Friday, November 22, 2013

Gestational Diabetes - When Someone Else's Life is Depending on It Too

I have four children. I have dealt with gestational diabetes all four times, with it getting worse with each pregnancy. With my oldest, I wasn't diagnosed until my third trimester, then was able to control it with diet alone. He was admitted to the NICU for prematurity and never had issues with his blood sugar. With my second, I was diagnosed a few weeks earlier than the first time, but still able to control it with diet alone. She was also taken to the NICU as a precaution, but had no blood sugar complications.

Then I became pregnant for the third time. I developed hyperemesis and started having hypoglycemic episodes almost immediately. By that point, well acquainted with blood sugar monitoring, I started checking it at home from the beginning. About halfway through the pregnancy, I began taking oral medication which helped with the high sugar, but also caused more hypoglycemic episodes. That labor was traumatic and scary - after crashing from a reaction to something in my epidural and requiring two shots of epinephrine, my blood sugar tanked and then skyrocketed. At birth, she was hypoglycemic and needed formula supplementation for the first two days to stabilize her.

The fourth one was more like the third in terms of the blood sugar itself, but I was better equipped to deal with it than the time before. I was also on oral medication and intentionally avoided an epidural because of what had happened before. He was transitionally hypoglycemic, but required formula only a few times to stabilize.

All of my children were premature. None of them were large babies, they were all delivered vaginally. The most I gained with any single pregnancy was 24 pounds, but most were in the 15-18 range. 

I saw an endocrinologist once in all of that time. I refused dietary counseling after the first woman I saw condescended to me and talked to me like I was a child. She shamed me for coming into the pregnancy with some extra pounds, never bothering to ask why the timing worked out the way that it had. I wasn't about to explain the cancer or the miscarriage or the infertility to someone who didn't seem to think I could wrap my head around portion sizes.  

Help might have been nice. Instead I was shamed. Warned about all the things that could go wrong. Shamed some more. Told that I would need a c-section because the babies would be huge. I told her to just give me the monitor and I left.

I taught myself how to count carbs in a hurry. I knew it wasn't just my life depending on this. My blood sugar was always very tightly controlled. When it edged up, I called my OBGYN (who was smart enough to realize that I was smart enough to manage it) and we adjusted my dosages. I did struggle with fasting sugars, though, and for the last three pregnancies would get up in the middle of the night to eat and check myself.

Pregnant women need real resources to deal with this condition. Shaming them about being overweight and pregnant will not do anything to help them right now. Not long after I dealt with it for the first time, a friend of mine developed it as well. My very thin, very healthy, very athletic friend. Seriously, she's probably the most in shape person I have ever met in my life. And she still had to deal with it.

It doesn't just happen to the big girls. Honest.

Gestational diabetes has a genetic component to it, just like every other form of the disease does. It's fairly uncommon to have symptoms of GD, because the desired blood sugar range is smaller than with T2. Often the only way to catch it is with screening, and the mild form of it most often doesn't show up until the third trimester. For most women, it will disappear after birth (the placenta disrupts your body's use of hormones, including insulin), but approximately 50% of women who have it will develop Type 2 down the road, with those odds increasing with each GD pregnancy.

With 4 GD pregnancies and family history, I'm screwed.

There ARE real risks associated with this condition and I don't mean to diminish them, but I can tell you that scaring pregnant women isn't the way to go. 

My plea to those working in the fields of endocrinology, nutrition and obstetrics:

We don't need more shame, thank you very much. We're already terrified enough as it is. We're already beating ourselves up for having this. We're already worried about what might go wrong. We're already feeling bad. I promise. Don't make it worse. We want to be able to call you for help. Give us actual useful hints and tips about quick snacks, about restaurant menu items, about starchy vegetables and condiments and how they will affect our sugars. Tell us that we'll figure it out, that we'll get through this, that we'll learn to say nothankyou to all of the people in the world who try to feed pregnant women things we can no longer eat. Tell us that you will help us get through this, that we are a team and will do whatever it takes for a healthy baby. Tell us that this can be managed, and that it will be hard, but that we can do it.

With love and respect, the stories of other women who have dealt with this condition.

You mentioned the other day about having GD with your pregnancies. I was recently diagnosed and am having to learn that 1. We don't really have a diabetes friendly food supply. I literally find myself spending an hour or more at the store reading labels trying to find something that I "might" be able to eat. 2. You would think that with how common GD is (well diabetes period if we are being honest) that there would be more support from the medical community. My experience has been "this is where we want your numbers, so make it happen" and "well I'm sorry that having the numbers we need makes you feel out of it, you're just going to have to learn how to deal with that." I have honestly gotten more support and guidance from other moms than I have from with my dietician or OB.

If we are being honest I am finding that diabetes is in many ways like mental illness. To most people it is a big mystery and in many ways kind of taboo. We claim to be supportive and that we are working to make it easier to live with. The reality though is that we seem to just want to push medicine. I am one of those moms who won't even so much as take a Tylenol while I am pregnant because I don't want that to get to my baby. So how do you think it makes me feel that instead of getting any kind of guidance on how to make it work with my diet I am told "well we may just have to put you on a pill or do insulin shots"? I honestly think I have cried more in the last month than I have this whole pregnancy.
- Whitney Cauthen


When I was diagnosed with gestational diabetes, I didn't realize how scary it could be. I managed it well, for the most part. Controlled it by strictly watching what I ate and when. 

There were a few times that if my family hadn't been around, I don't know what would have happened. We hadn't been to one of our favorite Chinese restaurants in a long while. I thought, I will skip lunch and snack, so I can eat a little more there. I remember sitting on the computer and suddenly it was like I had no control over my body. I tried to stand up and immediately fell back onto the chair. I was shaking uncontrollably and freaked out. I remember telling Anthony I didn't feel so good and him asking what I needed. He brought me half a pb sandwich and some of his Dr. Pepper. When I stopped shaking enough to test I was at 52. I don't know how low it got, but it scared me enough to get it into my thick skull how important it was to mind my diet very closely. 

The rest of my pregnancy went well, and when Lydia was born, she was 9 lbs, 10 oz. She is 9 years old now, and am borderline diabetic. I have blood sugar drops, not nearly as scary as the time I told you about. I am trying so hard to eat decent meals, because I never want to live with diabetes again. My mom has type 2. My grandma (her mother) died from complications of type 2 and cancer. A cousin, barely 45 died from complications uncontrolled type 1. Several more cousins have had gestational diabetes. This disease runs amok in my family and has caused all kinds of pain and suffering. I hope eventually there will be a cure. Thanks for bringing awareness to this horrible disease. Hopefully someone will be helped by the things they read in your blog. 
- Rebecca Osborne


  1. When I was pregnant I was so scared. So many things can go wrong. All of that shame just make it worse and you get it for all sorts of things and from all sorts of people and even from people with conflicting views. Everyone thinks they are an expert on you and really they barely know you. So, I agree, quit the shame talk and tell people what to do now because we can't go back in time and become perfect before we get pregnant. We're already pregnant and nobody is perfect anyway and sometimes being perfect doesn't even matter.

  2. I have recently been diagnosed with this. I have no idea how to keep my sugars good. I have 2 weeks to figure this out before we are going to decide if I need medication. I am afraid. I would like to try to regulate this effectively. I don't like taking too many man made meds to "fix" things...please any advice would be great. And I am broke out in hives alot does that have anything to do with this disease?

    1. Hi Amanda! It's very overwhelming at first when you are diagnosed. My biggest piece of advice would be to ask to meet with a nutritionist asap so that they can help you set up a diet and exercise plan. Even under the world's most idea low carb diet and with daily exercise, there is always a possibility that you may need medication or insulin to regulate your blood sugars. It's especially important in pregnancy to keep it under control. Drink lots of water, stay active kinda have to eat like a robot, which is hard when you're pregnant. Really hard. I don't think the hives have anything to do with it, though. I'm sending you all my thoughts and hopes - GD sucks, but it can be managed. <3


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