By Lucy Hulm
I’m sitting in my antenatal appointment and the midwife says I have your Gestational Diabetes result – its come back positive. Oh good I say… then my brain catches up and I realise positive isn’t actually good, positive means I have it. And I start freaking out. That was four and half weeks ago, so I thought I’d share with you what I’ve learnt so far as this may be useful for others.
What is Gestational Diabetes
Gestational diabetes is diagnosed when higher than normal blood glucose levels appear during pregnancy. From 3 to 8% of pregnant women will develop gestational diabetes around the 24th to 28th week of pregnancy, however, some may be earlier. In most cases it can be managed through diet and exercise (like type 2 diabetes), but in some cases the mother will need to have insulin for the remainder of the pregnancy to manage it.
How do they test for it?
Typically at between week 24 to 28, pregnant women are sent for a Gestational Diabetes Test (a Glucose Tolerance Test – GTT). I had mine at week 26. It goes for 2 and half hours! (I recommend bringing a movie or a good book along). This is how my test went:
- Fast for 12 hours before the test (I stopped eating at 8pm the night before and had my appointment at 8:30am the next day).
- Upon arrival, I’m told, no eating, only allowed one glass of water in the next 2 and half hours, no chewing and I can’t leave the waiting room during the test period (as they need to keep a watch to make sure I’m ok).
- Go into the doctor’s room and have a finger prick blood test (to check Blood Glucose level – to ensure it is safe to proceed) and have first blood test drawn (this will give your fasting blood sugar level).
- Get given Glucose drink (which I’m later told is the equivalent of eating 5 pieces of white bread in one sitting). The drink needs to be finished in 5 minutes. The rumours are true, it isn’t the nicest, but it is also doable to drink.
- 1 hour later have second blood test. Return to waiting room.
- 1 hour later have third blood test. Return to waiting room – wait couple of minutes and allowed to head home.
- Go find nearest café and eat a big breakfast and huge glass of water – starving!!!!
What does positive actually mean?
Well after I had the ‘drink’ my blood sugar levels spiked above the normal level, at an hour on, then two hours on still hadn’t returned to normal. This was basically my body not processing the sugar properly. This is gestational diabetes – the pregnancy, hormones and placenta are affecting the way my body processes food. The main risk is that if it goes unmanaged you over supply your baby with nutrients (the placenta is unable to regulate the supply) and your baby puts on too much weight. The risk therefore is a big big baby… aint no body want to push out a big baby! Jokes aside sometimes a larger baby means an increase in delivering earlier, C-section and your baby may have some issues regulating their blood sugar levels in their first few weeks as they had an oversupply in the womb and their body needs to adjust. I’ve been told my risk factors of having this were only that I am over 30, I’m not an A typical diagnoses. The good news is that thankfully I’ve also been told in most cases it goes away after the birth of your baby.
So how do you manage it?
I am now on a diabetes friendly diet, which means counting carbs, watching portion sizes, eating spaced out times during the day, testing my blood (via finger prick tests) four times a day, exercising more and trying to remove stress from my day-to-day. I am not on insulin and hoping to manage the diabetes via diet and exercise. I still have the occasional high result – they appear to be a combination of stress (when I’m under the pump, it is amazing how quickly my levels shoot up!) and changes in my diet (like I tried weatbix – fail, I swapped brands of porridge – fail). As the pregnancy progresses, I’ve been told the insulin resistance will increase, so what works diet wise one week, might change the next week.
What do I eat now on a typical day?
It is like going on a diet – except you don’t want to lose weight and you need to make sure you and baby are getting enough nutrients. I’m allowed 1-2 carb exchanges in a snack and 2-4 carb exchanges in a main meal (an exchange is 15g of carbs). I need to eat 3 snacks and 3 main meals a day to spread the carbs across the day – you can’t just cut carbs – you still need them. Wake – test blood to get fasting Blood Glucose level (BGL) 7am – Breakfast – ½ a cup of porridge (cooked with water), add in ¼ banana mashed up and stir-thru, almond flakes, teaspoon of coconut flakes and ¼ of cup of milk. Cup of tea. (This is about 3 carb exchanges) 9am – test blood 2 hours later for BGL. 10:30am – eat a snack of 4 vitaweets with tasty cheese. (1 carb exchange) 12:30pm – eat lunch of salad sandwich (on rye bread) (2 carb exchanges) 2:30pm – test blood again 4pm – afternoon snack – 200grams of plain greek yogurt with 3 cut up strawberries added (1 ½ carb exchanges) 7pm – dinner – piece of salmon, green veggies streamed, sweet potato mash (2 carb exchanges) 9pm – test blood again 9:30pm – supper – hot chocolate (250ml heated milk with sugar free hot chocolate added) (1 ½ carb exchanges) You still need to get a good mix of diary, fruit, veg, protein and low GI carbs.
What am I missing?
Cake, finger buns, ice cream, bars of chocolate, biscuits, hot chocolates from cafes and pasta/pizza. I can’t just snack in-between meals, I have to wait two hours after main meals before I eat again. I can really only drink water and tea. This makes it sound like I pigged out on these things, okay so I had developed a finger bun habit in my second trimester and have missed hot chocolate more than not drinking alcohol. I have a list of things my husband will be bringing to the hospital for me – chocolate mud cake with butter cream icing is top of the list. This has been an amazing insight into what it is like to live with diabetes type 2 and gain a greatfullness for the work my body does for me.
What has been helpful?
- Planning out my meals in advance and having the right food with me (did someone say emergency almonds and an apple). I can’t just skip a meal or eat a late breakfast – otherwise it affects the spread of carbs and food across the day. I’ve been doing my groceries online and this has helped avoid foods I can no longer eat.
- This website has tips of eating out.
- This low carb banana bread is really yum.
- I’m planning to make a recipe from this website this week.
- Grill’d have a low-carb bun (yay!)which is not really a bun so much as two firm pancake like discs, but tastes quite nice and means I have a treat take-out meal (minus the chips).