Gestational Diabetes, like any other complication during pregnancy, is uncalled for and can cause anxiety. Read on to find an overview of Gestational diabetes, tips on managing it and lessons learned from my own experience.

Disclaimer: I’ve written this post based on my experience with Gestational Diabetes and by no means is any medical advice. Please ensure that you speak with your gynecologist and nutritionist before making any changes to your diet, exercise, or medication.

“Diabetes taught me discipline – A Snapshot from kids book on Sonia Sotomayor, a Supreme court judge who was diagnosed with Type-1 Diabetes when she was very young.”

What is Gestational Diabetes? 

During pregnancy, also called the gestation period, one can develop Diabetes, which usually goes away after the child is born. Scientifically, when the pancreas cannot make enough insulin, it leads to high blood glucose levels, which can, in turn, affect the baby. If the sugar levels are not too high, the doctor usually recommends exercise and diet control, else may prescribe medication.

Nearly 5% of women are diagnosed with Gestational Diabetes [Kampannan et al. World Journal of Diabetes, 2015].

How is Gestational Diabetes Screened? 

Sometime during  the 24th to 28th week of pregnancy, the gynaecologist may prescribe the glucose screening test. Right before the test, one is asked to drink a sweetened liquid, and the blood test is done after an hour (additionally two hours also depending upon the doctor’s recommendation).

If the one-hour levels are higher than 140 mg/dl, one is usually asked to retake the test- one, two, and three-hour tests this time. For the up-to-date numbers, please speak with your gynecologist.

These tests might vary a little, but the broad idea is to monitor how well our body brings the glucose level down to a reasonable level.

What to expect after the Diagnosis?  

Once diagnosed with Gestational Diabetes, the gynaecologist might refer the mom to a specialty practice. Following are the few things to prepare oneself for what might come. 

Firstly, the doctors might state the risks to you and baby. These risks can instill fear, but you must keep your calm because that is what can sail you through. Secondly, you might be asked to consult a nutritionist who can work with you to come up with a diet chart. Regular nutritionist visits require tracking the food and sugar levels and sharing with her/him.

You may be asked to track and log your blood glucose levels around four times a day. Next, the doctors might decide to get multiple ultrasound scans to ensure that the baby is not macrosomic (a large baby – which is another risk that they might list). Lastly, the obstetrics team might perform routine non-stress tests. Non-stress tests are nothing but monitoring the heartbeat of the baby, without giving any stress to her.

 

My Experience with Gestational Diabetes – in a nutshell 

When I was diagnosed with GD, we kept debating whether I had a big meal the night before, or the levels were marginally above the threshold – anything to deny that I had GD! If the doctor states that the reports suggest you have GD, please face it head-on and manage it with a great spirit.

I was diagnosed with Gestational Diabetes in the 28th week of my pregnancy. It was very worrying, but then my husband and I quickly switched gears to managing it well and educating ourselves. Those were tough but very educative weeks. In retrospect, I think GD was a great teacher for life for us.

Once diagnosed, it was followed by multiple obstetrician specialty visits, routine non-stress tests (to monitor baby’s health/heartbeat), regular nutritionist visits, pricking finger to draw blood, and track sugar levels multiple times a day.

In summary, what we took away from monitoring GD minutely is that our body is sensitive to food, being mindful, and exercising regularly. Disciplining ourselves on these fronts can help us manage a disease. 

 

 How to Manage Gestational Diabetes? 

The first recommendation is to work closely with your nutritionist and the gynecologist. Gestational Diabetes can be managed using diet and exercise [Gestational Diabetes Mellitus, AADE, 2018].

The methods below helped me manage Gestational Diabetes. 

(a) Short Meditation Breaks.

(b) 30-45 min walk after all meals.

(c) Small portions but frequent meals (every 2-3 hours).

(d) Maintaining a food log to understand what helps or hurts my body.

(e) Planning for meals and snacks and keeping a few healthy snacks handy.

Towards the last leg of the pregnancy, managing GD becomes challenging, so I had to take a bit of oral medication. Because everyone’s body responds differently, please don’t blame yourself if the sugar levels don’t get controlled with only exercise/diet. Stay positive – that helps manage GD too! 

 

 How to Eat during Gestational Diabetes? – My Learnings 

 

Snacking on a high-fat food – Excess fats (or excess anything!) should always be avoided. However, if weight is not your concern, snacking on high-fat food will not hurt the sugar levels. Please speak with your nutritionist.

Examples: I added nuts and spinach to fruit smoothies, flax seed powder to the whole-wheat dough, would add a spoonful of ghee to my bread/chapattis. These measures help not spiking the sugar levels. 

Planning – I used to select and shop for the ingredients that can be stir-fried. e.g., Tofu, Cottage Cheese (Paneer), Edamame, Broccoli, Carrots, Soy Nuggets, Unsweetened Yogurt, and Makhana (Foxnuts).

A lot of Vegetable recipes – The idea is to snack a lot on vegetables. Vegetable soups, stir-fried Vegetables, curries, even Fritters or Pakoras are good go-to snack ideas. 

Carbohydrates are important! We should limit the carbs to manage the blood glucose levels, but cutting them down a lot can affect the baby and us. Carbohydrates are essential for growth and development; please make sure that you are taking at least the recommended amount of carbs. However, please eliminate refined carbohydrates from the diet completely. 

Please reduce the portion size and maintain a food log to gain insights about what hurts or helps your body. You may treat this as an opportunity to learn about the impact of diet and exercise on your body. 

 

Resources

1. mySugr app – The application that I had used to track food and sugar levels. It also came handy to show the sugar levels tracker to the gynaecologist and nutritionist.

Apple Store: https://apps.apple.com/app/id516509211?mt=8

Google Play:  https://play.google.com/store/apps/details?id=com.mysugr.android.companion&referrer=adjust_reftag%3DcZykyFolrhwC9%26utm_source%3DmySugr%2BWebsite%26utm_campaign%3DFooter

2. An informative paper on Gestational Diabetes Mellitus: https://www.diabeteseducator.org/docs/default-source/practice/educator-tools/Gestational-Diabetes/gestational-diabetes-mellitus-practice-paper.pdf?sfvrsn=2

A few last words: Be Mindful

1. Starving yourself of carbohydrates is not suitable for the baby or the mom. Please speak with your nutritionist to make sure that you’re taking minimum recommended Carbs at frequent intervals. Please eliminate refined carbohydrates like white bread, white flour from the diet altogether. 

2. Processed foods raise sugar levels -please avoid them as much as possible.

3. Walking after every meal not only helps one manage glucose levels but also being calm and having a healthy pregnancy. 

3. Make sure you dispose of the needles which you use for testing glucose levels in a sharp-needle container.