Diabetes ‘n Me Blog

Because of all the risks and complications associated with poor control of blood glucose levels during pregnancy it is best to keep them in check all the time. But if there is a time during your pregnancy where it is considered more important to have your blood glucose levels under control it is when you are in labor.

If you have a very high blood glucose level while you are in labor, your baby is going to produce enough insulin to compensate for the sugar in your system. But what happens when your baby is born is he or she is no longer exposed to your high blood sugar and has an excess of insulin in their system. This will cause the baby to be hypoglycemic and can be quite dangerous for the baby.

For this reason, your baby’s blood sugar levels will be tested a few times after the birth. The test is administered immediately after the birth and when the baby is a couple of hours old. The blood is taken from the baby’s heel and is tested in the same manner as when you test your own blood with your glucose monitor.

When you go into labor, do not take any more insulin even if it is time for your next injection. When you go to the hospital be sure to bring your insulin and glucose monitor with you and advise all medical staff of your condition. Your doctor will give you more specific instructions to follow about nutrition and your blood sugar. When you pre-register at the hospital, ensure that you write down on your paperwork that you have gestational diabetes and who your care providers are. The more information you can provide the better the care you will receive when you are admitting to the hospital.

In order to diagnose you with gestational diabetes, your healthcare provider will order a test from the lab. There are two levels of the test that can be taken – the one hour glucose tolerance test and the three hour glucose tolerance test.

The one hour test involves taking a blood sample after you have fasted and then drinking a beverage high in glucose and testing your blood again one hour later. With the three hour version, you proceed the same except the drink has a higher concentration of sugar and your blood is tested each hour for three hours instead of one. The purpose of these tests is to see how your body reacts to and process the large amount of sugar in the drinks.

The American Diabetes Association lists the following blood glucose levels that would indicate gestational diabetes is present:

* Fasting 95 mg/dl or higher
* One hour 180 mg/dl or higher
* Two hours 155 mg/dl or higher
* Three hours 140 mg/dl or higher

If any two of the above readings come back in the ranges indicated you will be diagnosed with gestational diabetes. Once you have been diagnosed, you doctor will provide you with the blood glucose guidelines that should be maintained for the optimal health of you and your baby. They are:

* First thing in the morning – below 95 mg/dl
* One hour after a meal – below 140 mg/dl
* Two hours after a meal – below 120 mg/dl

There will be occasions when your blood sugar reading is higher than the recommended range. In that case, adjust your next meal. If you had planned on having a meal that was higher in carbohydrates it should be changed so that there is more protein. Protein helps to lower your blood sugar and carbohydrates convert to sugar raising your glucose levels.

Eating and pregnancy go hand in hand. Even though it doesn’t seem fair to be pregnant and not get to eat what and when you want it is healthier for you and your baby. The old adage of eating for two is true but many women overeat when they are pregnant and gain more weight than they should.

The more food that you eat in one sitting the harder it is going to be for your body to produce enough insulin to turn the sugar into energy. Not only is what you eat important so is the portion sizes. Your doctor or dietician will provide you with a meal plan and it is wise to follow it as closely as possible.

Since you will be eating smaller meals, you are going to need to eat more frequently to keep your energy up. The best way to do this is plan on eating six smaller meals throughout the day. You will keep a steady stream of nourishment going into your body and if you eat at the same time each day it will make it easier for your body to regulate insulin production and use.

A schedule that works for many women is to eat a small breakfast and then continue to eat approximately every two to three hours. This will include a mid-morning snack, lunch, an afternoon snack, dinner, and a bedtime snack. If you are still finding you are hungry in between meals or are finding ketones when you test your urine, consult with your doctor or dietician. They are sure to have suggestions to help you make changes that will work better for you. Such as eating more protein at meals or filling up on more vegetables (something that can be eaten as a free food at any time).

In a perfect diabetic world, you take your insulin, eat your meals and exercise and your blood glucose levels remain stable. But things happen, you take your insulin late, you eat a light meal and then spend all afternoon running errands. This is a recipe for hypoglycemia – a condition when your blood glucose levels fall dangerously low.

Hypoglycemia isn’t so much a hazard for the baby but it is for a mom with gestational diabetes. The best way to prevent this from happening is to know the signs and how you feel when you blood sugar is getting low and to carry emergency supplies with you at all times.

Some of the symptoms of low blood sugar include feeling:

* Hungry
* Nauseous
* Light-headed
* Faint

In the case of any of these symptoms, you should test your blood sugar right away and have something to eat. The best choice is a glass of juice or another food item that is considered fast-acting such as a piece of fruit or a piece of candy. Carry something with you at all times and a regular snack too. If you are out and need to eat (say you are stuck in your car during a traffic jam) it is important to have food with you.

Other precautions that you should take when you have gestational diabetes include carrying a card or another item that identifies you have diabetes and what type of insulin you are taking. The worse case scenario is you passing out and the people who come to help you need to know that you are diabetic. Make sure people at work and your family members are aware of your condition and know what warning signs to look for if you need help and when to bring your some juice or something else to eat.

Depending on when you are diagnosed with gestational diabetes during your pregnancy (most likely between weeks 24 and 28) you are going to have many weeks of watching what you eat ahead of you. If you find a meal that you like and works well with your blood sugars you may be tempted to eat it again (and again and again).

You are going to reach a point where you do not want to even think about a piece of toast with peanut butter again. And when you do, here are some ideas for a diabetic friendly breakfast:

• One piece of whole wheat toast with 1 tablespoon of natural peanut butter and a glass of milk
• A bowl of cereal and milk with almonds sprinkled on top
• One egg (cooked to your preference) a piece of toast and a glass of milk
• Natural peanut butter spread on half a banana
• Egg and cheese omelet with your choice of vegetables

Go for quality foods because as you can see, meal sizes are going to be small. By combining your breakfast foods with a protein you will assist your body in processing the sugar. The added benefit of the protein is be satiating for a longer period of time. If you fill up on carbohydrates (which is very easy to do at breakfast) you are going to be hungry sooner and have a higher blood sugar for your next reading.

As breakfast is going to set the tone for the rest of the day, don’t cheat. If you have a high-sugar cereal for breakfast, your blood sugar will be elevated for the rest of the day. After indulging you will have to make up for it during subsequent meals by having less to even out your blood glucose levels.