*Note* This is all personal view. In no way should this be used instead of the advice given to you by a medical professional.
It has happened a few times now that someone has asked me for advice on how to deal with gestational diabetes. I’ve done so much research now and I have an entire folder of recipes and diet plans that I’ve actually had people contact me asking for tips and tricks. I belong to a few support groups online and I’m happy to be an active member. I also have a wonderful chat group that I belong to spanning two different websites with other mothers due in December of 2011. These women have probably been the best support (other than my own family). Some have faced similar situations, some have faced things different and things far worse or concerning. Regardless of the circumstances we each face I’d like to think that there is a bond within the group and that we’ve all been able to help one another at some point. I know that, at times, just being able to log on and complain/vent/gripe or rave about something fantastic or bring up a topic that I wouldn’t feel comfortable with discussing with someone NOT pregnant, has been a sanity saver.
So while there is no magic wand or special tip that I can start off with, my best advice would be to FIND A GOOD SUPPORT SYSTEM. That goes for anything in life. We all need someone to talk to at some point. Find people that are in a similar situation or people that have gone through it. It makes dealing with a difficult situation far easier.
When a lot of people hear the word “diabetes” they automatically assume that sugar is the enemy. They think that if you just cut out extra sugar from your diet that you’ll be fine. This, in fact, is not the case – at all. Sure, excess sugar is a no no but the real glucose killer is the beloved and dreaded refined carbohydrate. White breads. White pasta. Potato. Corn. Rice. So many of the things that we love really aren’t that great for you especially when you are a diabetic. Carbohydrates break down into sugar and it is these sugars that spike the blood glucose. Awhile ago I found this site and it broke down information so it was easy to understand. The section on Impaired Blood Sugar Regulation should be a good read for anyone that is starting out and dealing with GDM. Of course, your dietitian or diabetic counselor should be telling you all this anyway but if you are like me, it helps to see something in writing as well.
So based on that I learned that NOT ALL CARBS ARE CREATED EQUAL. When I’m meal planing I try to incorporate a lot of protein and fiber into a meal or into a snack. It takes longer for the body to digest these things and in essence this “exercises” our bodies and we metabolize the carbohydrates and sugars better. This results in lower glucose levels in the blood stream. I’ve seen on carb counting sites something called Net Carbs. These are the carbs ‘left over’ after protein and fiber is taken into account. This isn’t a tool I’d personally recommend for GDM. A serving of carbs (15 grams) is still a serving of carbs no matter how many grams of protein and fiber is in something. Your body may process things better when loaded with protein but you’ve still eaten the carbohydrate to begin with.
People often ask me what my day is like and if the sudden diagnosis of GDM messed up that daily life. I won’t lie – when I was told that I had gestational diabetes I felt like there was a noose around my neck. I knew that I had a chance of developing this in my pregnancy so I had taken steps to try and avoid this. I ate well. I exercised. I didn’t pack on pregnancy weight. So when I took my glucose test and it came back positive I felt like I had failed. I felt like I had failed for my baby. But that isn’t the case. There honestly wasn’t much that I could have done to avoid this. I meet almost ALL the risk factors for GDM and it isn’t that I did something wrong or ate bad things while pregnant, it’s just that my body is reacting in a way to the pregnancy hormones that I’m not creating enough insulin. The American Diabetes Association has a nice explanation of this condition and they also go into the risk factors toward the baby. But that’s not what this blog is about.
When people ask me if the diagnosis messed up my daily life, the answer is simply no. Am I faced with challenges? Yes!! Absolutely!! It’s difficult to go out to a restaurant and just order something off the menu. I’d be lost without my iPhone. I’m able to get on Safari and look up the restaurant’s nutrition information and then make a better meal choice. Most places are very willing to cater to a special diet. I’ve had to ask a couple times for an extra side of vegetables instead of potatoes because I’m diabetic. I’ve asked servers not to bring bread before a meal – rather to bring it with my husband’s so I’m not tempted to eat it. I have no problem saying no to eating a slice of bread but why deal with the temptation?
Another thing that can get a little tiresome is having to check my glucose two hours after every meal. When I’m home this isn’t a problem but when I’m running errands it can be a bit of a nuisance. I actually set an alarm to remind myself to check my glucose when I’m out and about. So when the alarm goes off I just make my way to the restroom and pull out my glucometer. I’ve gotten funny looks from people but I just smile and wiggle my wrist with the bracelet that says “Diabetic” on it. Then the light goes on… and usually they look at my stomach and just sake their head sadly. A lot of people don’t understand. The area I live in is poor and education is lacking. I can only imagine the looks I’d get if I had to pull out my insulin supplies in the restroom to give myself an injection!
Basically my day goes like this:
0600: Wake up
0610: Fasting glucose check (should be under 95)
0615: Injection of insulin. (NOTE: I didn’t start on insulin, only doing glucose checks and many women don’t ever need to use insulin)
0630: Breakfast. 15-30 grams carbs
0830: Glucose Check (should be under 120)
0930: Snack of 15-30 grams of carbs
1200: Lunch. 30-45 grams of carbs
1400: Glucose Check (should be under 120)
1500: Snack of 15-30 grams carbs
1745: Glucose Check and Insulin Dose
1800: Dinner of 30-45 grams of carbs
2000: Glucose Check (should be under 120)
2200: Insulin Dose and Bedtime Snack of 15-30 grams carbs
I do most of my errand running in the morning since I have a good few hours where I don’t need to check my glucose. I have “free hours” as I call them where I don’t need to worry about that but I do need to remind myself to have a snack. Snacks are important to maintain a steady glucose level. Drastic highs and lows can be dangerous. I always have something to snack on in my bag. Nuts are easy to bag up or the little packs of presliced apples. That’s actually what I usually grab for my ‘on the go’ snack.
Some things that have become a staple in my diet are: nuts, cheese, eggs, turkey bacon, chicken sandwich meat, sugar free jello (zero carbs – great for something sweet or put 2 Tbsp of cool whip on top for an extra treat and minimal carbs). I always have a carton of hard boiled eggs. I buy two dozen eggs at the store when I go and automatically boil one of them and stick them back in the fridge. It’s an easy way to get some extra protein during the day. Mayo has no carbs so deviled eggs are a quick snack, egg salad is a great lunch on a low carb wrap, and hard eggs are great on salads. Meals do take a fair amount of planning but SparkRecipes.com has a fantastic tool that you can enter all your ingredients and adjust the serving size to get a nutritional breakdown. But remember to include EVERYTHING. Some carbs are hidden. I never knew there were carbs in garlic!
Once you get used to the new diet you’ll figure out where you have a little fudge room. The other night I made my husband a pumpkin pie. Now, one slice of pie depending on how you make it can be 20-29 grams of carbs! And mostly this is loaded with BAD carbs! I could have made his pie more ‘diabetic friendly’ and used splenda but this was for his birthday and I wanted to make it “right”. Pumpkin pie is my favorite… and the pie had been calling my name for two nights. So, last night I allowed myself a TINY sliver of the pie with a scoop of cool whip after my dinner (which was fish and green beans). It was just enough of something sweet that I felt satisfied and two hours later my glucose came back well within my normal range. But I’ve been following this diet and cutting sugar and bad carbs for a few weeks now. Had I done this when I was first diagnosed I would have felt sorry for myself that I couldn’t eat a bigger slice or I would have given into temptation and eaten too much. But now, a little bit of sweets go a long way! Yes, I miss treats. I miss making cookies for my family and being able to sit with them and have a huge glass of milk and a big cookie. But is that worth risking my developing baby’s healthy? Not at all. And really, that’s what it all comes down to. Can I change my lifestyle to help ensure that my baby will be born healthy? Absolutely! Is it worth pricking my finger five times a day and giving myself three injections? YES! I know that in a few weeks weeks I’ll be able to cuddle with my baby. I know that in a few weeks the gestational diabetes will be gone (unless I actually developed type two diabetes during this pregnancy).
Really, the pricks and pokes are small potatoes compared to the end result of creating a new life.
Hmmm, potatoes are bad carbs. Maybe that shouldn’t be a saying for this blog. Small… cucumbers?