Navigating the Gestational Diabetes Test
Itās stuff like this that makes me want to grab a midwife and a bearskin and my husband and just hang out in a cabin in the woods until I give birth in a warm pool outside under a full moon.
But alas. This is the age of highly medicalized pregnancies, for better and worse, and I have opted in for most of it.
The week before the test, I dropped all refined sugar (I was eating a treat a dayāchocolate croissant, or a small bowl of chocolate ice cream, or some actual chocolate; can you see a theme?); lowered my carb intake (which mostly comprises veggies and some gluten-free pasta); and made sure to exercise more regularly, even if it was just a short walk after dinner. Not to ātrickā the test, but to avoid getting caught in the false positive crowd. Of all the risk factors for GD, I have only two: being (well) over 25 and being pregnant. Iām not overweight, I have no family history, no diabetes history, and Iām Caucasian. Being older is a factor because, well, I donāt know why, but Iām guessing a combo of lifestyle choices and slowed metabolism. And pregnant is a factor because the placenta itself releases hormones that mess with insulin and blood sugar levels.
The morning of the test I drank the orange stuff, called simply āGlucose Drink,ā (no money wasted on branding there!) which tastes like flat, slightly syrupy Sunkist dosed with something bitter and off. The ingredients freak me outāI had read online that some docs allowed their patients to brig in crazy-sweet natural drinks like grape juice; my docs said nope. But alas, organic me was swigging a blend of glucose, citric acid, natural and artificial flavors, sodium benzoate, and FD & C yellow #6. Stuff, in my opinion, no one, especially pregnant women, should be putting in their bodies. The best I can say is that it was cold. And cold was not to be underestimatedāit was sweltering out.
That done, I waited for a while, we went in for a regular appointment, and when an hour had passed, they took my blood. I prayed and finger-crossed and still didnāt eat sugar. Next day, I called for the result andĀ farginnabbit!: 134. A year or so ago, or in a different doctorās office today, that would have been just fine. 140 used to be the recommended cut-off. No longer. Studies found they caught yes, more false positives, but also more women who actually had gestational diabetes, when they lowered the number to 130. So, being slightly over the new limit means I failed. Which in a practical sense means I have to be retested. My doc, though, goddess bless her, said that it would be fine with her if I just re-took the one-hour in a month, since I was just a hair over. Whew.
But still, emotionally, this result hit me in three key areas in my mindās worry zone:
1)Ā Ā Feeling like a failure. One of the reasons I choke on tests is because the specter of being judged by a neat external number feels so fundamentally wrong to my soul that I get nervous and rebellious and lose it. The idea that I failed at something often translates in my brain as, āIām a failure.ā Working on it. But this brought that up big time. (Which reminds me of my friend Dara who used to say, āBring it up? What are you, puking a little?ā)
2)Ā Ā Food issues. Letās just say my history with food has been rocky, once quite dramatic. Being told by a test that I might be doing it all wrong even though I put tons of energy into trying to do it right doesnāt go over so well. Guessing Iām not alone in this one either. And as a result Iām now worrying about everything I put into my mouth, something Iāve spent a lot of therapy money to not do.
3)Ā Ā Feeling like a bad mom. Welcome to my first āIām a bad mommyā thought! The main reason you want to catch gestational diabetes is that, as the ADA says, unchecked high blood sugar, ācauses the babyās pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat. This can lead to macrosomia, or a āfatā baby.ā Oy. It can also potentially set them up for obesity and type 2 diabetes. Plus, a big, big baby is no fun to get out the birth doorāfor anyone involved.
After a day of wallowing in a swirl of the above (sadly, not a soft-serve swirl; too much sugar), I emailed my docs asking what I could do. One doc in the practice wrote, āIf you do have diabetes of pregnancy thereās lots you can do, unlike many other problems where we are very limited. Remember that the problem is the hormones from the placenta so donāt be too hard on yourself.ā
Aw. Ok. I was starting to feel better. The next day I spoke on the phone with the doc who had been lenient with me. She said I can track my carbohydrate intake via an iPad app called My Net Diary and aim for 150 to 200 grams of carbs a day or get a glucometer and test my sugar after eating, which is the only real way to see how foods are specifically affecting your blood sugar. And in general just eat fewer carbs and more healthy proteinsānuts, lean cheeses and meats, eggs. Iām opting for a blend of theseāthe glucometer prescription is in the mail, Iām working on my diet, Iāll buy the app once I have the glucometer so Iām tracking my food with a real-life test, not just arbitrary numbers that may or may not be affecting my blood sugar; every body is different. Iāve predictably rebelled the last few days though, eating a little more bread than usual and even some ice cream in anticipation of pretty much giving it up until this little guy is safely out of me in October. Itās a process.
Even though my number was only marginally over and I havenāt even been diagnosed with anything, Iām trying to be proactive because of my dedication to an unmedicated vaginal birth (more likely with a smaller little dude)āand a healthy baby.
We shall see how it goes. If youāre going through a similar GD-testing rollercoaster, let us echo the words of my kind doc: āIf you do have diabetes of pregnancy thereās lots you can do unlike many other problems where we are very limited. Remember that the problem is the hormones from the placenta so donāt be too hard on yourself.ā
Amen to that.
To learn more about gestational diabetes, talk to your doctor and check out the ADA website.
Valerie Reiss is the Managing Editor of Mom365.