Motherhood

The pregnancy diagnosis I least expected: Gestational Diabetes

January 28, 2016

Looking back at the course of my life, I thought I had done everything right to prevent getting diagnosed with a pregnancy disease I would have never expected. Pregnnacy anemia? Maybe. Problems with my baby? I had accepted that possibility. Spotting or having to be on bed rest? I knew that could happen. But Gestational Diabetes? Never in a million years.

A quick google news search of gestational diabetes at the moment would give you headlines such as “High potato diet increases risk for gestational diabetes,” "Regular exercise can reduce risk for gestational diabetes,” and “Impact on weight gain in gestational diabetes.”In my mind those headlines translated through an inner, untruthful, critical voice saying, I brought GD on myself from eating potatoes ( I rarely eat potatoes in any form), got it from gaining weight (I’ve weighed the same for over 5 years and in pregnancy am gaining on track), and don’t exercise regularly (I always have exercised religiously). No wonder women feel defeated when they are told they have gestational diabetes. Reading the headlines about gestational diabetes can be very discouraging, as the finger is pointed back at the woman with it. Although it can be prevented often, as a very health-conscious person my lack of accurate information about and public perception of the disease left me humiliated and flabbergasted when I was told at 28 weeks I had it.

Background 

Since September of 2012 I have been a board certified Adult Nurse Practitioner with the first two years of practice spent working at a Free Medical Clinic. While there, diabetes, weight control, and nutrition became my biggest interest as it coincided with the largest need in my patient population. I treated hundreds if not a few thousand diabetic patients and counseled them on nutrition choices, exercise, managing their disease, and more. I enjoyed my diabetic patients because of my deep passion for health and because such power rests in the hands of the patient with this disease as it is mostly preventable and manageable and sometimes even partially reversible. However, it is definitely not an easy journey!

For as long as I can remember I have had a passion for a healthy lifestyle. The triad of healthy mind, body, and soul are deeply woven together and have become the focus of my calling and the theme of my blog. Being active and exercise has always been more of a pleasurable hobby and necessity than a dreaded duty and option. Undergraduate Clemson was where I received my first dose of health and nutrition and became greatly interested in pursuing a health-focused career.  At Clemson my major projects were usually on combatting obesity and while studying in Australia my major paper was on the health disparities that exist between Aboriginal and non-indigenous Australians. After obtaining my degree in Health Science from Clemson, I graduated from nursing school and then Nurse Practitioner school at the Medical University of South Carolina, which included years of healthy lifestyle and medical training. As you can see, health has been a primary focus of my life.

Pregnancy, a Positive Test, & Denial

Pregnancy has been a fun and welcomed experience. I haven't been quite as disciplined with my eating and exercise routine- for reasons of exhaustion and food adversion, but still I have been sure to maintain a healthy lifestyle. Many women think that we are "eating for two" in pregnancy or you can just eat all you want, but these are actually very unhealthy approaches for both mom and baby. Women really only need about 300 extra calories per day per baby - which isn't much. There are so many benefits to mom and baby for continuing to make healthy diet and exercise choices through pregnancy.

My glucose test was last week. That day I ate as normal but had more chocolate than usual, and yogurt with sweetener, peanut butter sandwich, and a sweet orange . . because it was the day we got back from traveling from Arizona and I didn' thave time to pack my lunch appropriately. I chugged that glucose drink and bragged that I hadn't drank a sweet drink like it since at least high school, save some island cocktails. I had a good doctors visit and then sat in the waiting room for my timer to go off. She checked my blood sugar and next thing I know --- BAM - Gestational Diabetes.

I'm not proud of my reaction. Perturbed, arrogant, and pretentious are probably some (shamefully) accurate descriptive words. I questioned the coordinator and told her there was no way- I was small, healthy, ate right, exercised, and had no risk factors except for my age. I asked why they hadn't done the 3 hour glucose test --- well because my 1 hour was SO HIGH that the 3 hour wasn't needed! I was automatically diagnosed with gestational diabetes. I was set up for specialist visits, told I would have ultrasounds biweekly, have to prick my fingers four times every day and fax in the results, told I must take a mandatory gestational diabetes education class, and was now at risk for a myriad of complications.

I stayed in denial for a couple of days, venting to my closest friends, mom, and husband that the OBGYN office had to be wrong. There was no way that I could possibly have gestational diabetes. I blamed that the nurse hadn't cleaned off the alcohol and so the glucometer machine detected the alcohol. I blamed my eating for that day. Me the nurse practitioner who had cared for thousands of diabetes patients, educating them on how to prevent and treat it. Me who meticulously and intentionally set out each day with a healthy-lifestyle focused mind. Me whose greatest passions, besides Jesus, were health focused?!

Finally, I accepted it.

I watched my blood sugars over a few meals and realized that indeed, they were too high.

The only risk factors I had going into my glucose tolerance test was 1)being over 25 2)being pregnant (duh).

Acceptance

Maybe you are like me and your first question to yourself was, "What did I do to bring this on myself?" Blame. Shame.  Maybe you were floored because you will ill informed. Even being a health care provider, I still didn't realize the truth about GD. However, that doesn't negate the fact that public perception is inaccurate and people believe Gestational Diabetes is always a disease a woman brings on herself -- essentially her fault. While it is to an extent preventable by decreasing your controllable risk factors (weight, exercise, diet, etc.), other risk factors are beyond a woman's control.

Gestational diabetes can result solely from the placenta's hormones blocking insulin in the body. That awesome placenta just takes over! If you aren’t aware of how ingesting sugar works, basically the pancreas secretes insulin when we ingest sugar or anything that turns to glucose such as carbohydrates. The only way glucose can enter cells is for insulin to unlock the door and let glucose in.  Insulin is needed to break down glucose into such a form to get it "usable" by the body. Otherwise, if insulin and glucose don't hook up, glucose free floats in excess. This is why people say they have "sugar in their blood" or often uncontrolled diabetics will have sugar in their urine. There is too much sugar in the blood and not enough insulin to match it; therefore, often patients have to begin taking insulin shots to give their body enough insulin to match up to the sugar. As for urine, this is one way your body gets rid of WAY too much glucose - you urinate it out. I once read in an eastern medicine book that the way they knew if someone had diabetes is they would urinate on cement and if ants were drawn to it, they could be diagnosed. Typically, you should spill no sugar in your urine even if you are a diabetic - only if you are very uncontrolled will this usually happen.

Thankfully, I am not yet on insulin or diabetes medicine and thankfully my training puts me in a place where I know how to control my blood sugar to optimum level. Knowledge is power. But power isn’t enough to block diagnoses.

As for lifestyle changes, this just means cutting out junk food, sweets, and non-nutritional, empty calories. It means being very limited when eating out. It means more monitoring by doctors and higher risks. But truly, I see it as blessing in disguise because of the lessons I've learned, I know its in God's hands, and I can be a good steward of my body for the remaining 10 weeks of my pregnancy! This disease is a blessing in disguise.

Lessons I've learned so far:

1) Humility. Through this experiecine I came face to face with arrogance over my health and training. One of my weaknesses and worst traits is my lack of mercy and tendency to think "you get what you deserve." I now understand that this can happen to anyone and the importance of having a posture of humility and gratitude. Even when we “think” we are humble and grateful, God will humble us and show us our lack. Believe me, I thought I had tackled that mountain of pride in my life, but thankfully Jesus keeps putting his finger on it. 

2) Vulnerability - The definition of vulnerable is "susceptible to physical or emotional attack or harm." My first reaction was to protect my pride. Honestly, I wanted to cry when she told me this but instead...I exhibited anger. Hurt people hurt people. And this diagnosis hurt me. But I know that opening up can be the greatest blessing and have the most potential to help others. Did I want ANYONE to know that I had GD? NO!!! I wanted to keep it a secret from everyone! My initial reaction was shear embarrassment. How could I have this disease? I take care of myself! IT doesn't matter, any pregnant woman can get it. We are given our stories and struggles to help others. What helped me? Looking on Instagram and message boards to find examples of women in similar shoes.  One I found had a master's degree in health, a theseis on diabetes, and is an avid health advocate. She definitely inspired me and helped me to accept my diagnosis. Vulnerability paves the way to intimacy. Acting like you have it all together is often repulsive to people. It makes you seem unrelatable and cold. People want to connect on a level of brokenness. And this just further helped me to embrace vulnerability.

3) Empathy - Even though I couldn't have prevented gestational diabetes, I realize the weight of being told you have any diagnosis, especially one you had zero control over. I empathize with my diabetic patients better now. I understand first hand the daily struggle they have with exercise and eating. I understand their concerns better than ever. I understand first hand what it means to have to take a glucometer to the most inconvenient places like a movie theater or church. I understand the annoying pain of that tiny little finger prick at least four times per day every day. Yes, diabetes is for the most part preventable and manageable, but it isn't easy. Without a strong reason to maintain your best health (such as a baby's life to protect), I can understand why so many get discouraged. I am grateful for the first hand reminder and deeper ability to relate.

4) Pearls - I've learned a lot of small things that have made big differences: a ripe banana versus a green banana has a tremendously different effect on my blood sugars. Of course I knew it was sweeter before but actually seeing the effect on my blood sugar register on my glucometer was eye-opening. I’ve first hand learned the importance of balancing a carb with a fat or protein in order for the carb to be broken down more slowly instead of instantly being converted to glucose, and the effect simple carbs like white rice have on blood sugar versus complex carbs such as quinoa. Ezekiel bread really is some of the best bread you can eat for blood sugar control and health in general. Cheese and peanut butter have been my saviors. Biting the inside of my mouth while pricking my finger helps to not hurt so bad. 

5) Control & Surrender- As much as I dedicate my life to and am impassioned by health, as many degrees as I have in health, as many days I have spent sweating it out, as many times I have carefully selected my food choices for optimum health and denied the things I reallyyyyy may want, I still had no control over this diagnosis. This taught me that of course this health quest is not in vain, but that ultimately I am not in control. Control must be surrendered! The firmer we grasp to control, the more difficulty we will have when life presents something different. Ultimately I just need to be a good steward of the life and body I have and the rest will be up to our Creator. His plans and ways are much higher than mine. He is fully worthy of my trust.

6) Gratitude - To make this sound like a terrible monster is absolutely not my intention. It was the weight of it crashing against my expectation that was so stunning. Yes it can lead to heart defects, preterm delivery, seizures in the newborn, stillborns, macrosomnia, C-sections, etc. but I know it could be much worse. I am aware there are lots of women who face far more difficult diagnoses and situations in their pregnancy.  In nursing school at MUSC I remember a lady who had cancer but wasn’t taking treatment because she was pregnant with twins. She sacrificed herself for her children. I cannot and will not ever forget her story. The ultimate display of love is self-sacrifice as parents do for children and as Jesus did for us on the cross. I have way too much to be grateful for and a God way too big to let a small diagnosis bring out the worst in me. Gratitude combats the ugliness of entitlement.

Going Forward
All in all, I’ve had a wonderful pregnancy so far. I’ve loved it! I am in a place of gratitude in being reminded that I did nothing to have this great pregnancy- it was by God's grace and power that it has been smooth sailing. Its been by his grace that this baby girl continues to grow right on track and momma feels great! Whatever you have to be thankful for, focus on that, be thankful for that, and learn what you can in the tough spots. Often degrees, passions, and the best of intentions still won’t change the course of something in your life, and you’ve got to decide in advance to be okay with that! 

Gestational diabetes affords us the opportunity to truly see food as it was intended. My hope is for women experiencing the same diagnosis to find some solstice, comfort, and guidance and if nothing else, learn a lesson through my own learned lessons! If you’ve been diagnosed with Gestational Diabetes, look at it as the blessing that it can be! You have the best reason in the world to eat healthy during your pregnancy. Food is not the pleasure-giving, fulfiller of us anyway. We mistakenly think it is our comfort and source of joy when our Creator is meant to be that for us. Food is nourishment. As Hippocrates said, "Let food by they medicine and medicine by thy food." I'm thankful for the empowerment that came from a disease I couldn't prevent.

In Sedona, Arizona after the Clemson vs Alabama National Championship game, 28 weeks pregnant, & two days before I found out I had Gestational Diabetes!

You Might Also Like