Gestational Diabetes part 3 - the testing results

Saw the doctors for my follow-up appointment today.  I've spent 5 days tracking all of my eating and stabbing myself 1 hour after eating anything to get blood glucose readings.

The results?

Things are actually pretty darned good.  Over the 5 days, I only had 3 instances where my readings were above the desired numbers.  The desired number for 1 hour after eating is anything below 130.  Well, one reading was 131 and another was 142.  So nothing astronomical, just kind of technical fouls that they had to call out.  Usually a bad reading goes into the range of 200 and something so my minor infractions were practically nothing.  And all of this with no diet change of any sort, just me eating whatever I felt like eating.

But one number was a little concerning.  I have to test as soon as I wake up.  Before eating, drinking, or really moving around.  We want this reading to be below 90.  Most of my readings were in the upper 80's with one reaching 92.  They should be in the 60's or 70's after going so long without eating.

So we're going to continue testing upon waking and then full days of testing every other day or so since it's likely that the numbers are going to creep higher as the pregnancy goes along.  And if my morning numbers don't improve by eating a small dose of protein right before bed, I'll need to go back on metformin.

So here's the good news of this situation, at least for me.  As I said before (did I say it before?  I forget), diet plans and structured eating are really emotional for me.  I fail.  Over and over again.

The numbers show that when I eat exactly what I want, when I want to - my numbers are perfectly fine.  Nothing to worry about.  My natural cravings are managing to keep things pretty even keeled without me having to think about it.

And the numbers show that the (currently very small) problem occurs when I have absolutely no control over what my body does - when I'm sleeping. 

So it's official.  It's strictly the hormones that are doing this and NOT anything I've done wrong, haven't done, done too much of, whatever.  Even if I were perfect in my eating from day 1, my hormonal makeup with 2 placentas made the gestational diabetes inevitable.  It's not my fault.  I've done nothing wrong.  I have numerical and doctoral proof.  Obviously this is a very important fact to me because I've been feeling REALLY guilty this week.

And looking over every other blood test they ran, they said I'm very healthy.  I've never had a doctor say that to me before!  I'm really healthy!

And they tell me I should probably eat some more carbs.  And temper it with a bit of protein.  Wow, that's another thing a doctor has never said to me.  Eat more carbs.  Ha!

I'm eating pretty well, but I'm not eating a whole lot according to my food log.  I'd just like mention that when you have to stab yourself 1 hour after eating, every time to you eat, it kind of makes you wonder if you really want to grab something from the fridge or not.  So I've probably not been eating as much as usual over the last week.

We do expect the problem to slowly increase as the placentas grow and the hormones get stronger.  But we're catching it really really early and we'll be keeping an eye on those numbers so we can slowly combat it as needed.

Gestational Diabetes?

So I went to the specialist yesterday and got all sorts of advice about diet, learned how to use the glucose test meter, etc etc etc.  And just to make it more unpleasant, I cried the whole time.  Diet is a very emotional subject for me and the pregnancy hormones kicked in full gear and before I was even called in, I started crying and couldn't stop.

But here's the thing.  Other than the results of that one glucose test, all evidence is pointing to me not having an issue with my sugar levels.

The diet advice she gave?  Stuff I'm already doing.  She said if I eat fruit, cut it with protein.  Well, I already do that.  Cut down the carbs.  My pregnancy taste buds have already done that.  I should probably do it more, but yeah, already doing it.  Eat a little bit throughout the day instead of a few big meals.  I've never been able to tolerate eating a lot in one sitting.  I have to snack all day so, not a problem!

I have never been able to just eat an apple off the core.  It makes me sick.  But I can eat the same amount of apple if I have it with peanut butter.  Apparently, this wasn't my imagination all my life!  An apple makes your blood sugar spike, but if you cut it with a protein, the protein slows down the dose of sugar your body is getting so it's more even and long lasting.  That sick feeling I always got was a blood sugar spike.  Who knew?

I spent all of yesterday collecting little drops of blood and measuring my blood sugar.  Every single test came back where it was supposed to be.  1 hour after eating, it's supposed to be under 130.  Well, I measured exactly one hour after everything I ate and throughout the day it slowly climbed from 90 to 117.

And I got my test results back today.  They measured my hemoglobin (?) which is kind of a picture of my sugar levels over the last 3 months.  Kind of the long term test to see if I've been spiking and dipping or if things have been where they should be whereas the glucose test that started this whole thing is a specific set of circumstances designed to stress your sugar levels and see how your body deals with it.  Well, the hemoglobin number is supposed to be between 4-6.  My number was 5.  In other words, perfect.   Other than a little lack of Vitamin D, all my tests came back great.

So I talked to the nurse who called me about the test results today.  I asked if it's possible the first test was affected by the fact that I hardly ate anything that day before the test.  I had my usual decaf (well now that's normal for me) latte and bagel and then other than about 3 bites of granola, didn't eat anything for the next 4 hours before drinking the glucose and going in for the testing.  I was at work that day.  That always throws off my eating norms.  She said that it might have had an effect.  So we left a message with the nurse assigned to me and I expect to talk to her about this tomorrow.  If not tomorrow, we have a follow up appointment on Monday (the 20th).

I also checked with K to see if I'm reacting to wishful thinking or if this is a rational interpretation of the evidence.  He thinks it's a rational conclusion and we need to talk to the doctors about it.


I think the best thing to do is to continue testing my levels for the next week to get that data.  If we don't see any spikes, then I think I should do the glucose test again on a more average day.  If that comes back normal, then I think I should spend 1 day a week tracking food and testing glucose levels for the rest of my pregnancy.  That way, if there's an issue, we'll see it appear, but if there's not an issue, I'm not sitting here stressing myself out for no reason. 

Diet plans and food tracking are extremely stressful to me.  If I don't have to do that, I don't think I should.  But now I am more educated on how to keep my sugar levels stable and I can certainly keep them in mind.  Like adding protein to my morning carbs.  That's easy enough.  And if I am worried about it, I now know how to calculate how much sugar I'm getting so I can read labels and do a little bit better than I'm currently doing.

Gestational Diabetes

Guess what I have! 

Apparently this pregnancy was going too easy and my body decided to make it a little more difficult.  It figures.  Me and my body have been enemies for decades.

I can't say I'm surprised.  I've been on the diabetes watch list since I was 12.  I'm overweight, it runs in my family, and I tend to show symptoms all the time like thirst and wounds healing very very slowly.  I actually get tested quite often because doctors have a hard time believing I'm NOT diabetic but I guess my luck has run out on that pattern.

I really did do my best to prevent this.  I took Metformin prior to conceiving and into my 8th week to try to avoid this.  My horrible diet has been a million times improved since getting pregnant.  But I guess it wasn't enough.  I admit it, even though I logically know that it's not really my fault and that I really did do what I was supposed to do to prevent this, I'm feeling like a failure.

Did a glucose test the other day.  That consists of drinking a 10oz bottle of glucose water in the span of 5-10 minutes.  It tastes like flat, over sugared 7-Up.  It was so gross!  I nearly couldn't keep it down it was so disgusting.  You then get your blood drawn 1 hour after finishing the bottle so you have to note what time you finish and then get to the lab at the hospital.  And then all sorts of blood is taken out of your arm. 

Fun was had by all.  Usually this isn't done until late in your second trimester, but because of the increased odds of my having it, we tested massively early.

And my sugar numbers came back really high.  And my iron numbers came back slightly low.

So I'm starting on an iron supplement every other day.  My numbers there were only slightly below normal so it's not necessary every day, but every other day should push me into the normal range.

And next week I get to meet with a nutritionist and learn all about foods and probably get prescribed a very restrictive diet.  And I get to learn how to prick my fingers and test my blood sugar levels.

I'm predicting this will be very difficult for me.  I've been able to succeed at a lot of things in life, but living by an actual diet plan has never been one of them.  I've tried several times and I've never been able to do it.  And this time, I absolutely have to.  It's one thing to tolerate being fat as a result of my failure, but I won't subject my kids to my failure.

On the upside, I've got a husband who likes to cook and his doctor has told him to drop a few pounds.  So he'll be going to the nutritionist with me and plans to do whatever diet is prescribed with me.  And if he's going to do most of the food prep, it will make it easier for me to have him do the thinking and I'll eat what he puts in front of me.

And the effects that this can have on the kids so far haven't manifested so it's still totally probable that it won't affect them at all since we're catching it and will start managing it early.  One of the issues is high blood pressure but I've been in the perfect range from day one.  I actually tend to have low blood pressure so I've got a little bit of leeway there.  Another concern is that the babies will gain too much weight in utero resulting in gigantic babies.  So far they are textbook size for their age.  And being twins, they are likely going to be too small anyway so if this adds a smidge of weight to them, that's probably not a horrible thing.