Thursday, December 20, 2012

30 weeks: Gestational Diabetes

Gestational Diabetes is one of the most common health problems during pregnancy. When pregnant, the placenta releases hormones - one of which is called HPL (Human Placental Lactogen) - that have anti-insulin properties. They're basically there to ensure the baby receives enough nutrients. Usually, the mother's body compensates for this specific insulin resistance by working harder at the pancreas, releasing extra insulin. A woman with GD, however, has a hard time accommodating, resulting in an elevated blood glucose level. If prolonged, a lot of dangerous things can happen. But if controlled, it's not a big deal - hence the routine testing. Though someone with GD has a higher chance of developing type II diabetes later in life, the condition usually goes away once the baby - more specifically, the placenta - is out.

There's a list of things that puts someone at a higher risk for GD: being older than 25, going through a 'high risk pregnancy,' having high blood pressure, being overweight before pregnancy, and having given birth to a large baby before. I am none of the above, except being older than 25. But as always, there are exceptions and anomalies. 

My blood glucose level came out slightly elevated after the initial glucose tolerance test (GTT), which routinely happens between 24-28weeks of pregnancy, when the HPL levels become higher and can start affecting the body. GTT consists of consuming within 5 minutes a drink containing 50g of glucose after fasting for 8-14 hours, then drawing blood an hour after. If the number is above 140mg/dl, doctors ask for further testing through the 3 hour glucose tolerance test. The second test consists of drinking a sweeter drink containing 100g of glucose the same way within 5 minutes (it's really sweet and makes some women vomit), then drawing blood for the next 3 hours at every hour. The cut off numbers - they seem to vary a bit depending on your doctor, but these are what my doctor used - are 95 mg/dl (fasting), 180 mg/dl (1hr), 155 mg/dl (2hrs), and 140 mg/dl (3hrs). If two or more numbers are elevated, Gestational Diabetes is diagnosed.

My weight is on track, and my blood pressure is 'perfect.' My baby's heartbeat looks great as well. But I failed the 3hr glucose tolerance test by a few points. I'm right at the borderline. For some more 'lenient' doctors, I might have passed. My doctor seems to be on the more cautious side, which isn't a bad thing. She suggested that I go on a restrictive diet and start monitoring my blood sugar level just in case. No more cookies, cakes, and ice cream for me until the baby comes - my doctor kept saying sorry because it's right before the holidays. But the thing is, I wasn't really into them anyway, at least during this pregnancy because they usually make me vomit. 

My doctor doesn't think it has anything to do with what I'm doing. She said it's probably my high hormone levels. She's putting me on a diet to make sure my baby's healthy and my birthing process is as smooth as possible. And keeping blood sugar levels in check never hurt anyone. 

When GD is severe and cannot be treated with diet and exercise alone, insulin injection or other form of medication is needed. But I'm not at that stage; I just need to monitor my glucose level and watch my diet. The biggest change will be that I have to cut down on my fruits and eat a lot more often. Oh, and I'll have to prick myself seven times a day. I was pretty bummed out for a day because I couldn't believe how helpless this pregnancy has made me, starting with Hyperemesis.

But after a good night's sleep, I've come to a completely different place of something closer to... excitement. After reading a bunch of documents from the Doctor's office, I made a meal plan chart for myself and went to Trader Joe's to get the ingredients. I also stopped by the Dr's office to learn how to use the glucose monitor. The needle is tiny and doesn't hurt (that much)! This is a great opportunity to revamp my diet, which has gotten a bit sloppy since Hyperemesis. This heightened awareness is going to only help me and my baby, not to mention my husband. And I've always been curious about my glucose level anyway. So far, things are looking good. I'm not hungry, and my sugar level is absolutely normal. Maybe these changes will help with my nausea and vomiting too. 

PHOTO at 30 weeks:
I feel heavy (my legs cramp up a lot at nights, probably from all the extra weight they have to handle), but I love the roundness of the belly. We saw our baby girl's face on the sonogram yesterday, and her cheeks have gotten chubbier! My husband thinks she looks like me, but I can't tell just yet. We're so excited to meet this baby girl!

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