I knew, going into pregnancy, that there was a decent chance I would have gestational diabetes. After all, my mom had it for all her pregnancies. I was in the clear my first pregnancy but, of course, fate caught up with me during my second. Just as the morning sickness abated, I was diagnosed with gestational diabetes. Lucky me. But despite having more familiarity with the disease than many, there are things no one will tell you about gestational diabetes (GD). I will, though, because I'm cool like that. You're welcome.
First of all, some people aren't even told what GD even is. Unlike Type 1 or Type 2 diabetes, gestational diabetes is a temporary condition — birth cures it. It's pretty neat, honestly. But like other types of diabetes, GD affects how your cells process glucose (also known as sugar), causing high blood sugar levels which, in turn, can negatively affect your health and the health of your developing fetus. Generally there are no noticeable symptoms of GD, which is why it's important to be checked for it.
Another important fact that a lot of people skip over completely is this: most mothers with GD will deliver healthy babies. The biggest complication with GD tends to be bigger than average infants, which can, obviously, complicate vaginal delivery. Pre-term birth and respiratory distress and hypoglycemia are additional, less common risks. But, as G.I. Joe used to say, knowing is half the battle, and these issues can be prepared for (or avoided all together) by knowing you have GD and working with your doctor to control your blood sugar.
Here are some other things to know to help you achieve the best birth outcomes (and maybe some peace of mind):
You Can't Outsmart The Screening Test
I'm constantly seeing and hearing people ask for advice on what to eat before a GD screening test in order to "pass." That's not at all how this works. First of all, the one-hour test is just a screening to see if you need the three-hour test, which is more precise and definitive. (In fact, most people who fail the one-hour will pass the three-hour.)
Listen, I get wanting to "pass" a test, but if you have gestational diabetes you should want to know! Say you could "beat" the test by eating nothing but cabbage the day before (you really can't, but for the sake of argument) — this just means that you're avoiding dealing with a disease that will affect your pregnancy and baby. It's best to know and deal with it instead of scrambling to convince your doctor you're all good when you're not.
Eat normally, following the fasting instructions, and see what happens.
It's Not Your Fault
Gestational diabetes has a huge genetic component. Yes, being overweight increases your chances, but there are plenty of not-overweight women out there who wind up with gestational diabetes. (And, frankly, being overweight has a decent genetic component as well.) Age, family history, and race all play a part in whether or not you're likely to have GD, so don't beat yourself up.
People Will Judge You
I wish I could tell you that everyone you mention your GD to will be understanding and supportive. Trust me, I wish I could tell you that. But pregnancy is not a fairy-tale world, my friend, and sometimes people are the absolute worst. They'll assume you ate your way to GD, critically analyze every morsel you put in your mouth, or side-eye your birth plan because they believe that having GD means you have to give birth a particular way. So just a head's up that, sometimes, people suck.
Those People Are Ignorant
The vast majority of people who will get all condescending about your GD are going to be people who don't know WTF they're talking about. Still, they think they're experts because they once watched an episode of Dr. Oz about how to reduce belly-fat with vitamin supplements or whatever. The people who are more familiar with GD or who have personal experience are probably going to be far more chill.
You Will Probably Be Able To Control Your GD Without Medication
A lot of people assume that GD means regular insulin injections. That's not an unreasonable assumption, since diabetics often need to medicate themselves in this way. But GD is not like typical diabetes and, generally speaking, people with GD can control their blood sugar levels with diet and exercise.
Medication Generally Isn't A Big Deal
Of course, sometimes, diet and exercise — even if you're really super-diligent about both — aren't going to cut it. I was one such case, in fact. While I didn't need insulin, I did wind up taking an oral medication that controlled my blood sugar levels, and it really wasn't a big deal. I just took it every day with my vitamin. And even people I know who have needed insulin have admitted it's annoying but hardly the most annoying thing about their pregnancy.
You Will "Cheat" Sometimes
Was I supposed to have muffins for breakfast? No. But I did every now and then? Yes, because I'm human.
I honestly don't know a single pregnant woman with GD who maintained a "perfect" pregnancy diet. So if you feel overwhelmed by a sense of guilt as you dab a small piece of birthday cake from the side of your mouth, don't take it too hard. I mean, don't make a habit of it, but don't fret that you've "ruined" your baby or anything.
Peanut Butter & Dark Chocolate Is The Best GD Snack
And by "best" I mean "it's something sweet that you're allowed to eat because it's a good serving of protein without a ton of sugar." You can't live on it, and you can't overdo it, but when your sweet tooth is throbbing a square of dark chocolate and a serving of peanut butter will go a long way in making you feel better without a ton of carbs or guilt.
You Will Get Sick Of Everything You Eat
Because you generally have to limit your carbs and do you know what has a ton of carbs in it? Literally all the foods you're probably craving. So, I hope you like lean proteins and vegetables because you're going to be eating a ton of them... and after a while your rotation will grow stale.
Your Fingers Will Get Sore
A big part of GD is monitoring your blood sugar levels and you do this by getting up close and personal with your blood via multiple daily finger-sticks. On a positive note, it's kind of cool to be able to put a little drop of blood into this cool tiny machine and know your blood sugar within seconds. On the other hand, ouch. It's not so much that the process hurts (it really doesn't), but when you do it every day as soon as you wake up and then after every meal, your fingers get tender.
(Pro-tip, try to prick the sides of your fingertips as opposed to the middle.)
You Won't Necessarily Need A C-Section
A lot of people think that when you're diagnosed with GD that means you're going to have a C-section. It's true that your chances do go up, and your doctors are going to be more cautious now because babies of gestational diabetic mothers tend to be bigger. Specifically they have bigger shoulders, which puts them at higher risk of getting stuck in the birth canal after their heads emerge and, well, that's not ideal.
That said, a C-section is not a forgone conclusion, either. Lots of moms with GD have uneventful vaginal births and even VBAC deliveries (including yours truly, and that baby was over nine pounds).
Your Baby May Need Extra Monitoring After Birth
Sometimes, babies of moms with GD have hypoglycemia (also known as low blood sugar). They'll be checked in the hospital and, if necessary, monitored until they basically even out. My daughter was actually quite hypoglycemic for a while, which wasn't ultimately a big deal, but it would have been nice to know ahead of time just so I could prepare to watch her precious little newborn heels get pricked for blood sugar testing. (I definitely cried more than she did, by the way.)
It's Not The Worst
Seriously. It's not fun, but if you're building it up to be a big huge deal it's really not.
Your First Postpartum Meal Will Be Amazing
#AllTheCarbs #SoMuchSugar #MakingUpForLostTime