Gestational diabetes rant (For Baby!)

by - November 20, 2023

Not fun fact: There isn't a national standard for diagnosing gestational diabetes (GD), as stated on the Royal College of Pathology Australia's website and also by my gestational diabetes educator. She opened our education session by stating, "This won't help you ladies, but if you were having your baby next year you may not have been diagnosed with GD because they're easing the diagnostic levels." Great. Just great!

It gets dumber. Each hospital has varying blood glucose limits and guidelines. So you can be in the same city as another pregnant GD mumma and get different medical advice. For example, I am trying to keep my levels within:

  1. Fasting - 5.0 or under

  2. 1 hour after meals - 7.6 or under (only if I know ahead of time I can't test at 2 hours then I should test at 1 hour if I can)

  3. 2 hours after meals - 6.7 or under

Other women's fasting numbers range in the 5.3-5.5 range that I've seen. Some women are told to test at the 1-hour mark, while others are told to test at 2 hours. Gestational diabetes guidelines are a bit of a joke, yet it impacts many pregnancies in Australia. I can see why they're loosening the GTT gestational diabetes diagnosis guidelines because it puts more strain on pregnant women who are already struggling with all the quick bodily changes. Though, let's face it - the motivator for diagnosing fewer women with gestational diabetes is probably the cost to the healthcare system. The number of appointments I had scheduled more than doubled when I was diagnosed with GD. 

Anyway, it's 2023 and they haven't changed the Glucose Tolerance Test (GTT) gestational diabetes diagnostic ranges yet so I am being treated for gestational diabetes. You can read about my GTT experience and results for a bit of background.

In my early pregnancy, I was counting down to Trimester 2 in the hopes that I'd feel less nauseous and fatigued. Though, once Trimester 2 arrived so did my gestational diabetes diagnosis. This has taken over my pregnancy and overshadowed sciatica and pelvic pain that seem like molehills compared to the mountain I'm now climbing learning how my body's insulin and blood glucose levels relate to the foods I eat, the exercise I do and stress factors like work, hot weather and poor sleep.

I'll be honest. Gestational diabetes management has put a huge dampener on my pregnancy. I can't sit back and enjoy not feeling nauseous for a few months before reflux and indigestion take over in Trimester 3. Instead, I have a tonne of daily logistics and duties to try and prevent my glucose levels from spiking and causing baby harm. I am juggling 3 meals, 2 snacks and 1 supper each day and testing my blood glucose levels (BGLs) 2 hours after every main meal, and my fasting level first thing when I roll out of bed. This is the most discipline I've had around body and health since... well, ever.

The diet isn't really a diet. It's basically healthy eating with a balance of protein, veggies, fruit and carbs that is recommended for all adults. The difference is I actually have to follow it strictly because straying into simple carbs and highly processed foods like white bread or hot chips spikes my blood glucose levels. Why is this bad? Because if I can't keep blood glucose in check, then my baby overproduces insulin to compensate for my high blood glucose levels. Why is that bad? Because insulin is linked with weight gain in adults and babies leading to macrosomic babies.

Why is big baby bad? They may be harder to birth vaginally, though I've heard of plenty of women birthing big babies who didn't have GD so I'm not worried about that. The main problem with having a big baby in our medical system is the hospital policies. They will want to induce you early (Week 38-39 at my hospital) instead of letting you go into labour naturally when the baby is good and ready to come out. What if they don't want to come out until Week 40-41? Women in my GD support group also seem to feel pressured into elective C-Section to avoid risks. In case you can't tell from my language, I plan to decline offers of early induction or elective C-section unless a good medical reason arises such as I develop preeclampsia or placenta deterioration or baby has health issues. I'm not scared of trying to push out a big baby.

What I am scared of is what could happen after birth if I don't control my BGLs and baby gets used to over-producing insulin. Once bub is earthside, they'll no longer have my blood glucose passing through the placenta to them, and could end up a severe blood glucose level crash, end up in NICU and we won't have skin-to-skin time in our first days together-apart. I want to do everything I can to be able to hold my baby even if it means going on insulin injections or taking metformin tablets. There's only so much you can do to manage your BGLs with diet and exercise. If my placenta decides to produce lots of insulin-resistant hormones as my pregnancy progresses, then medical intervention will be the way forward. 

So... this fear is how I am getting through the monotony, strict schedule and firm diet of gestational diabetes. Any time I've slipped up like eating mango, or having a late meal, my BGL has spiked to remind me to get back in line. On days when I don't feel like jabbing my finger for the two hundredth time or meal prepping yet again or eating another hard-boiled egg for supper, I either say my affirmation out loud or loudly in my head, "For baby!" I'm doing it all to give Baby Pham a chance at being as healthy as possible.

My dreams of an easy Trimester 2 before I got extra bloated in Trimester 3 is long gone. I'm now dreaming of Trimester 4 once baby is out and I can bite into a banh mi. Soft, fluffy, crunchy white bread and all the things I don't currently eat for risk of salmonella or listeria - deli meats, raw egg mayo, liver pate. Oh man... I haven't told The Phamly yet but whoever visits me from Brisbane's southside first has to bring at least two banh mi for me and maybe one for Boyfriend Pham.

I have roughly another 250 finger jabs to go before our due window. Sigh... For baby!

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