eat carbs for breakfast. I often had a string cheese and green tea when I first got up and then did a larger breakfast a half hour to hour later. I find I don't have much of an appetite first thing in the morning.

      As for the middle of the night, grab some protein or fat. Again string cheese is great or consider turkey, chicken, nuts or a hard boiled egg. Probably not what you usually grab. Perhaps you'll even find you're not interested in food in the middle of the night if you eat on the every 2-3 hours schedule during the day.

      Best of luck!

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  37. I felt like I was reading my own story while reading this post. Thank you so much for writing it, I am feeling a bit better now. There is such a stigma surrounding diabetes as a "fat people disease." I frankly haven't told hardly anyone because I don't want to be judged. I really appreciated the section about hormones from the placenta being part of the problem. It makes me feel like it isn't completely my fault. Now to fit more walking into my day!

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    1. I wish that all OB practices had a pamphlet of information to give out to every pregnant lady who fails the blood glucose test. Just the basics so she doesn't feel quite so lost or like a failure.

      The best part about walking is you feel like you can do something to make this better right now. Plus I found a little time to myself outside was calming. Although right now we have four inches of snow on the ground and no one has shoveled yet. In this case perhaps a walk on the treadmill or spin on a stationary bike would be better.

      Delete
  38. Like so many comments before, Thank you so much for sharing your experience and research. This really helped me realize that GD is more random and not so much about what I've done. (I eat healthy, exercise and have none of the risk factors besides being over 25) I was just diagnosed yesterday and while my emotions of anger and frustration are still very fresh, I know that this will be good help keep baby healthy. And, like a good friend told me right after finding out, "Isn't it worth having to go through this for 4 months and then the end result is a beautiful healthy baby?" Thanks!

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    1. Now that I've been through GD and I have a healthy baby, I like to tell my story to other women. I want them to know it's out there and if they or someone they love gets it, it's not that scary, and they can still have a healthy pregnancy.

      My other soap box is Urinary Track Infections. Which is another awkward conversation, but so many women don't know that to prevent them peeing after sex is all you need to do. And that you can treat them yourself without medication in most cases by taking cranberry supplements and drinking a ton of water. This one came about in Peace Corps when going to the doctor meant a full day of travel and a lot of expense. You better believe every woman in my group of volunteers knew how to treat and prevent a UTI!

      Delete
  39. Great Blog! Where did you get the book pictured at the beginning to keep track?

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    1. The book came from the gestational diabetes class at the hospital. Honestly it wasn't that great. I learned a lot more by doing my own research.

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  40. Just found out I have GD and have been discouraged all day. I found your blog as I was looking up recipes and information. Most encouraging info so far, especially since I am wanting to have a vaginal home birth. Thanks for sharing your story and all the details you included. I am looking forward to lowering these numbers and don't mind the effort it involves. Thanks again.

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  41. Thank you for your post! happened to browse the net because for the first time in 1 week, my morning reading was high like 161... it scared me to death- i feel like not writing it on my glucose diary. Thank God I read this, really helped a lot. I still cant believe that im seeing a dietician and endocrinologist for GDM, you see im almost underweight pre- pregnancy. I did not have GD for my first pregnancy and was confident i wouldnt have one on my second, it shattered me... I hope more people will get to read this. :)

    ReplyDelete
    Replies
    1. Please don't be discouraged and please write your numbers down. Your OB doc (or MW) will not know how to help you.
      You did not fail, do something wrong, or anything like that. As the pregnancy progresses, the placenta grows and there are more hormones. You may need medication and do not be scared of it. It will not hurt the baby. But your high blood sugars will.
      This is a hard thing to go through. But it sounds like you have good help. Pregnancy will not last forever. I promise.

      Delete
  42. Where did you get the first graph on insulin requirements during pregnancy? It looks like it came from a text book. I am looking for the reference.

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    Replies
    1. It came from the book in the first picture which was given to me by the hospital. Honestly, it wasn't that great of a book, although it is the only place I have seen that graph.

      Delete
  43. Thank you so very much for this. I was just diagnosed today with GD at almost 32 weeks. I have been crying all day. But finding your blog has made me feel so much better.

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  44. Came across this post while looking for graphs and it popped up. I had first better identify myself as a labor and delivery RN. I am currently writing gestational diabetes protocol for our unit based on current information.

    I have seen a number of blogs while doing research as it is illuminating to see what the patients are thinking. So far, yours is the best I have seen. It is positive and proactive and let me tell you, that makes an enormous difference in the outcome. Hence, you have a healthy baby. Kudos!

    Just a couple comments. First, the people who managed you were absolutely right in diagnosing you. The cutoff levels listed are actually much higher, as you said, than a normal pregnant woman. I cannot tell you how many people I have seen who "passed" the test with borderline results and a month later they are undiagnosed with high blood sugars and the complications that come with gestational diabetes. This has been linked with metabolic problems in the baby that may resolve after birth but have been shown to come back later in life, making them prone to diabetes, heart disease, obesity, stroke-the list is long.

    During the pregnancy, gestational diabetes, if not controlled, is associated with a MUCH higher rate of preeclampsia, cesarean birth, kidney disease, and a term that strikes fear in the heart of all who deliver babies, shoulder dystocia.

    For the ladies out there who do not want to accept the diagnosis and what it may take to control it-please, please don't do that to your baby or yourself. This is not intended to scare, just to try to help women accept what they need to do.

    There are a variety of medical treatments that are emerging that are seeing good, safe results. The two pills commonly used now are glyburide and metformin. Both have been used with good results and there are interesting things coming to light about metformin. It seems to have a positive metabolic effect on the baby, mitigating the effects of high blood sugar in the mother. If they do not work, there is insulin, (NPH is one of them and is injected, not taken as a pill) and when you need it, you need to take as much and as often as is needed to control those blood sugars.

    Treatment and medications do not hurt the baby. High blood sugars absolutely do.

    ReplyDelete
    Replies
    1. RNmama - I would love to read anything your publish on GD. I found I was gleaning and cobbling together a lot of information because the answers aren't easy to find. If you publish online, I'd love to add the link in this post.

      Delete
  45. I was diagnosed with Gestational Diabetes with my first pregnancy. For my one hour test, I was at 141, so the md was convinced I could control with diet. They ordered a 3 hour test and 2 of my values were high. They suggested that I go on the special diet for 4 weeks and retake the 3 hour test. After the second test, with being on the diet, all of my values were high. I was immediately put on insulin. I remember crying and not wanting to accept the diagnosis. My poor mom, not knowing that this is mostly a hereditary thing, told me that I must've eaten too much pasta in the beginning of the pregnancy. I read up a lot and discovered that it wasn't my fault. I have relatives on both my mom's and dad's side with type 2, and my father-in-law has type 2, so I can see now where it came from. As the pregnancy continued along, I required more insulin. At first, I thought it was my food choices and I began to get really frustrated. I finally just about broke down in front of my doctor. She let me know that as the baby and placenta get larger, the need for more insulin increases. I remember trying to go out to dinner and being shocked at how many carbs are in EVERYTHING we eat! I have taken that information into the future and now I eat a much more balanced diet than I ever have in the past. I just found out last week that I am expecting again. I am hoping that I am able to avoid the diagnosis this time around, but I know that if I do have it again, I can handle it. :-) Thanks for sharing your journey!

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  46. Thank you so much for all the great GD information and congrats on our daughter although I know she's now a toddler and not a baby anymore.

    ReplyDelete
  47. Hello! And thank you for this wonderful information. I was diagnosed a few weeks ago, I basically had to harrass the dieticians to see me and now I'm managing my sugars, for the most part, at 33 weeks. A question I have is this: my numbers can be 40 (?points?) apart depending what finger I test. I will wash my hands and almost always get a lower, more reasonable reading. Lately though, I feel like I am testing 2 fingers and washing my hands more and more frequently. I'm worried I'm flubbing the tests. This morning, I was in the car exactly 1 hour after breakfast, and I got a 137. But I recalled I had made my whole lunch, which included making a smoothie handling a banana and some berries, and had not washed my hands since. So I got to work, washed my hands and tested 10-15 minutes later and got a 114. Which number would you report? I feel like something similar to this happens about once a day at this point and if my sugar is not controlled I don't want to fake it, but I also want to avoid meds if I don't truly need them. My other thought is that there is no reason for me to think 1 finger or test is more accurate than the other?

    ReplyDelete
    Replies
    1. That's the worst not getting the same or similar readings from testing. I remember that a couple weeks into testing my fingers had so many pricks in them I considered using my toes to give them a break!

      As for consistent testing on the go, I used to carry alcohol wipes with me that I would clean my fingers with before testing. I asked for some extras from the gal who took blood samples at the clinic and she just gave me a handful or you can buy them from a pharmacy. Make sure your finger is completely dry before pricking. When you are at home unsented soap and water is the way to go. Clean fingers are really important to accurate readings.

      When in doubt take your glucose testing kit with you to your next appointment (or to the pharmacy you bought it from) and ask to have someone go through how to use it with you.

      I found it frustrating as well to get into a dietitian and wound up being mostly self taught which is why I wrote this blog post!

      Good luck Nichole! In the beginning there is a learning curve, but if you keep working at it you will find the strategies that work best for you.

      Delete
  48. hello, first I want to thank you for this blog!!! I was looking for something from the eyes of someone going/gone through this, not just medical websites! as they don't really address the feelings associated with it! so, I am 27 weeks (and a few days) and just got my diagnosis yesterday (happy valentine's day!! hope you didn't get any chocolates!) so, obviously I am still extremely new at this, but I picked up my meter and supplies yesterday, then started the testing this morning, my first test when I woke up was 67 mg/dl ?? I thought when you were diabetic you had high blood sugar!? I guess I don't really get all of this just yet, but I did read how you have to eat string cheese at nite, is that because you have low blood sugar in the morning as well? and do diabetics pretty much go from being hypoglycemic to hyperglycemic?? sorry, I still haven't got to talk to a real medical professional yet, and don't really expect a reply, guess I just feel like I am being proactive this way. ;)
    thanks again!! will definitely be trying out some of your recipes!

    ReplyDelete
    Replies
    1. Welcome to the GD club, something I'm sure you never wanted to join!

      Yes, it is common to have low blood sugar in the morning with GD. Ideally you should be above 70 and below 95 mg/dl when you wake-up. If you are below that it's because your body ran out of easy to get energy (ie sugar in your blood) and had to switch over to burning body fat and proteins. This is a much less efficient process and can cause other problems.

      One of the bi-products of this process of , known as ketosis, is ketones which show up in your urine making it cloudy and dark. That's one of the things your medical practitioner will look for when they do urine samples at your baby appointments. You might be asked to check for ketones yourself if low morning blood sugar is a regular thing for you.

      To avoid this problem you can have a high protein snack in the middle of the night, that's why my friend had her cheese alarm. That should keep your blood sugar stable so you wake up in a good range and you know your body didn't flip into ketosis.

      If having a late night snack doesn't do it for you there are medication options. Although since you are so darn close to 70, I bet a little protein at night would get you through. Although everyone's body is a little different so do a little experiment and see what works best for you.

      Good Luck!

      Delete
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  50. I found this post on Pinterest and had to let you know how much I appreciate the original post, and the updates you've made over the years. I am shocked and a little freaked out that I was just diagnosed at 8 weeks. I already have four kids, and I am at a new practice this time around. They tested me at my first appointment because of my history of two babies at 8#13oz and above, even though I've never tested positive for GD before. I failed the one hour by a bit, then failed the three hour with flying colors. I did not expect this, especially so early, and I can hardly eat anything right now as it is - and the "easiest" foods to eat are the bad ones. Anyway, I see the endocrinologist next week. Really, I just wanted to take the time to say thank you. I found it helpful.

    ReplyDelete
    Replies
    1. Having just been diagnosed this time around, I completely understand. There are times when I would rather not eat than try and figure out how much to eat of what.

      This time around I am tracking my diet and exercise with the free website MyFitnessPal.com. I highly recommend it especially if you have a smartphone, the app syncs with the website so you can use it where ever. Also you can enter recipes and it will create a nutrition breakdown for you; so much easier than doing it by hand. Another similar website is Sparkpeople.com

      Good luck, just after being diagnosed is the hardest part.

      Delete
  51. found this post on pinterest too like others have commented. thanks for your educated, informative, and easy to read info! i also liked reading your comments too! i just got diagnosed at 31 weeks, so i don't have long to deal with this. so far, i'm doing pretty well with my readings, but it's only been 2 days :) anyway, thanks again!

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