Gestational Diabetes management

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Gestational Diabetes management

Postby littlemarylela » Thu Feb 22, 2018 11:35 am

Hi, I am new here. I am 32 weeks pregnant with my 4th, and have been diagnosed with GD. My history is long. At 16 I was having hypoglycemia symptoms and worked in a coffee shop, with milk and sugar causing me to gain from 130 to 190 in the 3 years I worked there. I was a vegetarian until the last year, which is when I gained most of the weight. I got married and gained up to 230 over the next 3 years. My first 5 years of marriage I had PCOS infertility, and multiple early miscarriages. I tried some calorie restricting diets and could only ever lose 10 lbs, and gain it back. I eventually found some info on vegan diets and fruit diets that led to me losing 10-20 lbs with exercise and fruit. Surprise, I got pregnant and stayed pregnant. I used progesterone cream during the entire pregnancy as a precaution, and my diet was a reduced meat and dairy diet, as I had started to keep strict kosher and naturally ate less of each. I also ate more fruit, but didn't know what I was doing. I was diagnosed with gestational diabetes, and tried to manage it with the diabetes diet but was put on insulin because I couldn't figure it out in a week. Then I found Dr. Mark Hyman's blood sugar solution, and used that with very little actual use of insulin for the remainder of my pregnancy. No further complications, and baby was not huge. After I delivered my first, I lost more weight and maintained between 200-208 for the next nearly 2 years. I felt better than I had in forever. I exercised and ate a lot of fruit and tried to stay away from meat and dairy and keep it low fat. My focus was more on raw foods, but I was still holding onto a lot of bad habits. My next pregnancy was spontaneous fraternal twins, and I started eating more McDougall style in this one, partially for budget reasons. I didn't have all the info yet, but I did not gain a lot of weight and I passed the Gestational Diabetes screening. I ended up in hospital for the last 6 weeks though because of early dilation/preterm labour. I kept trying to eat good, but there was so much dairy in the hospital and I was supposed to stay mostly in bed. I had the twins at just under 36 weeks, healthy and everything went well. I was doing well for the first 4-6 months after they were born, but the weight was coming off slow and I was not sleeping. We had to move due to financial crisis, and ended up way out of town, away from the wholesalers and places I was used to buying produce cheap. With nowhere to walk with a stroller, I got less active and food started being just whatever we could afford. After spending the whole winter out in the country, we were able to move back to the city, but I was not feeling as well by then. My husband also gained 20 lbs. I wentback to 215, but with several attempts and cutting out dairy I got down to 194, but was not as fit as my previous 194. I got pregnant again when the twins were just 14 months and between all the toddler chasing and stresses, I have not been so good about food. I have been feeding my kids high starch - white pastas and fat free sauce, cucumbers and bananas (other things as well, but this is an example). I eat with them because I am so tired I can't make more meals. My husband struggles with the starch thing and ends up putting cheese on everything, but wishing for better food. He wants more put together meals, and not so much repetition, but I'm just struggling to make anything at all. I'm so tired all the time... but even the white pasta isn't as big of a problem as adding tuna or mayo, which started happening for convenience... I also can't get butter or margarine out of the house because my husband wants it. Anyway, I could ramble for a long time abut the complications of food in my house, and my approach has been progressive for everyone. My husband and I eat 70% better than we used to, but for me personally it seems like I need to focus on something more than just developing progressively better habits, since I have actual health issues. My sugar numbers on the test were after eating as strictly low fat starch based as I could for about 5 days. Fasting number 5.4 mmol, 1 hour 13.7 mmol, 2 hour 11.2 mmol. My ferrtin levels are low at 10, (should be 13-50 according to my midwife) which is probably contributing to being tired. My current weight is around 220-225, but my scale battery died a few weeks ago, so that's not for sure. I feel like if I could lose some weight, (while pregnant) I might be able to beat this. My biggest temptation is sweets like cookies etc and I manage to get my hands on some about once a week.

I am committed to making changes that lead to weight loss or change as fast as possible, but I am about to face the Diabetes in Pregnancy team who are going to tell me to eat fat and protein with everything and to limit carbs. If I don't manage to get my numbers low in a short amount of time they will put me on insulin quickly. I want to avoid it, but I also want to eat in a long term sustainable way.
Last edited by littlemarylela on Sat Mar 10, 2018 11:38 pm, edited 1 time in total.
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Re: Gastational Diabetes management

Postby f1jim » Fri Feb 23, 2018 7:28 am

When we get to the point where our weight is out of control it's easy to see that as 95% of our goal. We also tend to shorten our goal window to the point that losing weight at any cost seams viable.
It's very hard to take the long term path to health when ones mindset is focused on short term goals.
Remember, we tend to be in the situation our short term goals put us in. And it's very hard to actually take the long term view and fully act on it once we find ourselves in serious health trouble.

All I can tell you is rely on your knowledge of good nutrition and health every step of the way and not to be sidetracked by well intentioned, but nutritionally ignorant individuals along the way. Your health issues will not fully resolve themselves until you commit fully to a proper nutritional path. Your doctors can make your numbers look good, however, and if good numbers are your goal they have answers. This program addresses much more than your numbers. It deals with the underlying causes of the health issues you are dealing with. If you are fully committed to dealing with those issues you will succeed, despite your doctors or friends reservations.
You have seen the results of short term rewards like the kind that comes with binging on cookies. When your health becomes more important than the short term payback of junk food you will be ready to move on.
What ever you do, don't play the middle ground. You will get middling successes and the frustrations will exasperate you. Make the commitment to really turning your health issues around by facing squarely their causes. Most people won't. A small number of people will. I hope you will be in that minority of us that chooses the correct path.
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Re: Gastational Diabetes management

Postby viv » Sun Feb 25, 2018 10:00 pm

I have one word for you, POTATOES! Very cheap and quick to prepare (zap in microwave) and very healthy for you and the children. Give the children as many potatoes as they want, top them with salsa, veggie soup, beans, etc. Eat them for meals, snacks, whatever. Regular potatoes are loaded with vitamin C and many other nutrients and sweet potatoes are very high in vitamin A. So a variety of sweet and regular potatoes with steamed frozen veggies and some fruits will be great for all the family.

btw I was diagnosed with "pre-diabetes" in my last pregnancy (26 years ago) and I remember the dietician giving me a diet plan and she wanted me to have two tablespoons of mayonnaise a day ( I know weird) which I refused to eat, but I do remember she wanted me to eat lots of veggies such as broccoli. That was when I was eating meat so I basically followed the diet but took out all the fat and my weight gain did slow down.

Good luck!
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Re: Gastational Diabetes management

Postby Lyndzie » Thu Mar 01, 2018 6:46 am

I’m pregnant right now, too! Yay!! I’m 25 weeks along now.

Here is a link to some info on gestational diabetes: viewtopic.php?f=1&t=55580&p=562827&hilit=Gestational#p562827

If you go to the board index, type in “gestational” in the search box, and you’ll get a lot of posts. Same with Jeff’s forum, if you want posts from his specific section.

I don't think losing weight right now is a good idea, or the answer to your problem. Quite simply, you just need to increase your insulin sensitivity. Focus on eating starches, add in some veggies, and that’s it. No oil, no animals, and no high-fat plant foods.

I completely understand the lack of sleep and exhaustion part, and I can’t imagine a set of twins on top of it! White pasta is fine, just top with some oil-free sauce. Make a quick sandwich of whole wheat bread with hummus and your favorite veggies. Baked potatoes with salsa are quick (just nuke thise things!) and filling. Try to think of what you are used to eating, and see if those can be adpated to exclude the bad stuff.

You can totally do this! Reach out if you have questions, need food ideas, and keep us updated. Best to you!
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Re: Gastational Diabetes management

Postby littlemarylela » Sun Mar 04, 2018 11:51 am

Thanks for your comments everyone. I have been doing a lot better at avoiding bad and eating enough good starches. In the past week I had 2 days where my fat intake went over 10 grams, but I think it stayed under 20. I have been keeping tabs with my sister who is doing it for weightloss, and we are journalling everything we eat on our phones and sharing it so we can see where we are messing up and help each other. I had to reschedule my DIP clinic appointment for the 9th due to transportations issues, so I have been trying to be SUPER good so that I can just beat it before I start monitoring. Right now my issue has been low blood sugar. I don't have a tester yet, but all the symptoms match super low blood sugar. A couple of times it's been only a little while after I ate. This morning I waited to long to eat, and was a little shaky and grumpy. I ate 6 white pancakes with maple syrup, (no fat) and within 1 hour I was having a super low blood sugar attack. I thought maybe it was high at first, but looked up symptoms again and as soon as I had a cup of juice I was fine again. Does this mean my insulin is working really good? How much should I eat and how often to avoid this? Should I just have juice every hour or two today? Thanks again for the input! I wanted to respond earlier in the week, but I also wanted to have an update.
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Re: Gastational Diabetes management

Postby littlemarylela » Sun Mar 04, 2018 11:55 am

P.S. I don't usually eat white pancakes, but my husband is home on the weekend and doesn't like oatmeal, plus I'm out of wheat and whole grains that I usually make pancakes from. I got some spoonables shredded wheat for easy and fast meals (just 100% whole wheat), but we ate it yesterday for breakfast and dinner so I didn't want to have it again. My usual breakfast is oatmeal or whole grain pancakes with a little jam and cold cereal maybe once a week. I sometimes have a banana or other fruit as well.
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Re: Gastational Diabetes management

Postby Lyndzie » Sun Mar 04, 2018 1:31 pm

While you work on this, I would suggest avoiding all flour products, even when whole grain, and anything with refined sugar, including maple syrup and jam. These products can cause insulin spikes and quick drops, which explains the hypoglycemia. Sticking with your oatmeal, which isn’t very processed and contains loads of fiber, will help keep you full and keep that blood sugar steady.

I know it’s a bummer to skip pancakes when everyone else is eating them, but I have to do the same thing. There are a few recipes for oats that don’t require a sweetener that you might like, using diced apples and raisins to sweeten it up, and a sprinkle of cinnamon. It takes a little getting used to, but is filling and good.

Thanks for keeping us posted! I’m rooting for you!!
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Re: Gastational Diabetes management

Postby littlemarylela » Mon Mar 05, 2018 5:12 pm

I'm starting to wonder if I need to go way simple and just eat sweet potatoes, veggies and fruit. (Maybe a few other potatoes and brown rice). I started out focusing on eliminating the fat, because I believe that fat in the cells is causing the insulin resistance, but maybe eating white rice, sugar and flour is not good for me short term especially. After a couple of days with several sugar lows, I'm really wondering what kind of strategies I can use to stay level. Eat less at a time more often? Fruit in between meals or with meals? I still have until Friday before I have to start pricking my fingers and writing it down.
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Re: Gastational Diabetes management

Postby Lyndzie » Tue Mar 06, 2018 6:36 am

You have done a great job of listening to your body and quickly making changes. Bravo! Sticking with whole plant foods will definitely keep your blood sugar steady, just eat when you're hungry, and stop when you're comfortably full. I don't know if meal size and frequency will matter when you're eating with whole plant foods, but play around with it and see what works for you.

You might want to include at least 1 cup of beans per day in your diet. Beans are super good for you, and full of nutrients that will help you grow that baby, including folate, iron and protein, and fiber to keep you full and ward off constipation. I like a meal that I call "taco potato," which is simply a baked potato topped with black beans and salsa. It's simple, filling and yummy.

One last thought: you don't have to start pricking your fingers on Friday. Doctors are not gods to be obeyed, they are just smart people with more student debt than you. They are giving you advice, but can not make you do anything. If you want to give yourself more time to work on the diet, then do. They may huff and puff and threaten, but they also aren't the ones who are poking themselves. On the other hand, if you want to start monitoring your progress, feel free, but only if that is what you want to do.

I am really impressed with your motivation and willingness to work towards being healthier. Keep us updated!
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Re: Gastational Diabetes management

Postby littlemarylela » Tue Mar 06, 2018 8:22 pm

Thanks Lyndzie! I appreciate having somewhere to share my experience and get feedback.

Last night was horrid, with adrenaline attacks and multiple lows. I was up almost every hour to eat. I noticed a little hunger right before going to sleep, and got up and ate a couple of bananas. I had to walk around a little because I was feeling that restless/almost panic feeling. I went back to sleep and woke up 2 hours later with a full blown panic attack. I got up and ate an apple, and some puffed brown rice cakes. I wasn't really sure what to do, so I didn't want to overeat. I stayed up for a bit researching and found some info on the adrenaline rush that comes with a blood sugar low. It was sooo enlightening! I have been having some hypoglycemia since I was a teenager, but there were always other symptoms that I didn't understand. I had a few episodes as a teenager, and fewer than 4 in the past ten years, where I past out with stomach pain, followed by waking up sweaty and needing to move my bowels. Thinking back to it now, I know if was related to blood sugar. I have also had eczema on my lower legs since around the same time as a teen, and PCOS symptoms started then. In the past 3-5 years I have eczema on my hands too, but it started as winter dryness I think there might be an allergy involved. I don't know why, but I am having some aversion to potatoes and most beans right now. I had some red lentils today with my rice and they were good. Anyway, I ate an apple frequently throughout the night and survived. lol I ate about 1 1/2-2 cups cooked brown rice like 8 times today, with sweet potato, broccoli or red lentils and peas and a few pieces of fruit here and there. Keeping it simple and hoping tonight is better. Since about 2 pm I am feeling a bit better, and haven't had to eat every hour to keep going. I am going to be more prepared tonight with a fresh pot of rice in the instant pot, and having eaten rice and broccoli for the last meal.
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Re: Gastational Diabetes management

Postby Lyndzie » Wed Mar 07, 2018 2:45 pm

Oh man, that sounds awful! Sounds like you have a good game plan, sticking with those whole starches to stay full and keep blood sugar steady. I wouldn’t worry too much about portion sizes, I usually eat 4-5 cups of food per meal. Since the calorie density of these foods are so low, you eat much larger quantities, and that’s totslly fine. Also, you are third trimester, which does require more food than usual anyways!

I had a midwife appointment yesterday, and she wants me to monitor my blood glucose for a week, instead of the traditional challenge test. Fingers crossed!

When is your due date?
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Re: Gastational Diabetes management

Postby littlemarylela » Thu Mar 08, 2018 11:36 am

I am due April 21st. 6-7 more weeks, Yay! My midwife appointment went well, and my midwife is happy to hear about my diet. She is really good about believing in natural healing and being intuitive etc. I told her about the fat and insulin connection and Dr. Mcdougall's starch solution and she was excited to see how it goes for me. I am planning to do the finger pricking, if for no other reason than to prove this thing works. I know a lot of people are not receptive to this stuff, but eventually some people listen. They start remembering that they heard someone had such and such results and when they are confronted with a real need to change, they have somewhere to look for info. I'm hoping some of my type 2 diabetic friends will be interested in my results.

I ate brown rice and various vegetables yesterday, all day. Maybe every 3-4 hours, not as hungry as the day before. I was coffee free the two days before, but yesterday morning I made myself a 12 oz almond mocha (with earths own almond chocolate milk). It has 3.5 grams of fat per cup and not a ton of sugar. I was craving a full blown white chocolate caramel mocha from the local coffee shop, (on sale on Wednesdays) so I think I did ok there. The only other thing I had with sugar was a couple of handfuls of maple-brown sugar oatmeal squares (cereal) in the van while we were running around.

I made some whole wheat oil free bread and vegetable soup for dinner and ate with my husband around 6:00pm. I had 2 slices of bread, no butter and a single bowl of soup. I had a good nights sleep last night! Hubby and I couldn't sleep at first, so we got up and ate again late, about 10:30 PM. I had soup and rice and was hungry after the first bowl, so had two. I did not wake up hungry or adrenaline rushed at all. In fact, I got up at 5:20 (as usual) and was not hungry yet. I ended up eating at 6:00am, but not being really hungry. I tried to eat again about 8:30am, but wasn't hungry after a few bites. Soooo hoping this means I'm on the mend! I had a small latte this morning with unsweetened almond milk and a tsp of maple syrup. I have a breville espresso machine, partly because I struggled to give up the dairy half and half in coffee, but love almond milk lattes. For now, I just have to keep the quantity low. I've tried giving up coffee, and been successful for 3 months once, but I just can't find the motivation to give up one of my favorite things completely.

Are you planning a home birth? I am not sure yet. I want one, but my husband is not sure about it and I am doing the "be prepared" but sort of planning on hospital with the midwife. Testing for a week is a great idea. That test is so dumb. All the sugar, and waiting around in a room full of sick people for hours... ugh. Medical people, rethink this screening please!
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Re: Gastational Diabetes management

Postby Lyndzie » Thu Mar 08, 2018 4:22 pm

Wow, you’re almost there! April 21st is my half-birthday. Great that you’re feeling better, and that your midwife is supportive of what you are trying to accomplish.

I am planning a home birth. My first was a hospital birth, and my second I had at home. It did take some convincing to get my husband on board, but we had a really good experience. My mom, on the other hand, told me I was going to kill my unborn child if I wasn’t in a hospital!

You’ve got three other kiddos already (so impressive!), I’m assuming those were delivered in hospital? It really about where you are most comfortable. You’ve done this before, so it should be old hat at this point, right?
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Re: Gestational Diabetes management

Postby littlemarylela » Mon Mar 12, 2018 6:54 am

I'm doing a LOT better. Night times are better. I suspect maybe some of what I have felt has been progesterone, rather than adrenaline. Anyway, I went to my diabetes in pregnancy appointment, and went through the whole diet thing and what to eat as a vegan. I just didn't push anything about the protein or fat and showed that I understood the system. I have had good numbers so far, except one that I think was because I mixed up the time change, but I'm not 100% sure. I am going to run out of test strips before I can get more, so I'm not sure if I am going to test today or just doing some morning tests for the next few days. I am waiting to hear back that my tester is even working properly before I get any strips, and if they are not covered by a program, I'm thinking $200 worth of good food is a better investment at this point, so we will see.

When I tested in the clinic, at 1.5 hrs (usually done at 1 or 2 hours) I was 7.1 mmol/L (127.8) and when I got the meter tested at 2 hrs and 15 minutes it was 4.4 (79.2). Breakfast was a bowl of steel cut oats and a banana (about 75 g of carbs)

I didn't end up using the tester on Saturday, so I really only have part of Friday and yesterdays numbers. Yesterday was 5.1 and today was 5.2 when I woke up, and 5.2 is the highest they want to see for a morning number. However, both of these were after late bed snacks with over 70 grams of carb... (snacks are supposed to have 15-30, meals 45-60)... my after meal numbers have been 5.1, 4.9, 4.9 and 4.8 and they want to see 6.2 and under. (These meals were 90-120 grams of carb, because I thought it was 1/2 cup brown rice to a serving, not 1/3 and I was actually eating more than 2 cups per meal, and I did the math based on the package.)

I am pretty sure I still have GD, but I am just tolerating the high starch because of the low fat. My plan is to stick with what I've been doing and try to get the government program to cover some strips so I can keep testing, but I'm not going to sweat it or buy strips for myself. I have a follow up appointment on Friday, but I'm not going to take it as seriously, and cancel if I need to. I have an email address for the dietitian to send my numbers to, so I can do that instead of calling in.

The biggest stress these past few days was when I tested at the wrong time (3 different times!) and scared myself, and the one that I'm not sure if I mixed up the clocks or just had a high number from the toast. Either way, it was not a number I would consider taking insulin for, so that's the story I'm sticking to.

Oh, and the dietitian was not worried about sugar lows for me, she said even if I was having super low numbers, it wouldn't be a problem for the baby unless I was taking insulin. She did encourage me to get some b12 and use my iron fish, which I haven't been using enough because I use the instant pot so much, and I would have to boil it first.
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Re: Gestational Diabetes management

Postby littlemarylela » Sun Mar 18, 2018 9:46 am

So excited! After 1 week of testing, I was told that my numbers were great and I don't need to test as much if I don't want to, and that I am beyond the part where the sugars go up higher. My numbers have mostly been in the 4s and 5s, with a couple of 6s two hours post meals. They also said I could cheat a little if I want to. REALLY!? Anyway, I told them exactly what program I was using, and how many carbs I was eating (often over 100 grams of carb) and that I was adding zero fat to help increase insulin sensitivity. I hope it all goes on my record, because I signed a thing allowing researchers to look at my chart and contact me. You never know...

35 weeks yesterday and feeling better than I have felt the entire pregnancy. Thanks everyone!
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