Strategies for coping with gestational diabetes?

A close friend of mine is rather panicking right now as her pregnancy has progressed because she’s been diagnosed with rather serious gestational diabetes. Here’s what she told me:

“Was diagnosed at about 28 weeks and we are having trouble getting it under control. Diet changes and all – the #’s are still high. They were concerned at the Doc’s yesterday about baby’s tummy being ahead two weeks than the rest of his body – and of course scared the shit out of me. They upped my insulin to four times a day rather than just once a day… Do you know much about it?”

Can you help her with some advice or suggestions?

I have to admit that I don’t know much about gestational diabetes but am glad to report that we side-stepped this issue with our three pregnancies. Here’s what I could dig up on the National Diabetes Information Clearinghouse (a division of NIH) about gestational diabetes:
“Gestational diabetes is diabetes that is found for the first time when a woman is pregnant. Out of every 100 pregnant women in the United States, three to eight get gestational diabetes. Diabetes means that your blood glucose (also called blood sugar) is too high. Your body uses glucose for energy. But too much glucose in your blood can be harmful. When you are pregnant, too much glucose is not good for your baby.”
“Changing hormones and weight gain are part of a healthy pregnancy. But both changes make it hard for your body to keep up with its need for a hormone called insulin. When that happens, your body doesn’t get the energy it needs from the food you eat.”
This is all quite interesting, but I’m at a loss for helping out my friend.
Can you offer her some advice, suggestions or even calming words as she proceeds with the last trimester of her pregnancy? Thanks!

8 comments on “Strategies for coping with gestational diabetes?

  1. Our friend and surrogate had pretty serious gestational diabetes, and she had to inject two different types of insulin, 4x a day as well. Eating 6 small meals a day and really upping her protein really helped. Eat lots of nuts and lean protein, low fat dairy and lots and lots of veggies.
    Walking or swimming every day was really helpful at keeping the sugars low.
    A book on the low glycemic index could really be helpful. Our OB told us our baby would be HUGE and in the NICU because of the GD, but she was totally normally, 7 lbs, 7 oz and came right back to our room.
    It sucks having to check your sugar (ouch!) and injecting yourself, but you can still have a really healthy baby. Relax, exercise and eat small meals 🙂

  2. I had mild GD, but found exercise after eating really helped control it. I went for lots of walks. Best of luck to your friend.

  3. My OB put it best, “The baby has first dibs.” A mother’s body will feed the baby first, which is why we tend to have higher blood sugars (insulin resistance) as the baby grows–we just can’t absorb as much as we could before.
    Christie is right on; I would also throw in the advice to do *everything* your doctor tells you to do. This isn’t the time to attempt self-treatment.
    I had gestational diabetes during each of my pregnancies. Because my OB is brilliant and I did everything he told me to do (medication, exercise, and diet), both babies were under eight pounds.
    I’m happy to hear your friend got diagnosed and is getting treated. The only advice I can give to you is to give her a hug and remind her that the injections and restrictions will pass. :^)

  4. Gestational diabetes, because it is primarily an imbalance of blood sugar, can often be regulated by changes in diet and levels of exercise. The amount of changes that are necessary are dependant upon how poor the habits are that the mother have to begin with. Mostly changes consists of going on a low-sugar and low-carb eating plan. Gestational diabetes brings a risk of the baby getting too big during its gestational period and needing to be delivered early or by c-section. The more the pregnant mother cuts down on sugar intake, the less likely it is that the baby will get too large to be delivered vaginally.
    If you are pregnant or are thinking of becoming pregnant in the near future, take some time and learn about ways to prevent gestational diabetes. It is the best for you and your baby. Prevention is always a better option than having to find a solution to high blood sugar levels. Be wise with your food and exercise choices from the start and you should be able to avoid dealing with gestational diabetes in your pregnancies. Talk with your doctor and take every possible precaution.

  5. My midwife gave me a copy of the gestational diabetes diet she gives to all her patients. I’m not typing out the whole six pages in your comments, for which I’m sure you’re grateful, but just email me and I’ll scan it for you if you’re interested. The basics are 60 – 65 grams of high quality lean protein. Turkey, chicken, soybeans, legumes, that sort of thing. 83 – 84 grams of fat. Good fats, like olive oil, avocados, salmon (bonus protein, there and it’s not on one of the high mercury lists). 200 grams of complex carbohydrates. Nothing white. No white bread, no white flour, no white rice. Whole grains. The simpler the better. Old-fashioned oats are better than instant oats. Boiled whole oat groats are better still. Brown rice. Lots and lots of color: spinach, kale, beets, summer squash. Limit corn and carrots, they’re basically sugar. Only 1 small serving of fruit per day. Berries are best, apples and bananas are worst. Avoid artificial sweeteners. Use stevia if you need a sweetener, or agave syrup has a lower glycemic index than other sugars, but note that it is still a sugar. A lot of yogurts are too high in sweets. Greek yogurt is fabulous on this diet. Get the plain stuff, mix 1 cup Greek yogurt with 1/2 cup blueberries, and sprinkle some stevia on top and it’s the best. If she’s jonesin’ for some chocolate pudding try the above but substitute unsweetened cocoa for the blueberries, not as much, of course. I bet strawberries and cocoa would be divine too. A friend of mine recently had a VBAC after two c-sections with this midwife following this diet. I was on it myself until I had a miscarriage earlier. Anyway, hope this helps your friend.

  6. In addition to everything else said a major thing is avoiding the processed foods and the white flours, white potatoes and white rice. She can’t go wrong to get down to eating whole foods “foods in as natural state as possible”. Learning about high glycemic foods and avoiding all of them is key. Do everything the doctor says but I think sometimes regular OBs don’t tell enough about right foods/better foods. Even lots of doctors never discuss glycemic index with their patients which is ludicrious.
    Also once a woman has gestational diabetes she is at risk for developing diabetes afterwards. So any good nutritional changes to whole foods might have to continue afterwards to avoid insulin depenedent diabetes.
    On the extreme end I’ve read about people stopping (non-gestational) diabetes completely by eating a raw diet. Now that is radical!
    It is scary when we realize the foods we have been eating have gotten our bodies sick and the rest of the country goes on eating them like they are just fine.

  7. Hi,
    I had a very serious case of Gestational Diabetes that was also diagnosed at 28 weeks. Before I say another word, I’m going to skip ahead to the happy ending — my Katie was 7 pounds, 6 ounces when she was born, a gorgeous healthy miracle. She’s now 20 and a Regents Scholar at Berkeley who just got her nose pierced. (Just you wait, Mom!) So while my experience with GD is (yikes!) two decades ago, the fear I felt when I got the diagnosis will stay with me forever. Luckily, there was an awesome Diabetes Educator at the hospital who trained me in everything from using the Acucheck monitor to injecting myself. Once I got the hang of it, I started visualizing the experience as a Pac-Man game (I’m dating myself again) — I imagined these Pac-Men zipping around and devouring the evil blood sugar. It takes a while to get past the fear but it will help a lot to use the monitor, which gives you at least a semblance of feeling you’re in control. In those days, Excel had not yet been invented or I would’ve had my ‘sugars’ all neatly arranged in columns. I used two different types of insulin 4x a day — and checked my sugars in the am (fasting), pre-lunch, after lunch, pre-dinner, after dinner — and sometimes before bed.
    The regimen is uber-daunting at first but what kept me going was the idea that this was for my baby. In a really weird way, it almost brought me closer to her. I confess I am a helicopter Mom — maybe it started then? My sugars fluctuated wildly at first, too, despite exercise, diet and insulin. After about 2-3 weeks, things calmed down.
    Another godsend — two of my friends also had Gestational Diabetes. Sharing our experiences (from diet to insulin to amnios) really helped. If you can’t find a group or a friend who’s been through it, I urge you to check out, an awesome site run by a buddy of mine, that allows you to track your pregnancy, find other preggos, etc. I’m sure there must be a GD message board.
    In terms of size, my doctor did regular ultrasounds and two amnios to make sure the baby’s lungs were ready.
    Please feel free to get in touch. There is so much more that’s available today to help you medically — but emotionally, well, we parents need to help each other pull through. One of the toughest things about having GD is watching all these carefree pregnancies, where the happy expectant couple isn’t thinking about anything other than baby showers, decorating the nursery, PG Pilates and how soon can I lose the baby weight. Arggh! Sending good wishes and healthy energy, Sarah

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