Sawnet: Personal Experiences with Gestational Diabetes



Here are a few links to websites that may have useful information.
The NIH website is fairly comprehensive.
Here is the Arnot Medical Center's webpage on GDM.
The Canadian Diabetes Association website has a good page on GDM.


What follows is a compilation of the personal experiences of some sawnet members who had gestational diabetes. Bear in mind that these are only a few people's experiences and opinions; you must consult your physician on the specifics of your case.


I had gestational diabetes in India in 1981 and 1982. Both times, my babies were taken out by c-section in 34/35 weeks because I had gained too much weight. I was in bed from 30 weeks. My diet was low calorie. As far as I remember, I was allowed one cup of rice for lunch and one small chapati for dinner. For breakfast and afternoon snack, I had up to a cup of chhana, which is the Bengali word for paneer. It was very boring. There were little variations, but for my children's safe delivery, I went through it. I also had hypertension. I usually had fish with my meals, and some nights chicken. Some vegetable made with little oil. I missed the original question, but am wondering if this will help someone with gestational diabetes. The babies were hairy and heavy, but they lost both weight and hair very quickly. I thought they looked like pigs, but I also they thought they were the perfectly beautiful babies I always dreamt I'd have. They are now both grown into lovely, all-rounded leader-type personalities and are doing well at great schools.

One other thing: at 34 weeks, they were fully grown, all the way to cute fingernails, so never worry about an early delivery. Hope it helps someone. - Indrani Dutta-Gupta


Here's my take on gest. diabetes. Sorry it's shorter than I thought it would be. But it's amazing how quickly I've forgotten things related to my pregnancy:

Although it may not seem so at the time, there are a lot of benefits to having gest. diabetes detected while you're pregnant. First, you become much more aware of the food you eat and the way it affects your body. Second, you have a 50% chance of getting it later in life, and a much higher percentage if there's a history of it in your family, so it's better to know it upfront and possibly prevent it or delay its onset later in life. Third, your child's health during the pregnancy will be improved by your improved food habits, which might not have been the case in our mother's generation when g.d. was not diagnosed.

As for having g.d. while eating a predominantly South Asian vegetarian diet, it is somewhat difficult but can be done. The best way to think of it is as an "counterintuitive diet" which essentially means that you can't eat the things you normally think are good for you. I've put the following list together, so it's easier to read:

1) Read labels. In general, you don't want more than I believe 40g of carbs per two to three hours. A blueberry dannon yogurt has 55g of sugar; a bowl of cereal approx. 40g of carbs. Compare it with a Hagen Daaz ice cream bar which has only 25g of sugar.

2) Don't worry about the fat as much at first. Eat lots of eggs, peanut butter, dal, plain fat yogurt, tofu, etc.

3) Monitor closely your sugar levels. After a while, you will know what makes the sugar levels go up and what doesn't and can choose foods that you like that don't cause the sugar levels to go up.

4) Eat every few hours (5 meals a day) and try to take a 10-minute walk after every meal.

5) There's some Indian vegetables that are good for diabetes, like bitter gourd.

6) Avoid rice and all rice-based items. Replace it with one chapathi or one piece of bread and a vegetable.

7) If you're going to cheat, cheat when you know you can take a 1-hr walk after eating. If your body uses up the sugar right away, you may be okay.

This is all I can think of right now. I'm sure there's so much more that I'm not remembering.

Usha Narayanan


Good sources of information

First of all, there is some excellent info on GD on the web, the best being the NIH website. I borrowed some books from the Stanford Med Library but essentially they said nothing new.

My opinion of tests

I had to do the GD tests a couple of times before my doctor decided I was definitely diabetic. I haven't heard about false positives in GD testing. I think the 3 hour test is fairly conclusive, especially when its done between the 24th and 28th week.

The definition of good glucose level does depend on your doctor sometimes. Mine was pretty aggressive about keeping the fasting glucose level below 90 and after meal numbers below 130. There is *some* literature that indicates that allowances be made by race, but I don't know too much about that. I had a lot of faith in my doctor.

Risk factors for GD

No doctor told me that I had an increased risk for GD if there was a history of type II diabetes in the family. However, I was insistent on early glucose testing, and had high levels of sugar as early as 22 weeks. however, I didn't start working on a special diet/insulin until 24 weeks. I do think that people on high carb diets (vegetarians) do have a higher risk for GD. when you're pregnant, there is a lot of stress on your body, and your pancreas is working way over-overtime anyway. Add to that a diet of rice, pasta, milk etc and your poor pancreas just about gives up :-) My father was diabetic, but apparently GD had nothing to do with it (per my doc). IMO tho', GD may be indicative of things to come, and the risk is compounded by a history of diabetes in the family.

If you don't control your GD, minimally you are at risk of having a very large baby (C section) and worse, it might result in fetal death.

Controlling sugar

I had to take my blood sugar 4 times a day - fasting, after breakfast, lunch and dinner. Also had to check for ketones in the morning (urine test) so that I wasn't burning fat [bad for baby's brain development]. At first, I tried the diet. the nutritionist specified 9 carb exchanges (I don't remember the number of protein and fat). so i tried 2 carbs in the morning (like 1 english muffin), 2 carbs for lunch (1/2 a sandwich) or 1 chapati etc. I was really against the insulin, and really wanted the diet to work. So and I was psyched out to the point that i would prefer to not eat anything just to get my sugar down. started losing weight and burning fat. It also stressed me out to no end, whuch got my sugar up. BAD IDEA!

I started insulin once a day and it was such a relief to see the numbers come down! I also started working from home. finally I also experimented with a few things - like Ifound out I was more sensitive to wheat than rice - Icould eat 2 idlis in the morning and have better sugar levels than eating 1 slice of bread. Mom came to take care of me and she was really good about getting me eat all sorts of good stuff - she came up with this salad with mung sprouts, a lot of veggies chopped really fine that i would mix with sour cream and spices. it really kept my sugars down. Cracked wheat uppuma was good too. I also drank 1 mug of milk at the end of the day (sugars are low at night). I also walked for a good 45 mins after every meal and that REALLY brought the sugars down. in the 8th month, for some mysterious reason my sugars just came down dramatically - don't know why but it sure felt good! As far as food goes, everyone's body reacts differently to different types of carbohydrates, so you really need to experiment. Cheeses are great, snacking on carrots, celery, cucumber works as well, nuts are good too. Soy is also a great alternative. Stir fried tofu is a low carb and very filling meal. Avocados work well too. Mom's salad was a huge platter of many veggies chopped really fine with some spices. I actually used to eat it in lieu of rice. She also made all the "kootus" [esp. winter melon] with sprouted pulses instead of daal, so they made a low carb meal as well.

GD & labor

In the last month I had nonstress tests and ultrasounds almost every week to make sure that baby was OK, and wasn't growing too large. My doctor also didn't want me to go beyond my due date bcos of the GD. I went into labor 2 days before my due date. My sugar was monitored every hour ( took my monitor just in case). I was in labor for about 15 hours, I wasn't allowed to take any juice bcos of the sugar. So that was pretty tiring. When Ajay was born his sugar was tested right away, and it was predictably low. so he was given some sugar water.

In conclusion

I put on about 15 pounds in my entire pregnancy, most of it in my 1st trimester (before I had GD). I know I have an increased risk of getting type II diabetes (at least 60%). The GD disappeared as soon as I had the baby. of course, everybody brought me chocolates and icecream :-)

Psychology

In all the material I read about GD, there is nothing that talks about the stress that GD causes, the sense of failure that you have when you cannot control your sugar with dieting. Those numbers .... they controlled my life at one point. The patient can actually start lying about the numbers just to get a false sense of security, which is no good. A pregnant woman with GD needs a LOT of encouragement and support. Not working during this time is really the best way out, as stress increases sugar levels as well. It takes a lot of time & pain to monitor your sugar levels, walk after every meal, eat 6 small meals a day - there's no time for anything else. Of course, you can't eat out, and no baby shower cake either, not to mention that people around you are gulping down curd-rice, or your favorite lasagne. I have no idea how I summoned up the will to do all the things I did during my pregnancy to control the GD, I was just immensely motivated. Friends and family helped - they kept me company on my walks, made me salads, read the labels on food stuffs with me ....
Enuff said.

--A member of Samnet


************************************************************************

DISCLAIMER: The following are my findings, observations, and experience. Please consult your physician and those you feel you can trust before you embark on a course of action. If you are on medication, when you begin any nutritional/supplemental/complementary regimen, your doctor will need to monitor any changes to your medication. There is a good chance that you will need lower doses as your immune system heals. Diabetics who monitor their own blood glucose levels must be cognizant of lowered insulin or oral medication needs. I do not claim any medical expertise, and I am *not* dispensing medical advice.

*************************************************************************

THE IMMUNE SYSTEM


Diabetes is a auto-immune disorder: the body attacks itself, destroying healthy organ tissue and other cells, such as insulin receptor cells. Insulin-independent diabetics (Type II, or adult-onset) are given oral medication to enhance the performance of insulin receptor cells. Insulin-dependent diabetics (Type I or juvenile) produce less insulin from their pancreas, and therefore require an outside dose. However, both types may well be reversed through meticulous attention to repairing the body's immune system.

Every major "health care/preventive care" system such as Ayurvedic, Chinese medicine, and Native American "earth medicine" system, for example, addresses the immune system, and maintain that the liver or digestive system is the "seat" of disease. It is widely understood among "complementary care/alternative care" practitioners that our "modern" lifestyle fraught with stress and fast foods, and even if we eat fresh produce, result in malnourishment. Seemingly "healthy," athletic individuals suddenly experience stroke, heart attack, or many of us succumb to cancer, heart disease, high blood pressure, diabetes, arthritis, obesity, etc. Research scientists, biochemists, biologists have successfully created high-potency nutritional products to counter the ill effects of our yo-yo diets. The Native American healer who has helped me overcome my insulin dependency has done so by helping me rebuild my immune system.

DIABETES

You will find many answers, one-on-one, from medical care professionals at this site for your own particular needs:

They provide a team of doctors and nurses to work with you, addressing your needs, and they do this online, being accessible all the time.

Exercise is extremely important. Avoid sugary foods, very sweet fruits and fruit juices. Eat grapefruits rather than juice. Those with any allergies or respiratory ailments like asthma should avoid orange juice and dairy products.

GESTATIONAL DIABETES

Women experiencing gestational diabetes should be working with a nutritionist and a team of specialists so that both mother and baby maintain good health throughout the pregnancy. It may also be that a pregnant woman who experiences gestational diabetes may have a pre-disposition to the disease. I've heard that it does go away after the birth of the baby. If you maintain a strong nutritional regimen that supplies all the essential nutrients for a strong immune system, with a reasonable weight for your body type, you should be fine.

However, it takes effort and considerable knowledge about nutrition, the stress factor (lifestyle issues...your coping mechanisms). If you have a nutritionist, find out about foods that will not raise your blood sugar. The main thing is that you keep your sugars between 70 and 120. This is easy to do if you are eating the right foods. Dairy products contain a lot of sugar, as do fruit juices. Your nutritionist can help you eat for your health and your baby's health. Certain "green" foods supply calcium.

If after the birth of the baby, any mother is still concerned about blood glucose levels being high, I can send you a nutrional regimen that can help you lose/maintain your weight as well as perhaps reverse your diabetes and eliminate the need for insulin and/or oral medication.

COMMITMENT TO HEALTH

As I mentioned, all this requires a lot of effort, but if you have a good support system of family, friends, and health practitioners (including complementary care professionals), you will succeed. I have gone from 2 doses of insulin per day to just one, and I don't require even that one dose every day. I have, in fact, been able to increase days without insulin to a week. I have also not only lost 30+ lbs. in the past year, but have kept the weight off quite successfully and without counting calories. My energy level is such that, although I'm not a jogger, I'm jogging!

However, again, what is needed is a basic understanding of nutrition and how it helps to strengthen your immune system. I would encourage you to read the book by Dr. Julian Whitaker, "Reversing Diabetes." I would also encourage you to see your nutrionist. Further, I'd enourage you to contact the online diabetes web site where you can find answers to questions that pertain only to you, and not generic answers that may or may not address your needs.

Finally, the Native American "Earth Medicine" that I'm talking about is very similar to Ayurvedic practice, and is applicable to any individual, not just diabetics. Given the pollution in our foods, water, soil, air, and the presence of yeast and fungus in our bodies, every individual can benefit from a healthy immune system. This regimen is not about dieting. It is a lifestyle change.

READING LIST

"Your Body's Many Cries for Water" by F. Batmanghelidj, M.D.

"The Healing Clay" by Michel Abehsera

"Probiotics" by Leon Chaitow and Natasha Trenev

"Green Leaves of Barley" by Mary Ruth Swope

"Healthy Healing" by Linda Rector Page

Wishing everyone peace and good health,


-Manjusree Sen