By: Jennifer Steitz
When I was diagnosed with type 2 diabetes last year, my doctors and I were rather shocked. I was only 27 years old at the time, slender and in good shape. Diabetes does run in my mother’s side of the family, so I wasn’t completely taken aback.
But the diagnosis frightened me because I had watched my mother struggle with the disease over the years. Furthermore, my husband and I wanted to have a baby, and I knew that I had to get my diabetes under control before becoming pregnant.
I carefully watched my diet and exercise, and after my A1c test dropped to 5.5%, my doctor gave me the green light to start trying to conceive. When my pregnancy test finally came back positive, my husband and I were thrilled at the prospect of becoming parents. My diabetes, however, has continued to be problematic.
Once I was pregnant, my glucose levels were repeatedly tested. When the second round of glucose tolerance testing came back abnormal and I was diagnosed with gestational diabetes, I was determined to control my blood sugar without taking insulin.
I do realize that many diabetic women must use insulin to control their glucose levels, especially during pregnancy. Luckily, however, I have been able to control my diabetes both before and during pregnancy with diet and exercise alone.
A big challenge was the shift from sporadic testing once or twice daily to regular testing four times a day. Before pregnancy, I aimed to keep my glucose levels at less than 110 mg/dl fasting and less than 140 mg/dl two hours after meals, and I was usually able to meet my goal.
During pregnancy, however, I had a stricter regimen that required 90 mg/dl or less fasting and 120 mg/dl or less two hours after meals. My nurse explained that she prefers the lower numbers during pregnancy to ensure that blood sugar levels are safe for the baby.
It became more difficult to meet my goal numbers during my pregnancy, and I had to figure out a better way to eat. Working with a registered dietitian, I began to follow a stricter diet and record my daily food intake.
I wasn’t used to paying so much attention to what I ate and tracking my blood sugar so frequently, but I worried about the negative effects of high blood sugar on my baby. Diabetic women can have larger babies who are prone to overweight later in life. The baby’s organs may not be fully developed if the mother’s blood sugar remains too high and the baby is born early, or the baby’s blood sugar may be too low after birth. However, closely watching blood sugar levels and keeping them consistent minimizes these risks.
Although I’ve never eaten large portions of food, I have always really enjoyed eating and cooking. Now I couldn’t eat as much carbohydrate as I was used to, and I frequently had to pass on dessert. It seemed unfair, because isn’t pregnancy the time to freely indulge your cravings for lots of food?
Still, with proper portion control, the restrictions are not too onerous. Counting carbs and exercising are very effective ways to control diabetes and gestational diabetes, and it’s a good idea to add protein to every meal as well. Peanut butter, cheese, and meat became my new best friends!
Because I was hungrier while pregnant, my dietitian encouraged me to eat small meals and to eat frequently all day, allowing my growing baby to receive nutrition throughout the day as well. This meant eating less for breakfast, lunch, and dinner, but adding small snacks at mid-morning, mid-afternoon, and a couple hours after dinner.
The other dilemma I faced while pregnant was the need to avoid certain foods. Most obstetricians advise pregnant women to not eat deli lunchmeat, to avoid some seafoods and to limit others like tuna, to stay away from diet sodas with saccharine, and to give up caffeine and, of course, alcohol and cigarettes.
The prospect of following all the new food guidelines was at times overwhelming. Occasionally I was emotional (the pregnancy hormones were in high gear), and I would become upset when I couldn’t eat what everyone else was eating at a party or dinner. (Luckily, I have a very supportive husband.)
I soon adjusted to my new eating plan, and I began a more consistent exercise regimen. In addition to walking, I took a prenatal yoga class, an excellent form of exercise for pregnant mothers because it relieves stress and both stretches and builds muscles. Swimming is another low-impact exercise that is safe for most pregnant women. Again, my motivation was the baby growing inside me and my desire to do everything possible to stay healthy.
Fatigue is a big part of being pregnant, so sometimes exercising was the last thing I wanted to do. But I soon realized that once I got into a routine, it was much easier to stick to it. I actually grew to enjoy walking because I could do it with my husband after a long day at work.
The whole process of staying healthy for my baby has really required a lifestyle change, far beyond just a few dietary changes. But I have loved being pregnant, and I’m so excited to meet my little girl in a few months. Women who have gestational diabetes often do not have diabetes post-delivery, but it is important to get testing done to confirm that. And I know that I will be able to lower my blood sugar levels by breastfeeding my baby.
Although it’s been challenging to stick to my strict food and exercise plan, it will all be worth it in the end. Hopefully, my baby will not have to worry about diabetes because someday soon we will find a cure.