Dipika is a pharmacist who specializes in diabetes. With her first-born, she experienced Gestational diabetes, which is more common amongst pregnant women than we had realized. In this post, she shares with us the medical advice and the treatment she was given, along with feelings of her personal experience.
I was around 24 weeks pregnant with my first-born when my OB/GYN told me I had gestational diabetes. Gestational diabetes (GDM) is a form of diabetes you only get while being pregnant. The exact cause is unknown but thought to be due to the production of hormones from the placenta. These hormones block the production of insulin from the pancreas which in turn increases the glucose (i.e. sugar) in the mother’s blood. I wasn’t exactly surprised or scared to hear that I had GDM as I have a long family history of diabetes. Even though my family history made me higher risk, it’s important to note that ANYONE can develop GDM as it’s more the production of hormones from the placenta.
Upon diagnosis, I thought, how hard can this be? I have my patients monitor blood sugars, exercise, take medications and watch what they eat all the time. Oh was I wrong! It was a lot harder than I had anticipated.
The first thing I needed to do was to take a closer look at what I was putting in my mouth. My diabetic specialist helped create a tailored and personalized meal plan just for me. My meal plan was very restricted but it doesn’t necessarily mean everyone’s will be since each plan is individualized to the person and their circumstance. It’s important to know you don’t have to give up all the foods you love, it’s all about moderation and reading the food labels. One of the biggest things you want to focus on is your carbohydrate intake. Carbohydrates are broken down into two types: simple carbs and complex carbs. Simple carbohydrates raise your blood sugar right after you eat because they get broken down faster, whereas, complex carbohydrates take longer to break down in the body causing sugar in the blood to rise more slowly. My typical meals included the following:
- Breakfast: 15-g of carbohydrates (i.e. 1 serving of a carb=1 slice of bread) with lots of protein (e.g. egg whites or vegetable sausages)
- Mid-morning snack: also only 15-g of carbohydrates ( e.g.1 small apple) with some form of protein (usually peanut butter or handful of almonds)
- Lunch: I was allotted slightly more carbs (yay) but only 30-g ( e.g. usually grilled chicken salads)
- Mid-afternoon snack: 15-g of carbohydrates ( e.g. a few crackers and cheese or fruit and string cheese)
- Dinner: 30-g of carbs with lots of proteins (this is where I learned to be very creative with recipes)
- After dinner snack: couldn’t give up the ice-cream so i would have ½ cup of vanilla ice-cream with handful of walnuts mixed in it (15 g of carbs + 1 serving of protein)
This meal plan doesn’t look like it would keep anyone full, but surprisingly I was never hungry and learned a lot of creative recipes of my favorite foods. Outside of being conscious of what I was eating, I had to check my blood sugar first thing in the morning and 1 hour after each meal. I’d then send weekly reports of my food diary and blood sugar readings to my Certified Diabetes Educator. In return, I would get a ‘report card’ on my health that told me how I was doing. I’ll be honest, I started slacking by the end as I had a good feel for what I was doing. I know all of this sounds like a lot and very annoying to monitor and keep track of, but trust me it’s not that bad; you learn so much about yourself and healthy eating during this time period. It’s important to take care of yourself and your unborn child.
If GDM is left untreated, it can lead to several complications for the baby such as birth defects, being too big, and too much insulin in the blood at birth which can lead to other complications. Don’t worry though, you can still have a healthy baby with GDM.
So, what did I do to ensure my blood sugars stayed control without need of medications? I watched what I was eating, took weekly yoga classes and educated myself of GDM. However, if you do need to take medications, don’t worry the outcome can be the same as long as you control it.
Here are a few tips to go by if you do get diagnosed with gestational diabetes.
- Do NOT skip meals. Skipping meals may lead to low blood sugars which are dangerous.
- Breakfast is the most important meal to control intake of carbohydrates because blood sugars are usually the highest in the morning.
- Eating more frequently every 2-3 hours help stabilize blood sugars and prevent sudden spikes or drops in blood sugars.
- Avoid juices, sweets, refined carbohydrates (i.e. white rice–TRUST ME AVOID THIS ONE), saturated fats (i.e. butter) and caffeine as much as possible
- Eat foods high in lean protein (i.e. chicken, turkey, legumes, tofu), good fats (i.e. avocado, olive oil, grape seed oil), and fiber (i.e. quinoa, oatmeal, other whole grains)
- Drink plenty of water at least 8 glasses per day
- Eat lots of veggies but be careful not to have too much fruit as that is a natural sweetener and can still raise your blood sugar
- Exercise and stay active
Even though all this was only for a short time period for me, I am not out of the woods yet as I am now considered a high risk for developing diabetes later in life, not only because of gestational but also my family history. Remember that just because you had gestational diabetes with one pregnancy doesn’t mean that you will have it with every pregnancy. Each pregnancy is different. Looking back, even though it was difficult, I am glad I had gestational diabetes because it taught me self-discipline on leading a healthier lifestyle. As a result, I am now able to better relate to my patients and be more sympathetic/empathetic to what I ask of them since I too had to endure what they are going through. I now practice what I preach for a healthier lifestyle and overall well-being as diabetes is something that is very preventable.
Dipika Patel, PharmD, BCPS, CDE