I had my educational session at a diabetes clinic last week and wow – there is a lot to learn! I was very grateful that my nurse also had gestational diabetes (GD) and told me how angry she was when she was diagnosed. She said whatever I was feeling was valid and that set the tone for the start of our relationship. I appreciated that more than she likely knew – since I’m not the biggest fan of ignoring feelings and jumping straight to silver linings.
She started off by explaining what was happening in my body and assumed no background knowledge. While I knew some of what she was telling me, I liked her approach a lot so I’ll try to explain here in a similar manner. I’m no expert but I find it interesting and hopefully I relay the information in an easy to understand manner and definitely simplified.
Essentially, during pregnancy, your pancreas needs to produce 2-3x more insulin to process the glucose into energy for your cells. If it doesn’t, the glucose stays in your bloodstream and causes elevated levels in both you and baby. Baby’s pancreas then has to work a lot harder to try to produce enough insulin, which isn’t ideal.
She explained that I did not cause this and it is hormone-based during pregnancy. Family history and other risk factors do play a role in that but there’s nothing I could have done to prevent it. As frustrating as that is in some respects, it’s very helpful to know so that I can let go of any guilt that I’m feeling.
Managing this through nutrition and exercise is the best plan of attack, and sometimes even then someone will need insulin injections. Why insulin instead of medication? Because insulin doesn’t cross the placental barrier so you’re addressing the problem in the mom to help baby, rather than medicating both. She said that most women who need nighttime insulin injections do so because their morning glucose reading is high, and there’s nothing you can do about that as long as you’re following the guidance about what/when to eat before bed. Sometimes the pancreas simply can’t keep up with this intensity of insulin production and needs some help.
So, I learned exactly how to manage it based on my clinic’s requirements. Here’s an example of a day in the life now:
8am – Wake up – finger prick glucose test
8:30am – Eat breakfast (within 30 minutes of waking up – 15-22g carbs)
8:45am-9am – Walk at least 15 minutes
9:45am – post-breakfast glucose test
11:45am – Eat lunch (30-45g carbs)
12:15pm – Walk at least 15 minutes
1:15pm – post-lunch glucose test
3:15pm – Eat a snack (15g carbs)
6:15pm – Eat Dinner (30-45g carbs)
6:45pm – Walk at least 15 minutes
9:45pm – Eat a snack (either 30 minutes before bed snack 30g carbs or reg snack 15g carbs)
11:45pm – 30 min before bed snack if staying up late (30g carbs)
*Make sure to eat protein and fat with every meal and snack
***Eat “free foods” when I need more calories or if I’m feeling hungry (these are foods that have little effect on glucose levels)
Eating and testing times vary based on when I wake up but essentially I need to test first thing in the morning, eat every 2-3 hrs, walk 15 minutes after every meal, test an hour after every meal and make sure breakfast is within 30 min of waking up and my bedtime snack is 30 min before I go to sleep. I also need to follow their carb guidelines and track everything.
Now, this first week has been trial and error to see what works for me. Based on my morning test numbers, I don’t need insulin injections right now so that’s great! However, I’ll have to keep this routine for the remainder of pregnancy and because my body and hormones continue to change, my body’s response to glucose will continue to change.
One interesting piece is why I need to eat so frequently! Apparently, if you go longer than 3ish hours without eating, your liver releases stored glucose because it thinks you’re in a fasting state and your body needs it for energy. So if you eat after your liver releases glucose, you have glucose in your bloodstream from your liver and then also from whatever carbs you just ate – likely elevating your level if you don’t produce enough insulin to convert it all to energy.
Anyway, I’m really grateful that right now, I’m home a lot so I can really take the time to figure this out and follow somewhat of a schedule. As I continue to get more personal training clients outside of the house, I do wonder how I’ll manage such specific guidelines. I know women do it all the time with work and kids and all sorts of responsibilities but it is all I think about/plan for right now and I just hope it gets a little easier.
I am being proactive though. I created a spreadsheet with some of my most cooked meals at home and used MyFitnessPal to calculate everything so it fits within the required carb guidelines. This helped me come up with options for every meal and snack requirement that I can choose from as needed. I also found some restaurant nutrition information to come up with a few eating out options if I’m in a bind outside the house. It’s a start, and hopefully I can keep building on this list to help me stay on track with everything.
In the meantime, I’ll feel what I feel as my emotions ebb and flow and I will really try not to force myself into toxic positivity. I always feel pressure to suck it up and just deal with it with a smile on my face but sometimes I need to feel my feelings first. Yes, GD is completely manageable and 2-10% of pregnant women each year get diagnosed with it, but that doesn’t mean it’s a walk in the park. I had cancer… so I certainly have perspective and I know it will all be okay, but that doesn’t minimize my experience as I have to manage the situation. Additionally, I feel added pressure because I’m not only doing it for myself but I’m doing it to keep our baby healthy and hopefully prevent any future medical issues that could be caused by this. That’s a huge responsibility (as is being a mom, so this is just a start, I know). But I keep reminding myself that it’s okay to feel whatever it is I’m feeling as it can be so easy to try to force positivity and silver linings.
If anyone reading this is going through something similar – GD or not – know that your feelings are valid and you do not need to suppress them. Feel your feelings and work through them as best you can, with outside support if needed. You’ll likely get to a place where you feel better about the situation, but you don’t have to force it and there is no timeline. Remember, we’re still rising! ❤