Gestational Diabetes

Gestational Diabetes

Gestational diabetes mellitus (GDM) is a condition that develops in 2-10% of women during pregnancy. This is due to hormonal changes caused in pregnancy that make your body more likely to be resistant to insulin. Those affected by the insulin resistance have prolonged elevated glucose levels that are higher then “normal” levels that can effect both mother and baby.

Screening to test for gestational diabetes is generally done between 24 and 28 weeks of fetal gestation. If you have a medical history giving you a higher risk of GDM you may be asked to test earlier in your pregnancy to rule out Type 1 or Type 2 diabetes and then again in the second/third trimester.

The actual testing type can vary depending on the practice your receiving care at. Asking what types of testing that is available around your 20 week anatomy scan can give you time to educate yourself with the risks and benefits of each testing type available to you.

Testing Choices

• Glucola Drink - Orange or Lemon/Lime flavored

• Testing of your A1c

• The Fresh Test

• Jelly Beans

• Twizzlers

• Maple Syrup

• Monitoring glucose levels 4 times daily for 1 week.

My Care

At my particular practice I am receiving care at I had two general choices, the standard Glucola drink or tracking my blood sugars 4 times a day for 7 days. Below is the conversation that I had with my provider.

12/14/2022 - Prenatal appointment with midwife.

Midwife: “Please make sure to schedule your glucose testing for gestational diabetes for your 28 week appointment.”

Myself: “I would actually like to decline the traditional glucola testing and opt for testing my sugars 4 times a day for a week if that’s alright. Being a birth worker I have had the opportunity to educate myself on the ingredients of the traditional orange drink and would like to peruse an alternative option.

Results

Pending results from any of these tests can lead you down one of four paths. 1 you are negative, you would continue on your daily grind; 2 you had some higher/borderline numbers and the providers are requesting that you either retest with a 3hr monitoring or continue monitoring for another week; 3rd you fail and you are diagnosed with gestational diabetes and advised to manage with diet and exercise; 4th you fail and your diagnosed and you need dietary/exercise changes and medication to aid in insulin control.

Treatment

• Monitoring your blood sugars. Making sure your levels stay in a healthy range.

• Nourishing your body with healthy food. Small frequent protein dense meals area great starting point. Discussing with your provider or a nutritionist health meals plans that are right for your will give you some additional guidance.

• Incorporating moderate physical activity aids in lowering your blood sugars. Chat with your provider what exercises are acceptable and witch should be avoided.

• Lastly monitoring yourself, your baby and follow your intuition. While seeing providers for prenatal care they will monitor both you and your baby. Checking for growth, fluids and development. For some additional testing may be necessary throughout your pregnancy, always ask what the testing is for, be educated. Lastly always follow your intuition. If you feel something is off, ask to be checked.

  Possible Symptoms/Outcomes

Mother

• High blood pressure

• Protein in urine

• Blurred vision

• Frequent urination

• Abnormal thirst

• Developing Type 2 diabetes later in life

Baby

• Higher gestational weight

• Premature birth

• Hypoglycemia

• Possible risk of breathing problems

• Jaundice

My Care

After submitting my documentation for my gestational diabetes testing I was delighted to open this portal message.

1/16/2023 - Message via portal

Myself: Submitted documentation of blood sugar testing.

Midwife: “Hey Ashley, I checked with XXX and your all set to stop checking your blood sugars. You has some fasting elevations, but does not meet the criteria for gestational diabetes”

Myself: “Amazing, thank you!”

I was borderline with both of my full term pregnacies but never diagnosed, being that I am carrying twins this time around there is a higher chance of gestational diabetes due to having two placentas. This portal message was a sigh of relief.

Recommendations

Ending this blog post I did want to share one of my favorite recommendations as a birth doula that I recommend if supporting a client diagnosed with gestational diabetes. This book is available on Amazon. Real Food for Gestational Diabetes: An Effective Alternative to the Conventional Nutrition Approach by Lily Nichols, RDN, CDE, CLT. You can also find more of her work at RealFoodforGD and LilyNicholsRDN.com . Below is the amazon link for her book.