If there is one thing I have experience with it is having gestational diabetes. I have had it with three separate pregnancies and I am going to provide you with some helpful information as well as detailing some of my experiences.
The first thing I would like to tell expectant mothers is that if you have been diagnosed or if your doctor suspects you may have gestational diabetes is that there is no need to panic. With proper medication, diet, and exercise as well as proper blood sugar monitoring you and your baby should be just fine.
What Will Happen If Your Doctor Suspects You May Have Gestational Diabetes
During my first pregnancy it was determined that I had a minor rise in my blood sugar. The doctor diagnosed me with gestational diabetes and immediately put my on a special diet. That pregnancy was generally managed by eating well. So you may be diagnosed with gestational diabetes but you may be able to keep it in check with diet alone. Make sure that you do monitor your blood sugar however to make sure that the gestational diabetes does not get progressively worse. Make sure that your doctor continues to keep track of your diabetes. Just because the diabetes may be mild in the beginning, it doesn’t mean that it might not progress to the point where diet alone will not be enough.
If your blood sugar is more out of whack than your doctor feels it should be then he will schedule a blood glucose test.
My Blood Glucose Test Experiment
During my second pregnancy my blood sugar seemed to be out of the normal range fairly early on. So my doctor immediately scheduled an appointment for me to come in and take the 4 hour glucose test. This is where they give you this bottle of incredibly sweet orange liquid to drink and they monitor it over a course of four hours. The test is used to determine the affect that it has on you blood sugar levels.
If you ever have to drink this stuff try and get the nurse to put it in a refrigerator for you for a couple of hours before you come in. It is really disgusting warm. I found this out because I was the first patient of the day and the nurse had forgotten to put mine in the fridge the night before. It’s really disgusting cold too but, it is a little more tolerable cold. Make sure the nurse does this, call them and remind them at the end of the day the night before or first thing in the morning if your appointment is not towards the very beginning of the day, but most likely it will be scheduled early.
Don’t make the mistake of going to work afterwards. I decided that I would work a half a day after taking this test. This was a big mistake, while I felt OK after the test it took my body a few hours to feel the after affects of the test, and unfortunately they came after I finished work and proceeded to drive home in rush hour traffic. I began to have some bad effects from the test. I started to feel the need to have a bowel movement, and the pain became more and more excruciating, and I was stuck in a long line of traffic and there was no place near by to get out and use the bathroom. I have never experienced, such an incredible need, I won’t share with you what happened after that but I will just say it was humiliating and degrading, and please just head my advice when I say, after taking this test head straight home. You may not experience what happened to me but if you are at home you will be better safe than sorry.
After the Diagnosis’
My doctor decided that I needed to see a specialist immediately. After a week of waiting for my HMO to approve a specialist they determined that they would only pay for the gestational care if I went to a hospital with a specific clinic for this. This hospital was 1 1/2 away. By the time I had my third child the need for gestational diabetes care has become more recognized and many hospitals now have a doctor who specializes in high risk pregnancies and a nutritionist on staff. Your doctor and the high risk pregnancy team will work together to make sure you make sure that your pregnancy goes safely.
When you first visit the specialist you will be given a blood glucose meter, they will explain to you how to use and how to measure and keep track of your blood glucose. You will also likely be prescribed some type of medication such as insulin or an oral medication. I was given insulin, and I was instructed on how to give it to myself and told how much to give to myself.
I was provided with a nutritionist that helped me create a diet that would work for me and not change my normal routine all that much. She taught me about portion control and also food combining. She also told me that in addition to 3 meals per day I should also consume three snacks per day in order to keep my blood sugar steady. This meant eating a lot more times during the day but, eating smaller portions. Also I was told to control my carbohydrate intake, not to eliminate it at all but not to consume more than a certain amount everyday. I was also told to record everything I ate and she went over it with me on my next visit to let me know what I was doing wrong and what I was doing right.
After my visit with the nutritionist my husband and I were sent to conference room where I was assigned a nurse who then explained to me what the risks were for leaving gestational diabetes un-treated.
Maintenance
For the remainder of my pregnancy I had to take my blood sugar three times per day and record it in a log book. I then had to inject insulin into the upper part of my leg approximately a half hour before each major meal. If you learn how to do this properly it really does not hurt. I think out of all the injections I had to do it only hurt about 3 times. If it hurts that means that you are not inserting the needle properly, as long as you do everything correctly insulin injections should not hurt.
After the doctors at the clinic realized that I was doing everything I was supposed to do and that I had kept my blood sugars pretty steady they let me transfer to a hospital closer to home. They only checked me once a month and I got to fax in my log every week. With my third pregnancy I had to call the nutritionist once a week and give her all of my numbers for the week. As my numbers went up as the pregnancy progressed the amount of insulin that I had to take increased.
Their actually was an advantage to being on insulin. After I started taking it I was less tired and had more energy. The largest downside to it was that although my insurance company would pay for the insulin and the blood testing machine, they would not pay for the testing strips or the needles. The needles were not that expensive however, the testing strips ran about $80.00 per month.
Gestational Diabetes Gets Worse With Each Pregnancy
As anyone who has had gestational diabetes knows the condition usually gets worse with each pregnancy. My second pregnancy was no exception. Even though most experts say that gestational diabetes does not start to become obvious until early in the third trimester my doctor started noticing my blood sugars elevating around the beginning of my 6th month. When I got pregnant with my third and final child I was also older (my last pregnancy was 6 years later), but the gestational diabetes showed up pretty much immediately and unfortunately it did not entirely go away after this pregnancy.
After the Pregnancy Is Over
Usually gestational diabetes will usually go away. Once your body goes back to normal the elevated levels will go back to normal. However there are cases where it does not. If you have risk factors for diabetes such as being overweight, or having a family history (diabetes is very prevalent on both my mother, and father’s side’s of the family) or if you are beyond age 35 (I was 39 when I had my last child) when you get pregnant you have a higher chance of retaining the diabetes.
Also know that after you have that baby you will likely lose the support of the high risk pregnancy specialist and their team. Once I had my babies they seemed to kind of wash their hands of me. So be aware that your physical care will now be up to you. After you have had your final follow ups with your gynecologist you should ask your regular doctor to check your blood sugar. Then if you find that the diabetes has stuck around you will then need to go see a diabetes specialist and get care for your diabetes.
Some Facts About Gestation Diabetes
What happens with Gestational Diabetes: When a woman becomes pregnant the hormones in the placenta create a resistance to the action of insulin and stress the pancreas. for most pregnant women this is not a problem but, some women are unable to produce enough insulin on their own to compensate for this stress. This results in Gestational Diabetes.
If Left untreated the baby will try to compensate for the mothers elevated blood sugar levels by producing insulin on it’s own. This will usually result in excessive growth of the unborn child creating labor complications. The child also has an increased risk for later becoming obese and developing diabetes themselves in adult hood.
This can also cause the baby to have problems stabilizing the baby’s glucose, as he or she has been accustomed to great amounts of sugar, which causes the pancreas to produce large amounts of insulin. This is can sometimes cause a rapid drop in the baby’s blood sugar after birth. This can take days to stabilize, since it was my third pregnancy and I was older my blood sugar became really difficult to keep under control. My son was born a month early, and when he was born they did have to keep him in the ICU nursery to stabilize his blood sugar. Unfortunately during that the IV was inserted in his foot improperly and caused an IV infiltration which killed some of the tissue in his foot, but this was a medical error so please don’t be fearful that this will happen to your baby. The baby was otherwise healthy and beautiful and was able to come home in a week.
Because gestational diabetes can produce larger children there is an increased possibility for a C-section, after attempting to have my first child the normal way, they had to do an emergency C-section, because my body was just not big enough to push her out. After that it was just assumed that future pregnancies would be C-sections.
Obesity, older age at time of pregnancy, and family history
Long Term Effects
Also a women who has had gestational diabetes also has a greater chance of developing type II diabetes later in her life.
Conclusion
I have had gestational diabetes 3 times. Each time it got progressively worse. But I did have 3 beautiful healthy children. My last child had some problems for the first few days of his life because my diabetes got harder to control towards the end. But most women should not be worried. Remember that this was my third gestational pregnancy and I was 39 years old. Most women who have gestational diabetes when they are pregnant come through it very nicely and have wonderful healthy babies. As long as you get and keep professional care, and do as you are told everything should be just fine, and gestational diabetes is nothing to fear.
