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Wait, I Have Diabetes?!

Gestational Diabetes was the last thing on my mind when I got pregnant in June.  According to the Mayo Clinic, I am not supposed to get Gestational Diabetes.  Here are the risk factors;

  • Age greater than 25. Women older than age 25 are more likely to develop gestational diabetes. — Ok, yes, this is me, but most websites say age greater than 35.  Heck, my mom was 41 when she had my brother and she didn’t have GD!
  • Family or personal health history.Your risk of developing gestational diabetes increases if you have prediabetes — slightly elevated blood sugar that may be a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes. You’re also more likely to develop gestational diabetes if you had it during a previous pregnancy, if you delivered a baby who weighed more than 9 pounds (4.1 kilograms), or if you had an unexplained stillbirth. — Nope
  • Excess weight. You’re more likely to develop gestational diabetes if you’re significantly overweight with a body mass index (BMI) of 30 or higher. — Nope
  • Nonwhite race. For reasons that aren’t clear, women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes. — Nope

But, what does the internet know?  My numbers showed around 28 weeks that I do indeed have Gestational Diabetes.  This news came two weeks after my doctor took my belly measurements and told me “you’re going to have another small baby, he’s probably been around 7 pounds”.  Funny, a week later he said “just be careful with your diabetes, as you don’t want your baby to get too large”.  Umm, what a stark contrast to just a week before!  At first, I was convinced my numbers were wrong. There was no way I could have GD.  I have been continuing to work out for at least 30-minutes on most days of the week, I’ve kept a fairly healthy diet (aside from the everything bagel with lots of cream cheese cravings, and the nightly 1/2 cup of ice cream with chocolate sauce).  I assumed the numbers must have been higher because I’d had a really bad cold for about eight weeks, which had morphed into an ear infection, yes, that was why my numbers were high; I was fighting an infection!  No, they were high because my placenta is producing more of the hormones that impair the use of insulin in my cells.  Period. End of story.  Off to the pharmacy, I went to get my glucose meter, lancets and glucose strips (btw, who knew glucose strips were so expensive?!)

After meeting with a nurse practitioner who suggested a 2000 calorie diet, and 300 grams of carbohydrates per day, I went ahead and created my own plan (because, well, I’m a dietitian!).  I counted my calories for a couple of days and realized, similar to my previous pregnancy, I was eating about 1600-1800 calories.  Yes, this isn’t a lot, I know, but I am a petite woman and this has worked for me.  I eat when I’m hungry, I don’t force-feed myself, I’m gaining weight at a great pace and my doctor has no concerns.  I took about 45% of that and it’s about 180g (175 is the minimum amount of carbs a pregnant woman should eat). But I’ll admit I went a bit lower, aiming for 130-15og/day.  My numbers have looked great, and I felt great after starting to really watch my carb intake and attend to eat similar amounts of carbs at around the same time of day each day (roughly). It’s been about three weeks and I’ve managed to get my carb intake up to about 150-180/day without having high numbers and continuing to put on weight at a good pace.  I’m filling my calories with;

  • Fatty fish (salmon mostly) – omega-3 and protein
  • Fruits and vegetables — fiber, hearty carbohydrates, folate, iron
  • Greek yogurt, almond milk, and String cheese — vitamin D and calcium are so important!
  • Peanut butter — late-night snack is 1-2 rice cakes with 1-2 Tbsp of peanut butter
  • Eggs and beans — I crave these. Eggs are carb-free, and beans have lots of carbs but the fiber and protein in the beans help attenuate Blood Sugar spikes

My best diabetes ally is exercise. On days I exercise I give myself about 150-180 g/day (exercise is my body’s insulin).  On days I am not active (about two days a week) I aim for the lower amount; 130-150g (typically getting more like 145g).  My sugars have been good.  Here is a look at my daily eats;

Breakfast: 35-40 grams carb (1000-2000 IU vitamin D supplement and my prenatal every morning)

  • A small bowl of cereal (Frosted Mini-Wheats) with half a banana and unsweetened almond milk
  • Cinnamon toast with the lower-carb bread (7 grams/slice).  I do two slices with butter, cinnamon, and Stevia.  I eat this with a Triple Zero Greek Dannon Yogurt.

Snack: 15-30 grams

  • Nugo Slim
  • KIND bars (they have several varieties with 15-20 g carbs)

Sometimes I eat more..such as half a small muffin or another half of a bar if I’m still hungry.  This is also the time my heartburn starts to act up…not sure why.  So, I tend to take a couple of TUMS, with 1.5 g carbs/one.

Lunch: 40-45 grams

  • Large salad with quinoa, lots of non-starchy vegetables, hardboiled egg or chicken.  I have this with a small bag of popcorn (10 g carbs) and a piece of fruit
  • Brown rice bowl; brown rice, sweet potatoes, cheese, chicken or salmon, lots of non-starchy veggies on top
  • Flatout Wrap with hummus, veggies, and feta cheese.  Sometimes I add canned tuna or salmon. So good!  I pair thing with yogurt or a piece of fruit

Snack: 15-20 grams

  • Small banana or apple and peanut butter (really into the Smucker’s Natural)
  • Greek yogurt and berries
  • Another bar, sometimes
  • Every once in a while I just want o splurge and I’ll eat half a large Orange and Cranberry muffin forms our dining halls.  They are vegan, so they are healthy.  JK

Dinner: 30-35 grams

  • Scrambled eggs with my low carb toast, a side of vegetables and some Greek yogurt and sriracha on top
  • Soup; I’m into canned soup.  I also make my own in the slow cooker sometimes. I always get a nice hearty bread from our local bakery to have with my soups at dinner!  I made this Cod Stew the other night and fell in love again.
  • Bowl of canned lentils (lower FODMAP) with an egg on top, Greek yogurt, avocado, and sriracha.
  • Flatout wrap with black beans, cheese, sometimes chicken or egg, side of roasted broccoli

Snack: 15-20 grams (I eat a snack right after taking my evening blood sugars.  The snack always contains some type of protein. Protein and carb as a light snack before bed is good for nighttime blood sugar control. My morning blood sugars have been great)

  • Frozen blueberries topped with Greek yogurt (plain) and Cool Whip Light (sometimes some unsweetened cocoa powder)
  • 1-2 Rice Cakes and 2 Tbsp peanut or almond butter

My doctor says I don’t need to track for much longer, but truth be told I will probably take my morning sugars every single morning until I give birth (and I’ll also take them on days I don’t work out).  I don’t want to take any chances here, as I know how poor blood sugar control can affect both me and my baby.  Look how crazy my notes are!

Some things I’ve noticed;

  • Protein is important.  If I eat a meal with 35 g carbohydrate and zero protein, my numbers aren’t great two hours later.  If I eat that same meal with some protein (even just 10-15 grams)  they are typically fine two hours later.
  • Workouts are important.  On days when I’m sitting a lot, I notice that my blood sugars aren’t as good (sometimes it carries on to the next day!)
  • My nightly snack of rice cakes and peanut butter is the perfect combination of carbohydrates, fat, and protein to keep my sugars under control at night.  My morning blood sugar levels have been great.
  • When I eat out and my meal spans over a longer period of time (such as 90 minutes last Saturday!) my 2-hour postprandial reading is a bit high (I think this is to be expected).
  • I do much better when I get most of my carbohydrates earlier in the day (from breakfast, morning snack, and lunch) and less in the late afternoon and evening.  This makes sense, as I’m more active in the morning and early afternoon.

Do you have any experience with Gestation Diabetes?  What did you learn during that time?  What questions do you have?

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