Tuesday, September 07, 2010

Gestational Diabetes

I'm 30 weeks. A couple of weeks ago I found out I have gestational diabetes. I had a lesson yesterday in monitoring my blood sugar, and now I have to prick my finger four times a day (but I don't get to sleep for a hundred years). I have occasionally modified my diet to lose weight - after I gave up smoking which was a year or so before I got pregnant with Fred I allowed myself four tablespoons of fat a day (mostly peanut butter or olive oil) and swam nearly every day, and last year or the year before I was kinda sorta 'French' for a while, which mostly involved eating yoghurt for breakfast, smaller serving sizes and walking. After a month or so of being super-conscious about it, I just found I incorporated certain things into my daily routine (like having breakfast, I'd never been much of a morning eater before) and having smaller portions of sweets, but didn't really think about it much anymore.

I have always carefully avoided the whole concept of bad food and good food. This is the first time I've really had to think about carbs and fats and sugars. It's the first time I've had to think about what I am eating (and drinking) when, staging all these small meals throughout the day, carrying carrot sticks and vita-wheats in my handbag, and a spare muesli bar in case I get caught out.

Last night, after avgolemono soup with toasted feta and silverbeet grainy flatbread sandwiches, and then my usual yoga make-the-baby-come-out-easier exercises, my reading was low and I felt smug and clever. This morning's reading, two hours after a bowl of low GI muesli and 2 strawberries my blood sugar reading was quite high. I'd forgotten my iron pill so took it about half an hour before testing and I have a cold and I had a cup of tea sometime after breakfast... Can this stuff affect the reading? How can I hold all this stuff in my head for ten weeks? Ten weeks isn't long to adapt to a condition but it's a long time to fret about the possibility of things going wrong. Not that I'm worried really... or I wasn't till I started monitoring my blood sugar. That pass/fail mentality that dogged me in high school is hard to shake, I feel like I am being graded on my meals (and like Lisa Simpson* my attitude towards grading is far more unhealthy than my attitude to food). I've been doing the diet for a few weeks (I have a very clever friend who also had gestational diabetes and she gave me lots of great advice) and on the whole feeling much better for it.

I met a lovely mum (also pregnant with her third) at the diabetes class and we were talking about the sense of guilt and failure associated with this diagnosis. The conscious, critical feminist in me (with two type 2 parents) knows that it's not my fault and more luck of the genes. But mothers are held so accountable for every morsel of food that passes their lips (as though their pregnant body belongs to the state while housing the innocent, vulnerable infant that needs protection as all children do by default). And there is a sense that "the rise of gestational diabetes" is invariably associated with "society today" and the overabundant supply of fast food and obesity. Perhaps the "rise of gestational diabetes" is at least partly related to the number of cases diagnosed now that nearly every pregnancy is screened for it. I am hoping I get used to the testing, at the moment the whole thing seems so obsessive. I hate thinking about food so much. The gestational diabetes will go away when the baby is born, but I'll always have to be a little careful - it's not uncommon for people with gestational diabetes to develop type 2 and with my family history my doctor says it's almost inevitable.

On the upside the diet changes have been mostly interesting and not difficult to adjust to. I am not craving the things I can't have (potatoes, butter, cake, chocolate etc), perhaps because I am eating so frequently I am never getting really hungry. I am enjoying the challenge of keeping food interesting for myself and incorporating foods that are healthy for me into our family meals. The girls have adjusted quickly to grainy bread (which is what we used to eat all the time, I am not sure when soft brown bread began to take over). They understand that I am foregoing sugar. They are not so keen on the idea of finger pricking and run and hide when I do it, though it is utterly unspectacular. The diet only feels restrictive when I go out to eat or when I go to a party or something.

Anyway, in case you have stumbled here by accident because you have been diagnosed with GDM too a daily meal plan for me might consist of:

Plain low fat yoghurt with a handful of toasted oats, plus sesame seeds and flaked almonds and a kiwi fruit or a third of a banana or some strawberries. (Which I think is kinder on me that the bowl of muesli I had this morning).
OR a piece of toast with vegemite and a low fat latte

Morning tea:
An oat biscuit OR four vitawheats spread with peanut butter and dotted with about 8 raisins or topped with sliced banana OR a slice of toasted raisin bread with peanut butter OR vitawheats and low fat cheese. With any of these I might have a piece of fruit.
Cup of tea or low fat latte (I only have one latte a day and some days none).

Varies but today it was leftover avgolemono (made with orzo pasta instead of rice). Yesterday I had two nori rolls with avocado and half a very uninspiring apple - the rest of which I chucked. Salads with tuna and a piece of grainy bread with avocado spread or minestrone with beans and pasta are two other mainstays.

Afternoon tea:
Pretty similar to morning tea.

Tonight we are having a veggie lasagne. If we have pasta we have small amount of pasta on the side of, say, a meat dish, or two different kinds of veggie sides (the other day it was spaghetti with wilted silverbeet with lemon and nuts, and a tomato based tuna sauce). Often I make some kind of hearty salad, making sure to include a grain like burghul or barley and a good sauce of protein, like meat or nuts. A quick popular meat dish (served with many veggies on the side) in this house is: veal (schnitzel type) steaks, put in a pan (you don't have to brown them but you can), with tomato pasta sauce thinned with a bit of water and the lot sprinkled with grated low fat mozzarella or parmesan and baked in a mod-hot oven for about 15, 20 minutes (till cheese is the way you like it). You can accidentally forget about it for a while because the veal doesn't overcook easily. We would eat this with pasta on the side and a big green salad (on the side I like pretty simple salads, which I usually dress with a squeeze of fresh lemon juice - salad might be spinach leaves with sunflower seeds and pear, or diced cucumber, tomato, red capsicum, spinach and parsley).

*Look at me! Grade me! Evaluate and rank me! I'm good, good, good and oh so smart! Grade meeeeee!!


  1. I sympathise. Can only suggest you think about the end result - the baby, who will make it all worth it.

  2. Anonymous3:41 AM

    Your diet is absolutely brilliant. So healthy and well thought-out, but your body does it's own thing. I had gestational diabetes too and the closer I got to my due date the harder it was to keep the sugar levels in the healthy range, no matter how careful I was with my food. Coupled with my constant morning sickness I got to the point where I had to use insulin just to be able to function. Unfortunately I didn't find out until two days before my due date that when you use insulin you have to be induced. Fun times.

    In the end we are all victims of our own genes and there is only so much we can do to control it. Good luck with it and I'll keep my fingers crossed that the healthy eating does the trick, but if it doesn't, then you'll do what you have to do to get through it and have a beautiful bub as a reward for all the hard yakka between now and then.

  3. It's all so mind boggling when you first find out isn't it. Before finding out I was eating pretty healthy anyway. I didn't eat chocolate or sweets and the only thing I really had to cut out was the occasional glass of caffeine.

    I found the first couple of weeks really good, I ate properly, exercised enough and took my levels and all was good. But the thing that really got to me was the levels, somedays you really do start to analysis them {even though you shouldn't} and go oh geez..what am I doing wrong?

    The other day I thought I made myself a really healthy lunch {chicken + salad wrap} and my levels sky rocketed. So I guess it's all about testing things out and going from there.

  4. All sorts of factors can affect your blood sugar readings. It's the overall average that counts, not the odd highs and lows. Billy's big favourite for steady blood sugars are roasted vegetables (not potatoes). Easy too!

  5. Oh so true about the sense of judgement that hangs over pregnant women. Our world is soooo damn misogynistic.

    Anyway, life is stressful enough and I am sorry you are copping another stress right now.