Archives for April 2012

Gestational Diabetes – How Often Should I Check My Blood Sugars?

Gestational Diabetes – How Often Should I Check My Blood Sugars?

fingerstick diabetesYou know you have to check them, right?  I read a Facebook post yesterday where a woman wrote that she was afraid to check them.

Let’s think about that, shall we?  I mean, I am afraid of a lot of things.  Data is not one of them.  And, that is what you are gathering.

It might feel like a judgement against you, especially if you have not been following a healthy gestational diabetes meal plan.  If you have been snacking too much, or eating too big of portions.  But the damage is already done and you are already making it worse by ignoring it.  Sticking your head in the sand doesn’t make it any better.  Face up to it.

Ok, now that I have that off my chest, I want to talk about how often to check your blood sugars.

First of all, make sure you know what your doctor or dietitian wants you to do.  Best practice in the beginning when you are still learning – and if you have to take insulin – is 4 times a day.

When you wake up

One hour after you start eating breakfast

One hour after you start eating lunch

One hour after you start eating supper

*Any time you feel “funny” or different.

You need to check your blood sugar at least once a day after you are past the early stages and are well balanced.  If your doctor wants more – do it.  If you end up checking it once per day, vary the time that you check it so you get a good idea of where it’s at throughout the day.  Our bodies handle sugar and insulin different depending on a lot of things.  Best that you understand your body, because it’s different than other pregnant and gestational diabetic women.

In the morning, you may have what is called a “dawn phenomenon“.

Basically,it’s that your blood sugar is higher than normal because your body (in the middle of the night) gets a little low on blood sugar so it reacts by making more blood sugar.  Add that to the fact that you may be low on insulin, and it’s going to be a little elevated.  Many women counter this by eating a little larger evening snack and making sure it has a combination of protein and carbohydrate.  That way it takes longer to digest, and gives your body carbohydrate throughout the night.  It’s not a good idea to counter the higher blood sugars by skipping a bedtime snack.

Most women are taught to measure their blood sugars about one hour after they start eating, also known as “post prandial”.  This is the time when your blood sugar is likely to have peaked and should be below 140 mg/dl.  If it’s higher than that, look at the meal and see where the carbohydrate is lurking.  Earlier this week I wrote about a gestational diabetes meal plan for a week, and I know it’s hard to understand that a lot of foods have carbohydrate in them.

Ask your doctor how you should treat your blood sugar numbers – the answer may be that it depends…  Either way, you have to check them.  Not checking them is putting your baby at higher risk, and you as well.  It’s just information that you can use to make a decision about how to treat your blood sugar levels.  That’s it, that’s all, and you need to track them throughout the day.

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Getting Started with Gestational Diabetes – A One Week Plan

A kit used by a woman with gestational diabetes.

A kit used by a woman with gestational diabetes. (Photo credit: Wikipedia)

Do you need a gestational diabetes meal plan for one week?  Did you just fail your 1 hour GTT or 3 hour GTT?  Let me explain to you what you can do…

What sort of meal plan do I need with gestational diabetes?

First of all, a meal plan is a great place to start.  I am glad that you are here and trying to learn more about gestational diabetes.  It’s a short term condition, and if you are like me, you will be fine with doing whatever it takes to make sure the baby is healthy!

So, to begin with, you need to plan out your day.  Start with learning what is a carbohydrate.  You can read the labels on your foods, and if you look towards the middle to bottom of a label, it tells you “Total Carbohydrate” (per serving).  This is the amount of carbohydrate – and carbohydrate is what increases your blood sugar.  You want to start out with eating only 30 – 45 grams per meal.  If you are having a hard time keeping your blood sugars under control, aim for the lower amount.  So plan out what you will eat at each meal that is carbohydrate.  Then add in the fat and proteins.  You can have extra on the protein and fat, and it won’t affect your blood sugar too much.  So, pick a slice or two of whole grain bread – then add vegetables and meat and make a big sandwich.  Eat some carrots with it, or a salad with just a light dressing.  Have a cheese stick or cottage cheese or other snack throughout the day.

What sort of options do I have with gestational diabetes meal plans?

Secondly, you can choose multiple items in each category to make a great meal.  Start your breakfast with eggs and bacon and an english muffin.  No juice or fruit for breakfast – they seem to spike gestational diabetes moms really fast especially in the morning.  For lunch, choose a tortilla to wrap some lunch meat and vegetables in – or go with rice and beans – but just a light serving and add lots of green and yellow vegetables to fill you up.  Again, you should aim for 30-45 gm of carbohydrate at a meal to begin with.  If you do ok with that, and you are checking your blood sugars regularly, you may be able to eat a bit more.  But you probably want to consider adding more protein and fat foods – like peanut butter on celery for a snack.

In the evening – you should aim for 3 meals and 3 snacks, you can eat a combo carbohydrate – some women love a small serving of peanut butter and crackers, others love 1/2 cup of regular ice cream.  The fat seems to help with their blood sugars in the morning.  All snacks should be about 15 grams of carbohydrate per session.

What will help me to succeed with a gestational diabetes pregnancy?

Finally, it’s important to manage your carbohydrate!  Most of all, you can eat a lot of things, but always combine your carbohydrate with another type of food – fat or protein – to reduce it’s immediate effect on blood sugar.  You will learn that almost all the foods you love have carbohydrate in them.  That does not mean that you can’t eat them, it just means that you need to be aware of the amount that you eat of them.

It’s a short term problem, and managing it during that time can be hard.  If you want a printed meal pattern for different calorie levels, complete with breakfast, lunch and snack ideas as well as dinner meals the whole family can enjoy, you can learn more about our plans that we offer.  We also have a great email group – sign up below to learn more about gestational diabetes today!

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Gestational Diabetes Symptoms – How Do I Know If I Am Going To Have GDM?

Gestational Diabetes Symptoms Are Hard To Spot!

Pregnant woman at a WIC clinic in Virginia (ve...

Pregnant woman at a WIC clinic in Virginia (vertically mirrored image). (Photo credit: Wikipedia)

You may be wondering whether you can tell if you are going to get gestational diabetes, and you want to know so you can get started on trying to manage it.  That is important, and I completely understand why you want to know what the general gestational diabetes symptoms are so you can prepare.  Isn’t that how we are as moms, busy and yet prepared?  We know it may be a problem – anywhere from 5 – 15% of women develop gestational diabetes, and it’s something we want to avoid.  But even if we can’t avoid it, we are going to do what we can to get ready and understand what is coming.

But, you may not realize that gestational diabetes symptoms are very similar to what you normally feel during pregnancy.  The symptoms of diabetes are things like increased thirst and increased urination.  What pregnant woman is not a little more thirsty, and feeling like she needs to urinate a little more often?  As the baby grows larger, and sits on your bladder, increased urination becomes a fact of life, especially at night.  I sometimes think that the last 3 months of pregnancy when you can barely sleep the whole night through is just a preparation for the birth.  Another symptom of diabetes in general is that you may have increased hunger or weight loss.  I don’t suppose that accounts for cravings, but you typically do have increased hunger while you’re pregnant.  As you can see, gestational diabetes symptoms are a normal part of pregnancy.

Because there are no specific gestational diabetes symptoms, your Doctor will test you between weeks 24 and 28.

Because there are a large percentage of women, ( about one in 10) who develop gestational diabetes, it is fairly routine for your Dr. to check you during that time to make sure that you haven’t developed the disease.  Gestational diabetes is not necessarily a huge risk to a mom, but it does tend to cause a lot of problems for the baby if not controlled.  I know it may be disheartening to learn that you can’t really avoid gestational diabetes, and that there really are no gestational diabetes symptoms, but the thing that you can do is to control your intake and your blood sugars while you’re pregnant.

Aside from gestational diabetes symptoms, there are some risk factors that put you at a higher risk of developing gestational diabetes during your pregnancy.  If you have a family history of diabetes or you have had a previous pregnancy with gestational diabetes, your risk is higher and your Dr. may check you earlier in your pregnancy to determine if you have developed the disease.  Some other risk factors include:

  • being over the age of 25 when you have your 1st pregnancy
  • family history of diabetes
  • having had a baby that was over 9 pounds at birth
  • having sugar in your urine at a doctor’s visit during pregnancy
  • high blood pressure
  • being overweight at the onset of pregnancy

So aside from the gestational diabetes symptoms, these risk factors mean your Dr. may check you earlier during pregnancy.  If a doctor is going to check you earlier, they usually do the glucose tolerance test around week 14.  While that’s not set in stone, that is the general guideline.

Now that you learned a little more about what gestational diabetes symptoms are, if you’re interested in learning more about gestational diabetes, please sign up for our e-mail list by filling in the form below.

[ois skin=”GDM Email Ebook”]

 

 

 

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Treating Gestational Diabetes – What Should I Do for a Healthy Baby? Part 2

treating Gestational Diabetes

Treating Gestational Diabetes – Learn What Works

You may recall my post about treating gestational diabetes with food and exercise.  I talked about how you can use food, such as working with a meal plan, to make your compliance better.  And with exercise you can lower your blood sugar as a way to decrease the highs that come with meals.

When you consider treating gestational diabetes, you usually ask about medications as well.

You need to keep your blood sugar under control – in the range of less than 95 mg/dl before meals, and <140 mg/dl at 1 hour after starting your meal.  That is the goal and that is what you need to understand to know what your doctor is going to do when treating gestational diabetes.

If diet and exercise are not enough, you will need to consider with your doctor what medications you should take to control your blood sugars.  Some information suggests that you should allow about 2 weeks for the diet and exercise to control your gestational diabetes prior to treating gestational diabetes with insulin or oral medication.  Depending on the amount of control that your diet and body can manage, you may be able to make it through the entire pregnancy without medication.  That is a fine goal to have.  Some women do just fine, and others find it is almost impossible to manage.

When considering treating gestational diabetes, think of it this way.  It’s only for the last 14-16 weeks of pregnancy.  You can do this and you should do what is necessary to manage your blood sugars so your baby will be healthy.  And I know that is what you are doing when you are thinking about whether or not you should take medication because it may have side effects.

Insulin for Treating Gestational Diabetes

Insulin is hands down the safest medication that you can consider.  It must be injected – usually several times per day – and a lot of women don’t like that.  It is a very fast acting medication and tends to bring the blood sugars down quickly depending on the amount you use and how much carbohydrate you have eaten.  It’s usually considered in women when their fasting blood glucose is over 95 mg/dl or their 1 hour values are over 140 mg/dl.  No magic amount of insulin has been found, every woman is individual and considered by her reaction to the medicine.

Insulin is safe because it does not cross the placenta.  In treating gestational diabetes, most women are given insulin either as a primary therapy if diet does not work, or as a secondary therapy after trying an oral medication.  Overall, insulin has been used the longest in pregnancy and is the best choice.

Oral Agents for Treating Gestational Diabetes

The main oral agent recommended by physicians is glyburide, but there is additional risk with oral agents because they cross the placenta and can affect the baby.  Glyburide has not been shown to be safe and effective, all oral agents have a pregnancy category of B at a minimum.  Other medications that may be used are metformin and glucophage.  Metformin works by decreasing your body’s production of glucose and improves your body’s ability to use insulin that it already makes.  Metformin should not be taken by women who have kidney problems or have had kidney problems in the past because it does affect the kidneys.  Glyburide works to stimulate insulin release, and increase insulin sensitivity in your body.  Allowing your body to use the insulin it has better.

Part of the issue with gestational diabetes is that your hormones that are being produced by the placenta have started to affect your body’s ability to handle insulin.  You may need more insulin than you like at meals and checking your blood sugar will continue to happen throughout the pregnancy.  You will need a gestational diabetes meal plan.

A few studies have shown that glyburide and insulin show similar outcomes while treating gestational diabetes.  You have to make the choice with your doctor about how you will treat your gestational diabetes because every woman is different.  Medication is not going to allow you to stop doing any of the other parts of this process to make it through your pregnancy and attain a healthy baby.  You will have to do all of the things (if required) to get the best outcome.

Treating gestational diabetes is not easy and involves a mutli-level approach, starting with food and exercise and adding medication as needed.

 

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