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I admit.  I got completely blindsided on Wednesday afternoon.  I received a phone call from my doctor's office to give me my results of the glucose test.  Now, the rule of thumb with my doctor and lab results is "no news is good news", so when I saw the number pop up on my phone, I hesitated to answer it. 

 

140.  That's what my glucose reading came back at.  What's so special about that number is that it is the target number that divides whether someone passes or fails the glucose test.  Of course I would nail it right on.

 

The ironic part is that with Conner's pregnancy I ate all the carbs my little heart desired, gained over 80 pounds, and never ended up with gestational diabetes (GD for short).  With this pregnancy I decided since the start of my 2nd trimester that I would follow a GD diet plan with an occasional cheat meal or treat here and there just to maintain a healthier pregnancy.  And now here I am with a result of 140.  Go figure.

 

I explained my eating habits to the doctor and the fact that I already have been checking my glucose levels periodically and exercising regularly.  Based on my action plan to-date, she told me she was impressed that I was already so educated on the topic and with my habits, she has no concern for me. In fact, she told me that as long as I keep with what I'm doing and monitor how the carbs are affecting my levels, I can go ahead skip any additional testing.  Whew! No more glucose drinks please!

 

If anyone reading doesn't fully understand gestational diabetes and is not interested in reading a ton of boring literature, here's my very quick "Cliffs Notes" on the topic.  Keep in mind, I'm no expert.  This is just what I've learned along the way.

 

What is it?  In short, your body can't produce enough insulin to counteract the amount of glucose in your blood.  Insulin is a hormone produced by the pancreas that acts as a key to unlock your cells and allows the glucose into the cell to be used as energy.  For some people, their pancreas can't produce any more insulin to get enough of the glucose in the cells or the cells themselves become resistant to insulin. 

 

Gestational diabetes typically shows up in the late 2nd trimester or 3rd trimester.  Why then?  Your placenta reaches a certain size and continues to grow throughout the remainder of the pregnancy.  The placenta produces three types of hormones that actually make our cells more insulin resistant and will continue to make more of these hormones as pregnancy continues.

 

In the meantime, the pancreas is already maxed out making three times the amount of insulin to try to overcome these hormones produced by the placenta.  Now, couple that with the amount of carbs we eat that get converted into glucose, and you got yourself a problem.  The bummer part is that it gets trickier to control as you go on because your body is already making as much insulin as possible and your placenta just keeps growing and producing more of the pesky hormones that make you insulin resistant.

 

What now?  A lot of the time, GD can be controlled by creating a diet plan that works with how your body uses carbs.  Unfortunately for some, controlling their diet won't be enough and will need to supplement with extra insulin to transport the glucose out of the blood. 

 

Diet:  It will be important to take in an appropriate amount of carbs at each meal and typically three meals and three snacks spaced 2.5 to 3 hours apart will be best to keep your glucose levels stable throughout the day and night.  Here is the starting point that I used and I plan to adjust the amount of carbs over the course of this week until I find a meal plan that will keep my glucose from getting either too high or too low.

 

Starting Point:

Breakfast:  30g of carbs

Snack:  15g of carbs

Lunch:  30g of carbs

Snack: 15g of carbs

Dinner:  45g of carbs

Snack: 15g carbs

 

From the reading I've been doing, it sounds like the typical problem areas are your levels right upon waking and after breakfast.  If morning fasting levels are high, your last snack of the day will be an important focus.  You may need to increase your carbs and protein to give your body an extra boost to get you through the next 10 hours and not freak out on you the next morning.  If your levels are high after breakfast, you may try adding a morning walk and/or decrease the amount of carbs you take in at breakfast. 

 

Exercise:  Exercise, even as simple as a walk, can help with blood glucose levels.  Your muscles use glucose as fuel to perform whatever task you are doing.  If you have extra glucose in your blood, your working muscles will use that glucose because it is readily available.  Ta-da! Your blood glucose levels lower as a result.

 

In my research this week I found a list of risk factors that cause women to be at higher risk for getting this.  I laughed when I read through the whole list and the only risk factor that I met was being over the age of 25.  My only thought is if there is a correlation or link between PCOS (polycystic ovarian syndrome) and GD because with PCOS your body tends to be insulin resistant whether you are diabetic or not and that seems to me like it would set the stage for getting GD. 

 

There.  That's all I got on my quick overview.  I can tell you from the past couple of days that I actually need to increase the amount of carbs in my first two snacks.  My 2 hour readings after these snack are in the 60's, so I will need to add in some fruit or other healthy carb options.

 

In case you're curious, here is the plan that I used as a starting point.  I'm sure it will continue to evolve throughout the rest of my pregnancy as learn how these meals/snacks affect my levels and as glucose levels get harder to manage.

 

Breakfast (7AM) - (2) Protein Pancakes

Activity - 1 mile dog walk

Snack #1 (10AM) - 8 oz coffee with 1/4c reduced fat milk, 5.3 oz greek yogurt, string cheese

Lunch (12:30PM) - Cobb Salad (Romaine, 2 oz chicken breast, cucumbers, tomatoes, onions, 1 small hard boiled egg, bacon bits, 2 Tbsp Italian dressing, shredded cheddar)

Activity - 1 mile walk at 3 mph

Snack #2 (3:30PM) - 1/2 medium gala apple, (1) Tbsp natural peanut butter, string cheese

Dinner (6PM) - Chicken Burrito Bowl

Activity - 1 mile walk at 3 mph

Snack #3 (9PM) - Lara Bar (Peanut Butter Cookie)

 

For the most part, I don't feel like my life is dramatically changing because of this.  I've been following a general GD diet, but now I will need to make sure that I keep an eye on how these foods affect me over the last few months.  The only thing that will be hard for me is not having the ability to just eat a treat or have pizza whenever I want without planning out a game plan ahead of time. 

 

Well placenta, I guess you're doing a great job at growing.  Pancreas, let see if we can just step it up a little more.