For most women when they are diagnosed with Gestational Diabetes (GD) for the first time they are in shock. “How did this happen?” is usually the first question. In a lot of cases the shock comes because you didn't think it would happen to you. The most shock happens to pregnant women who previously had a healthy lifestyle of exercise and diet.. so why me?
Imagine my shock when at 6 weeks my doctor tells me my fasting sugars were borderline high and I needed to do the lovely Glucose Tolerance Test already.. Damn! In a way, I kind of knew I would get it given my Dad and sister are both type 2 diabetic as well as half my extended Filipino family! By week 9, I was already being seen at the hospital by the diabetes educators and the endocrinologist.
I felt ashamed. The previous year I had lost about 10kgs and felt fit. I was running, going to the gym and eating well. So while I knew I had a strong family history and was previously pre-diabetic I had hoped I dodged a bullet.
When I had my first diabetes education session, I learnt that it was not my fault.
There seems to be a stigma with GD because people think it's the same as type 2 diabetes but it's not. What I learnt is that GD does not discriminate and affects anyone based on a whole lot of different factors – ethnicity, multiple births (twins, triplets etc), family history, genetics, age, and hormones to name a few.
Simply speaking, what I learnt was that the placenta is full of amazing hormones that help baby grow. Unfortunately, some of these hormones can interfere with the effect of insulin in your body and impairs the way it is able to remove excess sugar from your blood. From what my GD team told me, given I had 2 placentas with my twins this made it extra hard on my body. I see it like the placenta saying “It's not you. It's me!”
The diabetes educators helped me understand what foods to eat and how much carbohydrates I should eat per meal to ensure enough energy is fuelling my body and also provididing the nutrients for baby to grow. I found that it can take a bit of trial and error to see what foods worked best for me and what didn't cause a spike.. lasagne and any pasta with bolognese worked well!
I ended up using metformin at night and eventually insulin to help bring my fasting levels down. Fasting blood sugar readings are typically the hardest to bring down as this one is mostly hormonal.
I thought I handled the GD well with my first pregnancy so when I fell pregnant again I felt a lot more confident I could manage it should I go through it again.
Second time around I was sent straight to an endocrinologist at 7 weeks and I needed to do a week of finger prick testing – fasting and after meals. After a week all my readings were high so my endocrinologist started treating me as a GD patient and put me on insulin straight away. It took me almost 3 months to get my fasting levels down which almost got the better of me. I also needed to take insulin pre-meals by 16 weeks because I was cutting too many carbs out to get my numbers down and found I was really low in energy. So I gave in and asked for the help. I cried a little at that point because I didn't want to accept that my body isn’t coping as well as last time. When I did ask for the pre-meal insulin it was also a relief because I knew my body needed the help.
I did a calculation and estimated that I would have had over 3000 jabs (finger pricks and insulin) over the course of my pregnancy. My photo above shows all my insulin pens that I used. Can't imagine how type 1 and 2 diabetics do this!
With GD, one of the main things that baby is checked for after delivery is their blood sugar. If they're
used to having high amounts of sugar in your blood passing through to them in utero their blood sugar might drop low when they are out as they no longer have their food supply from you. I was lucky with my 3 babies that only one had one slightly low reading at 24hrs after birth and that was it. I expressed colostrum (with the advice of the midwives) couple weeks prior to delivery to help with their sugars in case they had low readings.
In my opinion, the hardest part about it all is knowing who to turn to for help. Your GD team is always available for you to talk to if you have concerns about how you're tracking. There will usually be an educator or dietitian that can help with your food choices if you ever get stuck. I tried joining a support group on Facebook but when I was reading the comments I just felt overwhelmed by the information and because the groups aren't moderated by medical professionals, a lot of misinformation is thrown around.
This second time around I happened to stumble upon an Instagram account by a Melbourne Dietician who specialises in GD (Robyn Compton - @gestationaldiabetes_dietitian). This page was a lifesaver! It offered a lot of insight on how to calculate your carb intake, meal and snack ideas/choices, posts relating to different cultures and their choices, reassurances regarding diagnoses, managing the emotional side of GD, dealing with insulin, physical activity etc. It is by far the most informative page I have come across and I always recommend this page to anyone who is diagnosed with GD. Robyn often replies to DMs if you needed someone to chat to but always directs you to speak to your own health provider for your own specific needs.
I guess its the unknown that worries us when we're told we have GD. If you are diagnosed with GD, just know that once you start to understand what's happening that it's actually very manageable. Your GD team will help you along the way and there are plenty of resources available for you should you need to reach out.
