TALK THURSDAY: My GD Survival Kit

In the previous post, I had spoken about the lessons I learned as I navigated my way through gestational diabetes.  Today, I’m going to talk about the tools I used (and was given to me) to manage it.

The Meal Plan

Like I said in my previous post, meal planning was the highlight of this journey.  I believe I got very lucky with my provider.  My nurse truly took the time to learn what I eat regularly, my preferences and indulgences, and constructed my meals according to it.  Because of that, it was easy to follow and adhere to.

My initial meal plan started out like this. We adjusted and substituted once a trend started showing in my glucose readings.

Another thing that helped tons is My Plate.  For the days when my food options are limited, My Plate presented a plethora of substitutes for my meal requirement of the day.  It’s also available online, but my old soul really loved the booklet my nurse provided.

Glucometer

This is covered by my insurance, thanks to my OB’s prescription.  Surprisingly, my nurse also provided me with one, so I had one reader for the house and another in the bag I would bring whenever we would go out.

There are a lot of options out there but my insurance only covered AccuChek.  I ended up getting the AccuChek Guide.  It’s pretty easy to operate and quite compact.  It came with a carrying case that can house lancets and strips, as well as alcohol pads.

Apps

I downloaded two apps specifically for monitoring my glucose levels:  Glucose — Blood Sugar Tracker and See How You Eat.  I know AccuChek has their own app, but I liked that one better.

With this glucose tracker, I was able to set reminders when to take my readings.  I was also able to generate reports of my numbers that I would send to my nurse every week.

SHYE is to make sure that I am eating right.  It was something that my nurse looked forward to because she loved seeing how I plated my meals.  Because portions were very much controlled for me, I made sure to make eating a treat.  Seeing photos of my food also gave my nurse an idea of what I actually eat, allowing her to adjust my meal plan accordingly, removing my triggers and reducing my sugar spikes.

For both apps, you will have to pay for a premium subscription to keep all your data.

Insulin Pen

Unfortunately, even with my diet and 30 minutes of daily speed walking, my fasting number wasn’t going down.  It was the one number we cannot control through diet and I was referred to another maternal diabetes specialist, who decided to put me on Levemir.

I looooved this pre-filled pen.  I mean, it’s not like I was so happy to be put on it; I prefer pricking myself less thank you very much.  But push came to shove and it was the best thing for our baby at the time.  I would inject this in my belly at night, and it helps bring down my fasting blood sugar significantly.

Cold Pack

I’m not as brave as I make myself out to be, and the first few weeks of being on insulin, I was still scared to inject myself.  I had The Husband do it, and I can tell he was as nervous as me.  The cold pack helped numb the injection site for a bit, but I do have to emphasize that the needle is very short and thin.  After a while, I didn’t need the ice pack anymore, but it was nice to have it handy for the nights when I feel extra sensitive.

More Scans and Tests

Because of the insulin, my entire healthcare team has put me on close monitoring.  I would report once a week for an ultrasound to check the baby’s growth (if he’s growing too fast, I will have to be induced to deliver early), and some days I would go straight to a non-stress test for the baby.  I would also go in every couple of weeks for a biophysical profile.  Then another visit to the OB to check on my well-being.  I must have seen a doctor/nurse at least 3 times a week.

When I said in my previous post that I felt so safe, I was not kidding.  Every step of the way, I was monitored (and well poked and prodded within reason), making sure that the baby and I are safe and within the normal limits.  Because of this, they were able to catch my amniotic fluid levels on time, leading up to the delivery…

Which is another story for another time :)

How about you?  How did you manage your GD?

FEELS FRIDAY: Lessons from Gestational Diabetes

As I attempt to catch up on my blog posts, I will be talking about bits and pieces of my pregnancy journey. While we are not expecting again, I hope these bits will help the next mom — and maybe kind of remind me what I had gone through to try to replicate or do better in the future.

This was one of the hardest parts of my pregnancy so please bear with the lengthy post.  I’ve also included links to some additional reading regarding gestational diabetes mellitus. 

If there’s one thing I was dreading throughout my pregnancy, it has to be the oral glucose tolerance test. I had heard so many horror stories about it and I was not looking forward to it at all. But when Week 25 came around, I was given the go signal to head to a lab for the test.

The first time, it was a drink. And OMG WAS IT A DRINK OR WHAT. It was sweet af and I couldn’t chug down it faster. I was reminded yet again of why I do not drink soda — that was the worse than soda. After a few (or one???) hours, they drew my blood and I was told results would be sent to my OB within the next 2-3 days.

The clinic called and told me I barely passed. According to the Mayo Clinic, normal range for the one hour test is 140 mg/dL. I was probably at 139. The NP offered two options: (1) start treating me for gestational diabetes or (2) see if I can pass the three-hour test. This brings me to the first lesson.

Lesson 1: Just get treated as a gestational diabetic.  My ego was so determined to pass the three-hour test, so I opted for that one.  Another week passes, and nope. It was a massive failure.  I didn’t even pass the fasting numbers.  And I had to kick myself because the smarter option was to just go ahead with the diabetes program.

12-10-19_DN_OGTT-Gestational-Diabetes

As soon as we got the results, we were setup with a nurse specializing in diabetes management.  If I didn’t insist on that three-hour test, I would have started managing it sooner.  So if presented with that option again, I would just go ahead and choose to be treated with GD.  The sooner this is managed, the better for me and the baby.  Because…  

Lesson 2: Gestational diabetes can be manageable.  I thought a one-hour block was enough to meet with my nurse.  Nope.  I ended up talking to her for 2.5 hours.  I don’t think I’ve ever consulted with a health professional for that long in my entire life.  During that time, we talked about the following:

  • Frequency of testing my blood sugar level:  four times a day — upon waking up and an hour after the first bite of every meal
  • Required activity level:  30 minutes a day with heart rate at 100-150 bpm, preferably speed walking
  • Required caloric intake and portions
  • Meal plan from that point forward until 6 weeks after delivery

The meal plan was my favorite part of this consultation.  She took her time in asking what type of foods I eat, how frequent, and even asked about my indulgences (fast food, desserts, and the like), based my meal plan on my responses, and because of that, it was easy to follow.   The main thing she highlighted was portioning.  It’s the tale as old as time:  too much of something is not good, so every component of every meal was moderated.

AAA

Another thing:  because I was sending my sugar numbers every week, we were able to pinpoint the type of food that triggers a high glucose reading.  The meal plan was then adjusted accordingly, and we looked for substitutes that are as accessible and as tasty as the one replacing it.

One thing that that she emphasized was the importance of carbs in my diet.  We determined early on that rice is the main culprit of my increased glucose levels (ASIAN LIFE <3) so I started removing rice altogether from my meals.  I was able to meet my glucose levels, but she called me out for not substituting rice with another starch.  She advised that I cannot go into ketosis and start using my body fat for energy because the baby needs my body fat, so my energy has to come from carbs.  This is of course an oversimplified explanation of the whole thing, but that’s my takeaway from it.  Right after hearing that, I started substituting rice with quinoa.  All is right again with the world.  Or is it?  This diagnosis really fckd with my head until I came to realize…

Lesson 3:  It’s not my fault.  Did I welcome the diagnosis with open arms?  Of course not.  While I have not been the most consistent person in terms of physical activity/exercise during the course of our getting pregnant, I do make conscious decisions about my diet.  It was very hard to accept that I was a diabetic.  Even The Husband didn’t understand how I “caught it” because I’ve always made healthier choices.  My OB was quick to clarify that it is through no fault of my own.  She phrased it as another “mystery gift” of pregnancy.  She even went on to say she’d had patients who compete professionally in CrossFit turn out to have GD as well.  It is not my fault.

And I wish I accepted that sooner.  I wish I didn’t waste time thinking if I had continued going to the gym regularly or if I had gone meatless every other day or if I just didn’t have that last bubble tea.  I spent a fair amount beating myself up for it when I really shouldn’t have because…

Lesson 4:  There is an end in sight.  I’m not going to pretend that I didn’t eventually get sick of pricking my fingers.  At one point, I didn’t know where else to prick myself.  I even had to go on insulin because my fasting numbers weren’t ideal, so that’s another injection site that completely ran out.  But there is an end in sight… and it is childbirth.

Almost immediately after giving birth, they took my blood sugar reading and it was normal.  The woman’s body is insane.  Hahaha.  I swear, I don’t understand how that all went down but it did.  There are more details to come with my son’s birth story but yeah, everything pretty much went back to normal after he popped out.

Important thing to note though:  I was advised by my nurse to continue the course of my meal plan until I get tested again for Type 2 Diabetes.  She mentioned that some 60% of women diagnosed with gestational diabetes develop Type 2 Diabetes within 7 years after giving birth, a statistic that hit close to home when one of our friends hopped the diabetic train early last year.  She had advised if I’m breastfeeding, follow the current plan. Otherwise, slash 500 calories off of the daily meals.

Oh, and another thing!  Because I was diagnosed with GD with this pregnancy, my OB said they will have to test me earlier (like at least 20 weeks) for GD if I choose to get pregnant again.  Chances are, I will ride this train again, but there is no way in actual hell will I ever drink that nasty drink ever again.  I’d rather be categorized as diabetic and “endure” the pricking and dieting throughout my entire pregnancy.

Why you ask?  Because I have never felt safer.  Going into my pregnancy, I was experiencing a lot of anxiety and worry.  But when I got diagnosed with this illness, at least three more healthcare professionals are checking in on me, on top of my OB, every week.  And each week I was presented with numbers and images, each week I had solid proof that my pregnancy was going well and that my baby was safe.  I don’t know about you, but I absolutely loved the extra medical attention.  It kissed my anxieties away (at least for the time being).

There’s more to my GD journey than these four lessons, and those are reserved for another time.  But for now, if you are reading this and you are experiencing the same thing, hang in there and hang tight. Your medical team has you covered and this is but a bump in your journey to motherhood.

Thanks everyone.