I really debated posting about this because I didn't want to deal with mom shame/judgment from people. When I've told people that I was diagnosed with gestational diabetes, most people have responded with things like, "Oh, do you eat a lot of sweets?" or "But you're so healthy!" Neither of which are mean comments, but I think they reinforce the fact that there is a stigma of Gestational Diabetes (GDM) that it only happens to overweight/unhealthy people. Implying that if you do have it, you did something wrong. And that's just not necessarily true.
One of my very favorite things about blogging is its ability to connect people who are struggling through or celebrating the same things. There are some things that we go through in life that seem like we're the only people we know having to deal with it, and it just feels so good to read a story about someone else in a similar situation. It makes you feel like you're not alone, and you're not crazy.
While I don't blog as regularly/seriously as I used to, I still think its such a valuable thing in my life right now that I don't want to give up because of these connections I've been able to make with people.
But back to the point: GDM.
GDM runs in my family. My mom had it with both my brother and I, despite being healthy and 103lbs. My aunt had it with her kids too, and she was also young and healthy.
While sometimes a GDM patient looks a lot like a typical Type II Diabetes patient - overweight, sedentary, poor nutritional habits, etc. - there are plenty of women who are otherwise healthy who end up getting it. That's why they screen every pregnant woman with the 1hr blood test, and not just the ones with typical risk factors.
GDM is a defect in the way that your body produces insulin caused by pregnancy hormones, and anyone can get it, regardless of weight gain/lifestyle.
The 1hr Test
Like I said, every pregnant woman gets screened with the 1hr blood test. You have to fast for 3hours or so and then go into the OBGYN where they will give you a horribly sweet drink to chug. It tastes like if you added a cup of sugar to Gatorade. It's awful.
After you finish the drink, you wait an hour, and then they check your blood glucose levels. Depending on your doctor, the threshold of what's "too high" may vary. My doctor said anything about 135 would mean I'd need to do the follow-up 3hr test. My score was 141.
The 3hr Test
The 3hr test was one of the worst things I've ever had to do. I have experience vasovagal syncope too frequently (I pass out a lot. I think it's rooted in a phobia or anxiety, but it often happens around blood/medical things), so it was especially horrible for me. For this test, you have to fast for 12 hours, come into the lab, and they take your blood to check your fasted blood glucose levels. Mine was in the 60s. Then, you drink the sweet drink again, sit around for an hour, and they take your blood again. Then you sit around for another hour and they take it again. And then you sit around for a final hour, and they take it one last time.
If you throw up, you have to come back another day and start completely over again. Matt was out of town the weekend I did this test, so I brought my best friend with me to the lab (bless her). I did pretty good; having her there to distract my mind was definitely helpful. After the first draw, I wasn't dizzy at all.
The lab tech switched which arm she was drawing from for each test, and I wasn't anticipating that at the time of the second one. She walked in front of me to get to my other arm and I saw the needle (I'm usually really good at avoiding looking at it). I felt BAD after that one. I was afraid I'd throw up and have to start over. I felt like I was going to black out. I laid on the floor of the lobby and talked to my friend and watched How I Met Your Mother, and looked at photos of pretty interior design/puppies.
Going into the third draw, I told the tech that I would most likely pass out on this one because I was feeling really awful. She let me lay down for it, which ended up helping a lot. My dizziness started going away, and by the time I was ready for the 4th and final draw, I was way more excited about leaving the hospital and going to get Torchy's tacos than I was scared of the poke.
I didn't pass out or throw up, which is great! It was terrible, but it could have been worse for sure.
A few days later, the nurse at my OBGYN office called me with a very cheerful voice that got my hopes up too much. "We have the results back from your test!" she said in a tone that she could have used to say something like, "Are you ready to know the gender of your baby?"
"Unfortunately, you failed," she said, still cheerful.
She told me my results for each of the draws, and I can't remember what they were. Two of the four numbers were too high, which means I failed. I can't remember which ones were bad because I had so much on my mind when she was telling me.
Initial thoughts that ran through my head:
- What did I do wrong?
- Does this mean I'm going to have to give myself insulin shots and do finger pricks? I'd seriously pass out every single time I had to do that.
- Why me? I'm so healthy. I do all the right things. I follow the rules. This isn't fair.
- I'm embarrassed to tell anyone.
- What will this mean for labor/delivery?
- What will this mean for baby?
- Does this make me a high-risk pregnancy?
- Does this mean bed rest?
Worst Case Scenario
Okay, so worst case scenario (if I completely just did whatever the heck I wanted and didn't manage my blood sugar at all), I could end up with a chunker of a baby at like 15lbs. When the body can't process sugar properly, all the extra sugar goes to the baby who then gets fat.
Also, unmanaged GDM could end up with your baby having issues with blood sugar, doctors have seen big drops in blood sugar after GDM babies are born and no longer being supplied the crazy amount of sugar that their mom had been giving them.
My endocrinologist said that this happens pretty exclusively in women who don't change their diet at all. She said she had a patient who ate an entire box of Oreos once whose baby ended up having major blood sugar issues after his arrival. Obviously, I wouldn't be doing something like that even if I didn't have GDM, so she tried to encourage me that if I just make smart choices that I can have a normal delivery and a completely healthy baby.
She also said that while the internet will freak you out, telling you that you're now 7x more likely to develop Type II Diabetes in the next 5 years, that also pretty much only happens to women who don't eat well/manage their glucose during pregnancy. So most likely, it will completely go away as soon as the baby is out of my body.
Current Treatment Plan
When my nurse called with the results, she asked me to make appointments with an endocrinologist, a dietitian, and obstetrics. And I also have to start coming to the OBGYN once a week now and getting a stress test every time.
I went to obstetrics the very next day to get baby measured. They want me to do this once a month until he arrives to make sure he's not getting over-sugared and growing way too big.
He's actually measuring a week behind. Meaning I'm not over-sugaring him, and he's not growing out of control at this point. She said everything looks great!
A few days later, I made it to the endocrinologist. They pricked my finger to check my blood sugar (it was at a normal level, even after eating lunch), and talked to me about next steps/options. Considering the fact that I was already having to lay down when the doctor walked in the door, she told me that the most common approach (finger pricks before/after every meal) may not be the best option for me.
The alternative was to get this robot thing installed in my arm that would read my blood sugar every 5min. She said I'd need to keep a log of everything I ate and the time I ate it for the next two weeks and then we'd compare the results with my food log and come up with a plan of action. Ideally, she'll be able to say, just continue eating the healthy stuff you're already eating and you'll be fine.
The dietitian wasn't available for a while, so I still have to wait until next Wednesday to see her. This hasn't been ideal because I've been overanalyzing my food intake too much. Obviously, I've cut out sugary stuff and fruit juices. But being someone who primarily eats vegetarian, I typically eat a pretty high carb diet. Good carbs, but lots of them.
Right now, I'm scared to even eat sweet potatoes and brown rice. I don't want to get my levels too high to where she wants to put me on insulin. I wish the dietitian could meet with me sooner to calm my fears about this because I've lost 4lbs in the past week due to a dramatic decrease in carb-related calories. I know I'm not supposed to be losing weight right now. I just want her/him to be able to tell me something like -- you can have 15-30g carb at every meal. I can do that. I just want clear instruction/guidance from the dietitian.
I've increased my fat and protein intake. I went from eating fish/chicken once or twice a week to eating it at most meals. I went from having fruit and oatmeal for breakfast to having egg whites with peanut butter every morning. I am playing it safe, but maybe too safe at the expense of being hungry all the time.
I'll keep you guys updated with how my appointments with the endo and dietitian go next week. Hoping for a good plan of action.
I'll do whatever I need to do to keep this baby healthy, so I'm honestly not too worried about him. Probably my biggest fear is that I'll go to the endo next week and she'll look at my food log and say, "Wow, even chicken and broccoli puts your blood sugar over the edge. You're going to have to give yourself insulin shots in addition to eating very little carbs."
It's only 7.5 weeks until his due date, so if I have to eat sad, boring food for that amount of time, I can do it. But if I have to do insulin shots, I'd probably have to have Matt administer them to me so that I didn't pass out every day. Just really praying that I'll be able to easily manage this with small dietary adjustments.
Did any of you get GDM? One of my nurse friends said that a lot of their marathon runner patients end up getting it. I wonder if there's any science behind that.