Wednesday, May 15, 2013

Gestational Diabetes Part Two: Dealing with the Disease

In my last post, the Diagnosis, I wrote about how I found out I had gestational diabetes, what causes it, and what that meant in terms of mine and my baby's health. This post is about what happened after the diagnosis and how I have been coping with it. I will also be throwing in a few tips for anyone who might be interested.

The first thing I did after my diagnosis was make an appointment with an educator and then a nutritionist. The educator discussed with me the causes and the risks involved and the nutritionist helped me come up with a healthy meal plan to try and keep my diabetes in check without insulin.

 (Something important to note: While I have been lucky enough to keep my glucose levels under control with diet and exercise this does not work for everyone and if it doesn't work for you, it is not your fault. During pregnancy your pancreas needs to create three times the normal amount of insulin and it just so happens mine was only a little behind.)

I was terrified of the idea of having to inject myself with insulin. The first time I had to test my own blood glucose I cried because I just couldn't handle the idea of pricking my own finger. I knew the pain was minimal and my issue was psychological, but it took me awhile to get over it. Insulin would have been worse because I would have had to inject a foreign substance into my body. I think that would have been much harder for me to get used to than pushing a button and not even being able to see the tiny pin go into my skin.

Consequently, I became more than a little OCD about sticking to my meal and exercise program. Even readings which came close, but did not go over my maximum level, sent me into a panic. I kept detailed notes on everything I ate, when I ate it, and what kind of exercise I did before or after eating it. Eventually, I learned how how my body responded to different kinds of sugars and carbs and the best times to exercise to get my insulin moving for the most benefit.
 Morning is a big issue for most women with gestational diabetes. As you wake up, your liver floods your body with extra sugar to help you start your day. That meant that my first meal had to be as low in carbs as could be. It also meant that the carbs I chose needed to be complex whole grains, not fruits or sugary snacks. I once made the mistake of having a banana for breakfast. That caused the largest spike I had ever had. I figured bananas didn't taste as sweet as other fruits so they probably had less carbs. WRONG. Bananas have about 30-45 carbs per fruit.

 For my meal plan I needed to eat 15-45 carbohydrates per meal or snack and 1-3 oz of protein. The proteins were to fill me up while the carbs would give me a more immediate sources of energy. Since pregnant women (and non pregnant people in general) are supposed to get no less than 175grams of carbohydrates a day this meant quite a few meals and snacks throughout the day to reach my goal. I quickly found that for breakfast it was not a good idea to go over 20g of carbs, and they had to be whole grains. I would usually have a snack before lunch of about 30 carbohydrates, after that, every snack or meal was fair game as long as I didn't' go over 45g of carbs and took a brisk walk for about ten minutes after eating (walking gets things moving).

The 1-3oz of protein at a time was important because for someone my size (I am only 5'-2.5") my body can only process up to three ounces of protein per hour. This does not mean it would take me two hours to process 6 ounces of protein, it means that my body would process and use the first three ounces and then waste the other three by turning it into more glucose or storing it as fat. So if I ate 3 ounces of protein, I needed to wait an hour before eating any more. Since protein digests slowly, three ounces of protein should keep me full for 1-4 hours, while 30g of carbs would only keep me feeling full of about an hour. That is why if you have cereal for breakfast you feel hungry more quickly than if you were to have bacon and eggs.

This is what an average day looks like for me:

9:30 AM (Breakfast)
1 (poached) egg and 1/2 Whole Wheat English muffin  within range of protein 16g carbs

11:00 AM (Snack)
1 cup of Cheerios in 1 cup of milk and half a kiwi  45g carbs

10 Min Walk
1:45 PM (Lunch)
1 cup black beans with 3 ounces of ground beef, bell peppers, and onions  within range of protein 30g carbs

3:00 PM (Snack)
1/2 cup of Fluff 15g Carbs (Recipe)

4:00 PM (Snack)
Peanut butter sandwich on 100% whole wheat bread (2 tbs peanut butter) within range of protein 34g carbs

8:40 PM (Dinner) 3 oz of chicken breast, zucchini, cauliflower, lima beans, carrots, and homemade sweet potato chips within range of protein 30g carbs

10 Min Walk

10:00 PM (Snack)
1 banana and 2 TBS of nuts within range of protein 32g carbs

Water throughout day: 10 cups

Daily Carbs = 202
All Protein within range
All Glucose readings <target levels

Picture of my lunch:

The most interesting thing for me is that I didn't really have to change WHAT I ate as much as WHEN I ate it. I had to separate my meals into smaller snacks. I wasn't starving myself, I was just eating more small meals throughout the day. That way my body wasn't being flooded with more than it could handle. Some days I feel like all I do is eat, and other days I feel like all I want to do is it eat more. Pregnancy is weird.

Another interesting thing to learn was some things I considered a protein weren't to be counted as proteins for me (such as beans and milk). Beans were too starchy and milk, being a liquid, is digested too quickly, so for my purposes they are counted as carbs only. However, the colder something is the more slowly you digest it, which makes ice cream (especially with fat to help stabilize it) an acceptable occasional treat. There are recipes for low carb or no carb ice creams and those are great alternatives. However, I need my carbs because it is sometimes hard for me to reach 175g a day so I go ahead and treat myself to regular ice cream occasionally. It helps keep my mind off of doughnuts...and cakes....and cookies...but mostly doughnuts lately.

So far, my readings have been wonderful and my nutritionist and doctors agree that my gestational diabetes is under control so well that my son is not at any more risk than babies in non gestational patients for any of the factors mentioned in my previous post! As long as I keep it up, smooth sailing is expected!

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