The Shock of Gestational Diabetes
Some people are not surprised when they are diagnosed with type 2 diabetes. They know they are at risk. They have family members with type 2 diabetes. They have had conversations about diabetes with others who live with it. They have learned by observing others what it would be like to live with it whether it’s ‘true’ diabetes or diabetes related to pregnancy.
But for some of us, it was the shock of our lives. We have no family history of any type of diabetes that we are aware of. Oh, we have heard of ‘diabetes’ but like most people, we don’t always pay attention to what it is because it hasn’t directly affected us. With the diagnosis of gestational diabetes you learn very quickly that diabetes has entered your life. Questions then come calling.
Q: What is gestational diabetes?
A: The pregnancy has caused my body to have difficulty using the sugars the way it should be.
Q: Is the baby going to be ok?
A: Yes, the baby will be fine but there are things I will have to do to try to control the sugar load so the baby doesn’t grow too big for a safe delivery.
Q: Did I do something to cause this?
A: No. (But I did get pregnant. LOL.)
Although I jest, it isn’t funny when it happens to you. The last thing any pregnant woman wants to find out is that part of her body isn’t working the way it should when she’s growing a baby. Or that she may have type 2 diabetes later in life.
I had gestational diabetes
My diabetes journey started with my second pregnancy. Not my first, my second. Want to talk about shock? Looking back, I think my doctor had been monitoring me for this for a while before it actually surfaced or he said anything. Throughout the pregnancy, I had the usual blood work taken with no issues I was aware of. The routine blood glucose testing during pregnancy was done around 30 weeks at that time so I had it done. (Today the testing is done much earlier in the pregnancy). I didn’t think twice about what it might show. The doctor’s office gave me the news.
I had gestational diabetes.
If you want to scare the daylights out of a woman, tell her she has something that could/will affect her baby. Never mind that it affects yourself now or that you may havetType 2 diabetes later in life. You don’t care about yourself when you’re pregnant. Your whole focus is on the baby.
So what do I have to do to keep the baby safe? The advice at the time was this:
- Test your blood sugars before and after meals
- Eat three meals a day and snacks
- Ice cream at night before bed (I know what you’re thinking but that was the best practice at the time. Apparently during pregnancy your sugars tend to go low at night and can be stabilized by foods like ice cream, at least that’s what I was told. By the end of the pregnancy, I didn’t want to see ice cream for a very long time!)
- Within 30 minutes of eating your meal, go for a walk (try and mobilize a toddler to meet this kind of schedule especially when my husband was on afternoon shift. I have a huge appreciation for single parents, it’s a hard job!)
- Connect with the referred endocrinologist (This doctor was a hero to me. Towards the end of the pregnancy she had me call her after my walks with my blood sugar numbers. Even on the weekend. I didn’t get her answering machine, SHE answered the phone. The reason for this close monitoring was because I was very close to needing insulin to help control the sugars. Even though I walked a very fine line, I never did have any insulin during the pregnancy.)
**Please note, the best practice or best advice might be very different today and more individualized**
I did all of this because it was for the baby. Let me tell you, it wasn’t easy. But it was worth it. My son was born at 9 lbs 8 oz., the goal was for the baby to be under 10 lbs. Why was that important? During the pregnancy if the sugars are not well controlled, the baby gets all that sugar and, for lack of a better way to describe it, overgrows. This puts the baby at higher risk for complications at birth like dislocated shoulders, being too big coming through the birth canal; puts mom at higher risk for Caesarian sections. What I wasn’t aware of was the impact on the baby after birth. No one told me that because of the gestational diabetes, there could be a delay in my breast milk coming in. No one told me that he might need some formula if colostrum wasn’t enough. No one told me that when the baby stops getting the rush of the sugars from the pregnancy, that if they aren’t feeding well after they’re born, they get very sleepy from hypoglycemia. And can go so low, it’s tough to wake them up. I wish I had known that.
I had type 2 diabetes
I kinda knew I was at higher risk for type 2 diabetes within the next 10 years but with a new baby my focus wasn’t on me. My sugars however returned to normal. For ten years. Then it happened out of the blue. I was a ‘true’ diabetic. I had type 2 diabetes.
The best advice I can offer for any woman who is told she has gestational diabetes is try not to worry, the baby will be fine. Do the best you can to control your sugars during the pregnancy for the baby AND you. Contact a lactation consultant during the pregnancy if you plan to breastfeed so you can ensure you have a plan in place if your milk is delayed coming in. And also very important, get some support from a CDE regarding those higher risk factors for type 2 diabetes because you don’t know what may be coming down the line. You are worth the time and investment.
- Chapman, Donna J. Risk Factors for Delayed Lactogenesis among Women with Gestational Diabetes Mellitus, Journal of Human Lactation 2014, Vol.30(2),134-135.