Tuesday, November 26, 2019

Gestational Diabetes

When I was diagnosed with gestational diabetes in this pregnancy, I was relieved - then resentful. I had suspected undiagnosed gestational diabetes as the underlying cause of my son's premature birth (and his abnormally large birth weight, plus low blood sugar and jaundice), despite the fact that I'd been tested at 28 weeks and told by my midwives that the outcome was "normal". Looking back, I had so many classic symptoms of diabetes - symptoms that I repeatedly reported to hospital consultants, GP, and midwives, with each one dismissing them as "normal" in pregnancy.

This time, at a different hospital and with a monochorionic (identical, two babies sharing one placenta) twin pregnancy, I pushed the consultant to test me sooner for GD. She said it was unusual to test so early, but agreed to at 21 weeks.

And my blood sugar readings were raised - to everyone's surprise but mine.

From there, the diabetes team moved quickly: scheduling a meeting with the diabetes nurse, who gave me a blood glucose testing kit to use once in the morning and one hour after every meal, and another meeting with the hospital dietician, who helped come up with a meal plan in an attempt to lower my blood sugar levels.

Initially, we tried to control my GD through diet and exercise. But despite being extremely restrictive (at one point, I was eating zero carbs, which was neither healthy nor sustainable) and going out for a walk immediately after every meal (not the easiest when you're pregnant with twins, especially as the pregnancy progresses), my glucose levels remained high - and I felt like such a failure. Like I hadn't tried hard enough.

The diabetes nurse was incredibly kind, and assured me that it had nothing to do with me - typically, GD develops during pregnancy and disappears after birth (though, given my family history of diabetes, it's likely to stick around permanently). It occurs when the body cannot produce enough insulin to support both you and the baby - or, in my case, the babies (apparently, twin pregnancies have a higher rate of developing GD).

The nurse suggested I start on Metformin, a pill, but I asked if I could move directly onto insulin, as I'd heard the Metformin caused stomach upset, which I really couldn't deal with when I was working and looking after a toddler in the evenings. They immediately agreed and prescribed Novorapid before meals and Humulin, before bedtime - so, four injections total, per day.

The resentment came in when I realized that, despite the insulin, I'd still need to follow a strict Keto-like diet, which was the last thing I wanted to do when pregnant. I constantly craved pasta and missed cakes; I was angry that I felt deprived and hungry a lot.  

Now, in my 32nd week of pregnancy, I can honestly say that this diagnosis of gestational diabetes has been a blessing in disguise. I've never felt healthier and better in myself: less sluggish, more fit, and just generally healthier.

Of course, I have moments where I'm annoyed because I would love to have a slice of cake for dessert instead of Skyr, a handful of raspberries and one square of 90% dark chocolate, but once I got used to the diet, I found that I stopped craving a lot of sweet things (though I find myself missing carbohydrates, for sure).

What surprised me was how many misconceptions people have about diabetes. A lot of friends volunteered to bring me "vegan cake" or "savoury muffins", which was very sweet and well-intentioned, but vegan cake still has sugar (natural or refined) and is high in carbs, and savoury muffins are (unless made with a flour alternative), also a total carb-fest.

I did have a few dreams where I was stuffing my face with bread and endless bowls of pasta (oh, how I miss pho and ramen! AND WHITE RICE!), but ... at the end of the day, I want to give these twins the best chance of being healthy at (and after) birth.

And the fact that I feel better for it all after this lifestyle change is the figurative icing on the cake.
© angloyankophile

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