Gestational Diabetes Update

It’s been around four weeks since I was diagnosed with Gestational Diabetes (GD) so I thought I’d give an update as to how it’s going!

I got a referral from my midwife to go along to the GD Clinic at BC Women’s Hospital for a total of six appointments over two days. The first day of appointments was actually two group sessions – so I was in a room with three other women learning about GD and how to manage it. We had a nurse explaining to us what it is and how it affects us and the baby, she gave us a file for us to look through and jot down any notes.

On the tables as we entered the room were bags containing our “gifts”… a blood sugar testing kit. Which is actually a pretty great gift when you think about the expense it would be to buy a bit of kit like it!! The nurse gave a group demonstration of how to use the kit, and then went through it with each of us individually to make sure we could use the finger pricker and the digital blood sugar meter. We were told to test for three consecutive days our blood sugar levels before and after breakfast, lunch, dinner and before our bedtime snack. We also had to test our ketones before breakfast and dinner – this is a urine test stick that changes colour as to the level of ketones present.

When the nurse was satisfied we had all the info and capability to do the tests, she left us with a dietician who then spoke through the practicalities of managing our diet to support our blood sugar levels. She went into detail of what kind of foods we can eat, what to avoid, how to space out our meals, and how often to eat. We were given documents outlining carb values of portions to help make it easier to plan which I referred to a heck of a lot in the first week or two.

We were advised to eat our main meals (breakfast, lunch, dinner, bedtime snack) four-six hours apart from one another, and then we can have a morning and afternoon snack two hours before our next meal. For breakfast and bedtime snack we are to eat two servings of carbs, for lunch and dinner, three servings, and for snacks one serving – for a total of 12 servings per day (one serving being roughly 15g of carbs minus fiber). To give some examples of what these 15g servings look like – one slice of wholemeal bread, two rice cakes, one fruit yoghurt, a cup of milk, two digestive biscuits, 1/3 cup of rice, a medium apple. There are also a bunch of “free” snacks you can have any time – celery and hummus, nuts, cheese, pepperoni.

As I said, I kept having to refer to the booklet in the first week or two, but I’ve got into the swing of things now having stocked the fridge and cupboards with snacks I know the values of and how much I can have. I also know what peaks my blood sugar and what steadies it – for example bread and pasta seems to keep me quite level, but rice and oats really spike; add peanut butter to anything and it seems to level out my sugar intake, so apples, toast, digestives and celery have all been coated in peanut butter… (I believe the protein helps to digest the sugars.)

One of the strangest things I’ve found is how different the meal plan is to what I had expected – I have to eat very regularly which does get a bit intense sometimes; I have to include carbs in every meal and snack where I had thought I’d be avoiding carbs altogether; fruit and veg is not always a good option, you have to choose which ones you’re eating wisely; there were only two kids of cereal/granola bars that were under 15g of carbs and the one with berries in spiked my sugars so I’m not down to a peanut butter bar! I have also discovered I can eat McDonalds if I have a happy meal and no drink, and I can eat poké if I have the eight grain rice mixed with salad!

Back to the hospital appointments – I did all the testing for four days between my hospital appointments and then saw a nurse, an Endocrinologist (diabetes specialist), a dietician, and a physiotherapist back to back.

The nurse took my weight, and I had to do a urine test to measure different things. Then I took the results of that and my four days of testing at home to see the Endocrinologist who was very positive and happy with the numbers I presented with. It almost seemed like he was surprised I was there as none of my numbers were particularly high. Phew! He generally told me to keep doing as I was, and continue adjusting when I saw the high numbers and not repeat those meals/snacks. He also measured my bump and got kicked while doing it. But everything was looking good so he told me I could test less and passed me on to the next waiting room.

Next up I saw the dietician who again told me to keep adjusting and learning from my blood test results and explained I would now only have to blood sugar testing every other day and on those days I would rotate pre-meal, post-meal and the full seven tests, and only do ketone testing on the days I was doing the full seven. She actually advised me to add more carbs to certain meals and snacks if ketones were present as they had been a couple of days. The other advice was to add some more protein to take down the higher sugar levels – so cheese, eggs, peanut butter. But generally, things were looking good.

Last appointment was with the physio, she advised that walking or exercising after main meals would help to bring sugar levels down as I’d be processing them for muscles rather than it sitting as sugar. She asked if I had any pain or problems preventing exercise so went through my short list of pregnancy ailments and she gave me some stretches to try out. Once again though, she did say that none of my numbers were too bad and if I continue as I am then I should be ok. Score!

So the general consensus was that I was managing my GD ok with my meal plan and snacks and to keep going as I was. I had a call from a dietician about two weeks ago to check in with me on my numbers, and she echoed the same advice, with the additional note that as I get later into my pregnancy my hormones will increase which may lower my tolerance for sugar, so to bear that in mind and make adjustments as needed.

*If you don’t like needles or blood, skip the rest of this post!*

I haven’t found the finger pricking painful – early on I did have a few times where I would prick my finger and no blood would come out, I’d prick another finger and the same again. One day, it took 20 minutes to get a large enough spot of blood to actually complete the test! Not painful, just very tedious! I had to spend about $100 on lancets (needles), a sharps container, ketone sticks and blood test strips up front and will likely have to get another batch of lancets and blood test strips before the end of my pregnancy, but I am very grateful for the healthcare system here taking care of me each step of this pregnancy!

I documented my blood sugar testing one day thinking some of you might be interested to see the process: