My sugar baby: Unpacking gestational diabetes
Gestational diabetes wasn’t something that mommy influencer Reevana Govender had planned for. She writes about her experience.
Getting the news that I had failed my standard glucose tolerance test at 28 weeks came as a shock to me and being diagnosed as a gestational diabetic was a game changer.
Being of Indian descent, there are a few common things that women in my lineage hear while we are pregnant. Eat for two! Satisfy all your cravings! Don’t exercise! However, after being diagnosed with gestational diabetes, this would be the advice that I needed to scrunch up into a proverbial paper ball and chuck straight into the bin.
Ironically, my lineage is probably the leading risk factor for my diagnosis. I weighed a whopping 4.5kg at birth, and had an entire family marvelling at the chubby cherub that I was. The probability that my mother was an undiagnosed gestational diabetic is rather high.
Even though I ticked two out of the five risk factors for gestational diabetes, I felt angry at my diagnosis. I also felt extremely guilty. How did this happen? Did I do something wrong? I ate all the right things, I exercised regularly and after already having an uncomplicated pregnancy and birth for my firstborn, I couldn’t understand how this was possible. The most ineffable part was that I wasn’t sure what this diagnosis would mean for me, my baby or my birth plan.
If there is one thing that I would like to mention at the outset, it’s that being diagnosed with gestational diabetes isn’t your fault. Don’t allow yourself to be consumed with guilt about your diagnosis; rather shift your energy into effective ways of managing it.
Unpacking gestational diabetes
So what is gestational diabetes?
Diabetes that develops during pregnancy is known as gestational diabetes. It is quite common and can affect 18 in 100 pregnant women. It occurs because your body cannot produce enough insulin (a hormone important in controlling blood glucose) to meet its extra needs in pregnancy.
The placenta, which supplies your growing foetus with nutrients and water, also produces a variety of hormones to maintain the pregnancy. Some of these hormones can have a blocking effect on insulin. This results in high blood glucose levels. Gestational diabetes usually starts in the middle or towards the end of pregnancy and in most cases, ends shortly after birth. It does however put you at risk for type 2 diabetes later on in life.
Some women are more predisposed than others due to certain risk factors. The risk factors include :
- your body mass index (BMI) is 30 or higher
- you have previously given birth to a large baby, weighing 4kg or more (based on the South African guideline for foetal weight)
- you have had gestational diabetes before
- you have a parent, brother or sister with diabetes
- your family origin is South Asian, Chinese, African-Caribbean or Middle Eastern.
Lifestyle changes to take on board
While any complication during your pregnancy is a concern, there is light at the end of this tunnel. Gestational diabetes can be controlled by specific lifestyle changes.
I was lucky enough to be able to manage my blood glucose levels with diet and I did not need to be on medication. Medication like hypoglycemics and insulin can be avoided by maintaining a strict diet, increasing physical activity and increasing water intake.
I attributed not needing medication to the fact that I had already made many changes to my lifestyle prior to my second pregnancy that were in line with my dietician’s recommendation. If you fall into any of the risk factors, I would suggest these lifestyle changes prior to pregnancy.
Some of these changes included :
- Converting all carbohydrates to brown, whole-wheat or high fibre.
- Reducing overall quantities of carbohydrates and increasing quantities of proteins in my meals. The protein-to-carb ratio is exceptionally important to understand.
- Increasing my water intake to at least two litres a day.
- Exercising daily for 30 minutes (I followed pregnancy safe exercise routines on YouTube).
- Avoiding processed foods, high sugar foods and fizzy drinks.
And yes of course, I did have moments where I craved a McDonald’s chocolate milkshake with some cheesy fries. And for sure, not having cake at your own baby shower is pure evil, but it just makes planning your after-pregnancy treat all the more fun.
I also didn’t completely deprive myself: with careful monitoring of my levels, daily exercise and increasing water intake I was able to have certain treats in moderation. I also experimented in the kitchen with some high protein and zero sugar treats that were diabetic-friendly. However, this was my own individual experience and I would strongly suggest chatting to your dietician in this regard before indulging.
I was closely monitored by my obstetrician and midwife during the latter part of my pregnancy and thankfully my baby showed no adverse effects from the gestational diabetes. Regular antenatal checks and ultrasound monitoring for foetal growth and amniotic fluid volume are very important for women with gestational diabetes.
I went on to give birth naturally at 39 weeks (in breech position, but this is a story for another day) to a 2.8kg little girl.
If being diagnosed with gestational diabetes has taught me anything, it’s the importance of making sustainable lifestyle changes. Being a gestational diabetic puts me at risk for type 2 diabetes in the future, and it also means that my girls are at risk for both gestational diabetes and type 2 diabetes later on. I have made a mindful effort to educate them about the importance of maintaining a healthy and balanced lifestyle, with the aim of somehow breaking the cycle.
I share my story in the hope that I can help another mama who finds herself in this situation. While I was supported magnanimously with information from my healthcare professionals, I craved a real life perspective from a woman that I could relate to and who had already walked this journey. I just wanted to know that it was going to be okay.
So today, I am here to tell you that it will be okay. Make sustainable lifestyle changes and, most importantly, enjoy your pregnancy. Don’t allow your diagnosis to consume you or drain the joy out of your pregnancy. This is a beautiful time in your life, and even though pregnancy can feel exceptionally long, it all goes by way too quickly.