Coping with Gestational Diabetes
I have Gestational Diabetes - what now?
Being told that you have Gestational Diabetes comes as a shock to any pregnant mother. I remember the day I was diagnosed with this condition. I had been to see my midwife for a regular check up at around 28 weeks of pregnancy. It was my fourth pregnancy and I was 39 years old. I had been feeling fine - I had aches, but being my fourth pregnancy I didn't find this unusual. I gave my usual urine test strip to the midwife and she did not look too pleased - there was sugar in my urine which concerned her. She told me that she was concerned about diabetes and sent me off to the pathology laboratory to have a glucose tolerance test. Even then, I was in denial - I never really believed there was a problem. I felt fine so there surely could be nothing wrong. The problem with this type of diabetes is that it is often silent - you don't feel unwell or sick so it can really catch you by surprise when you are diagnosed with it. When she called me and told me that I had gestational diabetes I felt my world was rocked. I cried and felt very disappointed in myself. I felt that my body had let me down in a big way. What I didn't realize at the time was that gestational diabetes can hit even the most healthy, fit women. It is not necessarily a reflection of poor eating or obesity. It has to do with your body coping with pregnancy and being unable to get the glucose to the body's cells. The good news is that this type of diabetes is treatable and usually goes away after pregnancy.
Am I at risk of developing gestational diabetes?
There are certain people who have a higher risk of developing this condition during pregnancy.
The High Risk Factors are:
- Women from certain ethnic groups including Melanesian, Indian, Chinese, Torres Strait Islanders, Polynesian, Indigenous Australians, Vietnamese and Middle Eastern women.
- Women who are over 30 years of age.
- Women who are obese or overweight.
- Women who have a history of Type 2 diabetes in their family line.
- A woman who has previously had gestational diabetes during pregnancy.
- You have sugar in your urine.
Managing my diabetes during pregnancy.
I was fortunate to have a very thorough midwife. She organised for me to receive treatment at the local hospital and to see specialists who could help me to manage my diabetes. It was a bit overwhelming receiving so much information and instruction all at once, but I had tremendous support from my family and the health system. The following suggestions should help you to begin to manage your diabetes.
- Monitor your glucose or blood sugar levels. This is done by using a glucose meter and strips to measure your levels. Ask for a demonstration on how to accurately measure yourself. It can be a bit daunting doing this up to five times a day but it will help you to plan your eating and snacks thoroughly and to keep your glucose levels stabilized.
- Diet is very important in maintaining stable blood sugar levels. I was referred to a dietician and this was very helpful with planning a menu and knowing what portion control to exercise. Make sure you eat the right foods regularly - avoid sugary treats like cakes, candy and fizzy sodas and make sure you never skip a meal as this can lead to a sugar low which will leave you feeling shaky and unwell. A diet that is full of fresh vegetables, protein and grainy carbohydrates is good for you.
- Exercise is also good for maintaining stable glucose levels. Moderate exercise helps your body to process glucose. A half hour walk or swim is good exercise if you are pregnant as it does not place too much strain on your body.
- Medication/Insulin - Initially your healthcare provider may suggest you control your diabetes with diet and exercise. This happened to me and I was very diligent with it, so I was very disappointed when it did not help. Again I felt my body had let me down. Do not feel upset if you need medication or insulin to help control your sugar levels. There is nothing wrong in using them and your baby will be safe. It may be safer to take medication as your baby will not grow too large as a result of too much glucose, causing other problems for you at birth. I participated in a trial and so was chosen to use insulin as my method of treatment. A health care worker will show you how to administer your insulin. Insulin is usually the preferred choice for treating diabetes as it controls sugars better than oral medications, however there are other options as well. Metformin is also used and safe during pregnancy (also known as Glucophage,Diformin, Glumetza and Glycon).
- More Frequent Check ups - You will probably have more check ups with gestational diabetes as the baby's growth and weight are carefully monitored. This is because your extra glucose is passed on to your baby and we all know that too much sugar makes one gain weight. This leads to bigger babies at birth. This may also mean extra prenatal scans to accurately assess baby's weight and size.
- Log your Results - You will need to keep a log of your sugar level results - your healthcare provider will show you how to read them and adjust your levels of insulin accordingly. My experience was that after a while I had to increase my insulin levels as I got used to certain levels. Do not worry or stress about this - it is possible for this to happen and won't harm you if more insulin is needed. If you have any concerns, talk to your doctor.
- Look after yourself - Make sure you look after yourself and have time to relax. Taking care of your feet is important as diabetes can affect your feet. Get a soothing foot rub every day from your partner. Take time to plan each evening for the next day so that you are not caught unprepared. Have an idea of what you will eat and an approximate time that you will eat your meals. Keep some handy, healthy snacks like a nutritious muesli bar or protein bar in your handbag for emergencies and moments when your plans change at the last minute. I suggest that you also keep a small bag of jelly beans in your purse in case you have a sugar low and feel strange. This is a quick fix for these moments. Carry your insulin kit with you at all times so you are prepared. When eating out, select meals that don't have huge portions of carbohydrate. Carbs are important for you when you have diabetes, but too much of any carb will send you blood sugars up. The idea is to keep your blood sugars as constant as possible and we do this by learning portion control.
Having gestational diabetes is challenging but it is not the end of the world. It is for a season. I found that adapting my habits was easier than I thought because my baby's health and welfare was uppermost in my mind. You don't have to feel restricted and deprived as there are ways to add foods to your diet that are tasty and healthy.
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