Getting ready for baby – Part 2

For most women who are diagnosed as having gestational diabetes, meaning diabetes diagnosed and only lasting through pregnancy, their blood sugars will be able to be managed with dietary changes only.{{more}}

This was the case for me: during my pregnancy with twin girls, I was diagnosed with Gestational diabetes, based on my two-hour glucose tolerance test. My OB agreed for me to check my blood sugars frequently during a week while I changed my food portions. After a week, my sugars were all normal. I DID however continue with the diet changes and blood sugar monitoring (six to eight times a day) for the next five months.

If you are a woman who has just been diagnosed with specifically gestational diabetes (meaning you did not have diabetes before you became pregnant), then your doctor and nurse will have already spoken with you about how important it is that your blood sugars stay within normal ranges throughout your pregnancy. As we discussed last week, there are MANY risks to you and your baby if you let blood sugars run high during pregnancy. The first best step that I would suggest is to sit down with a nutritionist if you can. A nutritionist will help you come up with a dietary regimen that will help bring your blood sugars down, while keeping up with the increased calories that many women need during pregnancy.

This last part is what gets tricky in the minds of many women. “Watch what I eat? Why? I am pregnant, eating for two, right?” Yes, you are eating for two; however, this has become some sort of license for many women to just eat whatever all the time and gain too much weight. The truth is that most women need an extra 300 calories a day to gain the recommended amount of weight during pregnancy. It is not extra servings of all meals, it is not a whole extra meal; at night before you go to bed; and it is not half a breadfruit instead of two slices. If you were overweight before you became pregnant, you will not need to gain as much weight. A nutritionist will help with this planning.

In general, the part of your meals that you will be changing will include starches or sugars of any kind. This includes of course ANYTHING that is obviously sweet, including sodas and juices, sweets, cakes, cookies etc. But it also includes “non-sweet” starches like rice, bread, ground provisions, starchy vegetables like corn, dairy etc. The amounts of all of these will need to be reduced and spread out, so that they are even throughout the day and not all clumped at one meal.

Will you need to check sugars? YES, you will. I encourage all women who have been diagnosed with diabetes in pregnancy to GET A GLUCOSE METER AND CHECK your sugars regularly. If it turns out that your sugars are not staying normal when you change your diet around, then you will need medications. There are several medications known to be safe in pregnancy, and what little risk may be associated with them is LESS than the risk associated with having untreated diabetes in pregnancy. So when you weigh the risks and benefits, the appropriate choice of medication wins out.

Please speak with your doctor and nurse at length if you have been diagnosed with gestational diabetes. Dietary management is the first step if your sugars are only a little high, and often it works, if done correctly.

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227