I knew something was wrong when I was vomiting up everything and started gaining weight. And not a pound or two; at 12 weeks pregnant, I had gained seven pounds in one week. According to the American Pregnancy Association, women with a body mass index (BMI) of 18.5 to 24.9 should only gain between 25-35 pounds during pregnancy. Without knowing my BMI, I knew the odds were already against me: My father has diabetes, and his two sisters had hypoglycemia and diabetes, respectively. My grandfather also had diabetes. My maternal aunt has diabetes. I'd barely passed my glucose tolerance test for my previous two pregnancies. I knew that, basically, my pancreas was working on borrowed time. And my giant placenta and hyperemesis gravidarum — morning sickness on steroids, which already had me hospitalized once — just kind of killed it. I had severe gestational diabetes, only at that point in my pregnancy, I hadn't realized it yet.
I texted my OB. We didn’t bother with the formalities of a glucose tolerance test to measure the sugar in my blood; she just pricked my finger and prescribed some Metformin. When I got to the pharmacy, the pharmacist showed me how to measure my blood sugar: take out a tab, insert it into the meter, prick my finger with something disturbingly and cringingly called a "lancet," then put the blood on the tab and wait. This worked for about two weeks, until the medicine just wasn’t keeping my numbers low enough. Uncontrolled gestational diabetics risk overly large babies, babies who have blood sugar problems of their own, according to the Mayo Clinic. They risk preterm birth and babies with resulting respiratory distress. Having uncontrolled gestational diabetes increases your risk of high blood pressure as well as the risk of preeclampsia and developing Type 2 diabetes later in life.
We had to get my sugar under control. That meant I had to go onto injectable insulin. On injectable insulin, I had to stab myself in the thigh four times a day: at breakfast, at lunch, at dinner, and before I went to bed. I was afraid, at first, that it would hurt, but much like the lancet, I barely felt the needles. First, I had to get a new needle, and then I inserted it into a tiny bottle of insulin and filled it to the correct dosage. After that, I pulled my pants down and stabbed myself in the fatty tissue of my thigh (or belly, but that freaked me out so I never did it). I had to be careful not to inject myself too close to any site I’d used in the past few days, which can cause necrosis. Finally, I had to push the used needle into a dedicated "sharps container," where it sat along with my used lancets. If there wasn’t a sharps container nearby, I had to wrap the used needle and take it with me: you can't dispose sharps in a non-sharps container. My thighs bloomed with bruises.
I started on a tiny dose: maybe 2 milligrams. But the dose crept up, and up, and up. I’d call by OB and tell her that I was sticking to a diet and then recount my blood sugar numbers. Once she heard those, she’d revise the numbers upward. They sent me to an endocrinologist, finally, who took over management of my diabetes. The endocrinologist just revised my doses upward more often. They told me not to eat fruit for breakfast, which seemed to spike my sugar. I panicked; I ate yogurt with fruit every morning. So I had to switch to honey and nuts on my breakfast instead. The honey was necessary; part of the dance of gestational diabetes is getting the right number of carbs at any meal. Too many and your sugar will spike; too few and your sugar will crash, then spike.
Instead of injecting me with insulin, they gave me cups of orange juice instead. I needed one almost every hour, and having your sugar crash is exhausting. It made pushing hard, hard work, and when they finally handed me my son, all I wanted to do was sleep. I cried that night, baby resting on my chest, because I had to stay awake with him.
They did give me one piece of good news: the best way, anecdotally, to stabilize my nighttime (and hence morning) blood sugar was to eat a bowl of ice cream before bed. I indulged: chocolate-caramel, chocolate-cherry, pralines and cream. It was the one meal I didn’t need to worry about.
By the time I delivered, I was using large-barrel needles to deliver over 200 milligrams of insulin into my thigh every single night. It was one of the larger doses the nurses had ever seen. I gave myself an injection just after they put in the Cervadil the night before my son was born, and that was all. Unfortunately, that meant that, since I couldn’t eat in the delivery room, my sugar kept crashing. Instead of injecting me with insulin, they gave me cups of orange juice instead. I needed one almost every hour, and having your sugar crash is exhausting. It made pushing hard, hard work, and when they finally handed me my son, all I wanted to do was sleep. I cried that night, baby resting on my chest, because I had to stay awake with him.
If I have another child, my chances of gestational diabetes are near 100 percent. It’s likely they’ll be even worse than they were before, and manifest even earlier. I’ll probably start Metformin along with a positive pregnancy test, and insulin soon after. I’m left with a standing prescription for test strips and lancets, and because my case of gestational diabetes was so severe, I have to check my blood sugar regularly for signs of Type 2 diabetes. So far, with diet and exercise, I’m only pre-diabetic. But I’m a motivated patient. I had diabetes once, and I don’t want to go back. I eat a paleo diet, and I'm currently doing a Couch to 5K. I have to work out and stay healthy; otherwise, I'll end up diabetic by the time I'm 40. My pregnancy proved that.