Gestational Diabetes

My trusty Dexcom sensor

You may remember that I started myself on insulin back in July, before I'd even seen my OB, because my morning blood sugars were running high.  My sugars were weird from the very beginning, so I've intermittently been wearing a continuous glucose sensor to make sure I wasn't missing anything, and was lucky enough for the first two trimesters to be able to eat just about anything I wanted to.  But at 24 or so weeks that changed and I became very restricted with my diet. Last week I finally switched my insulin from NPH to the newer, longer acting Levemir - and wow has it made a difference.  I'm constantly wearing my sensor now, and am amazed at how much better my blood sugars look, and so happy that I've been able to add some things (like fruit) back into my diet.

Dealing with this for the past few months has given me such a different perspective on managing my patients with gestational diabetes, both from a diet and medication standpoint, as well as from a personal interaction standpoint.  We've been taught that the best way to manage diet is to follow what's known as the Jovanovic diet, and for many women that does work best. But I have discovered that my sugars do much better with following the similar 3 meals and 3 snacks a day regimen as is prescribed with the diet, but with less carbs at lunch and supper.  I have a better idea of when NPH insulin works, and when Levemir is better.  And I know firsthand what it's like to look a donut in the face and think, "Is this food worth the health of my baby?"

Damn, it's hard to follow this diet!  Intellectually I knew that, but it is so much different to live it.  And I'm lucky enough to really understand the diet and insulin before getting the diagnosis (or should I say, giving myself the diagnosis), so I didn't need lots of training. I have access to things like a continuous sensor (I now can't imagine having insulin requiring diabetes without having a sensor!), and other endocrinologists and diabetes educators to bounce ideas off as I've tried to manage my sugars the past few weeks.  I think it's much easier for me than it is the average patient, and yet it's still frustrating.  I hope that this experience makes it easier for me to help my patients; I know that it has already made it easier for my patients to accept my recommendations once I share with them that I also have GDM, and that I'm also taking insulin.

I haven't eaten Fruity Pebbles in years, and yet that's all I think about when someone asks me what I want to eat.  Fruity Pebbles, PopTarts, Oreos, donuts, Peeps, milkshakes (I had one almost every day of my 3rd trimester with Finn), bagels, pasta and pizza all dominate my daydreams.  I cannot wait to be able to eat whatever I want to once this baby boy is finally born.

But on the bright side - I've eaten so much healthier this pregnancy than I did with Finn. I have a leafy green salad for lunch every day, I'm eating tons of veggies and a reasonable amount of fruit.  And I've actually lost two pounds in the past month.  I'm pretty sure that while I started out this pregnancy 10 pounds heavier than I did my last pregnancy, I'm now just a few pounds over where I was at this point with Finn.  While my stomach has gotten bigger, the rest of me has not, and that has been really lovely.

Is it wrong that one of the main reasons I hope I can exclusively breastfeed again this time is so that I can eat whatever I want and still lose weight?