Monday, January 6, 2014

Gestational Diabetes

I found out that I have gestational diabetes a couple of months ago.  I was not overwhelmingly pleased. We got the call from the doctor's office at lunchtime.  I was over it by dinner time, but that first half hour was not my finest.

To my understanding, gestational diabetes means that the placenta is killing my insulin and so more of the sugars are getting to baby who in turn would produce more insulin.  Insulin is a growth hormone, so they put strict limits on diet and whatnot so that the child does not grow too big.  The extra growth can cause early labour and other complications, should the child be allowed to stay in.  We shall not talk of those complications.

I was advised to see a dietician, a diabetes consultant and to learn as much as I could online.  The information online was good, but somewhat confusing.  I was quite pleased to see the dietician so I could get some things cleared up (and also pleased to learn that my interweb gleanings had been good and I was already following the diet).

In essence, to maintain a steady blood sugar when personal stores of insulin are not working properly, one must eat small amounts of carbohydrates regularly.   This was a bit difficult for me, as after I finished feeding Small, I attempted to give up snacks and just eat at mealtimes.  Being told to eat six times a day was a shock.  After meeting with the dietician (more good news), I got a blood testing kit and got to prick my finger four times a day to make sure the levels are good.

Thus, a good day should look like this:
Wake up: fasting blood prick blood sugar, 4-4.9
Eat breakfast: 2-3 units of carb (30-45 grams)
Two hours later: blood sugar, 4-6.7
Eat snack: 1-2 units of carb (15-30 g)
At least two hours later, eat lunch: 2-3 units of carb (30-45 g)
Two hours later: blood sugar, 4-6.7
Eat snack: 1-2 units of carb (15-30 g)
At least two hours later, eat dinner: 2-3 units of carb (30-45 g)
Two hours later: blood sugar, 4-6.7
Eat snack: 1-2 units of carb (15-30g)

Also, everything had to be low or no-fat while making sure that the flavour hadn't been replaced by sugar or the wrong sweetners.  And, you should have some protein with the carb.  Basically, you spend the entire day thinking about food.  You plan out meals in extreme detail.  I've done weekly meal plans for awhile anyway because it makes grocery shopping easier.  This was just another step, where you measure out your pasta with a cup measure.

The truth of it is, though, gestational diabetes isn't so bad (I could live this way if I had to, I'd just a bit grumpy around Christmas when I had to skip the cookies.). We'd already been trying to eat healthily, though I must admit I had been enjoying the occasional Pepsi to keep some pep in my step.  Little boys who were not sleeping well due to teeth and undiagnosed ear problems who somehow had energy in the day were wearing through my already depleted energy supplies.  I had sometimes enjoyed some yummy chocolate or a doughnut to keep going.  That all had to change.  Whole grains are recommended.  We already ate multi-grain bread and had tried wholegrain pasta, but hadn't enjoyed it.  We've found out that now we do.  And whole-grain couscous!  We already only used whole-wheat flour (or spelt if white is necessary).  And there is stevia in my cupboard now, but that has the most nasty aftertaste ever.  Just use a bit of raw sugar (15 g is 1 tsp).

In fact, gestational diabetes has given me a few things. Other than a nervous twitch of reading nutrition labels, I mean.  It's given me an appreciation for people who have to deal with this all the time.  My dear sister is type one diabetic and I never fully appreciated how difficult life must be for her.  I knew that she had to think about food a bit more, but there are charts devoted to glycemic index and how to make healthy food choices into healthier food choices.  And she has to survive with insulin! My sugars have been pretty easy to regulate thankfully, mainly because I've learned that my willpower is pretty good.  I love this child so much that I want them to be healthy and I've kept to this diet more than I ever thought I could.  Because my blood sugars have stayed within the healthy levels (4-8 in a blood prick, so says the doc), no extra insulin was needed.  I've also had the chance to try to new recipes! I had gotten lazy about the recipe thing because the boys had gotten a bit difficult about trying new things and cooking two meals sucks.  Unless you have to, and then it's a chance to explore.

Some recipes that we've stumbled across:
Sun-dried tomato and artichoke quiche
One sheet of puff pastry
Some sun-dried tomatoes, drained thoroughly
Some marinated artichokes, drained thoroughly
Half of a small container of ricotta
4-5 eggs
Pinch of herb salt

Beat the eggs.  Add the other stuff.  Pour onto the puff pastry, which in your greased quiche pan (but greased with EVO oil, not butter. Gotta watch those carbs).   Top with grated cheese.  Bake in a hot oven (240C) for 25-30 minutes.  Actually, Small taught me the last bit.  He turned up the oven on me from 190 and I could smell the quiche much sooner than I thought I should.  Upon checking it out (well and truly done in half the normal time), I learned that dinner prep could be done sooner and Small likes to play with dials.

Best Ever Brussel Sprouts
Quarter some brussel sprouts and boil until the water turns green.  Drain.
In the meantime, toast some pine nuts.  Keep your small sons away from the oven if you wish to maintain a regular temperature.
Drain some sun-dried tomatoes.
Grate parmesan cheese.
Mix all these things together with some minced or dried garlic and a bit of herb salt.

And then realize that brussel sprouts are delicious.

Tomato Salad
Chop up some small tomatoes of different colours.
Chop up a couple drained roasted red peppers.
Toss with a few capers and some garlic.
Add some dried multi-grain bread, a swoosh of EVO oil and balsamic vinegar.

And then there's that eat any brassica (kale, broccoli, etc) after it's been roasted in olive oil for 20 minutes in a hot oven and then sprinkled with parmesan and sprinkled with fresh lemon juice.

Cheese is a surprise delight of the whole GD thing.  Milk has carbs. Yogurt has carbs.  Cheese? Carb free.  About a month into the diet I asked my doctor if I could have fat again.  I was losing lots of weight (2 kg in one week) and my blood pressure was a bit low.  I've been back on fat since (woot, woot!) and that makes cheese consumption even easier.  Bocconcini is my special treat right now.  If I'm feeling peckish, it's free food! For whenever! And has calcium which is good for everybody's bones.  It's a bit odd when bocconcini becomes one's candy.

So where are these carbs found then, these highly regulated and documented carbs? In delicious things. In fruit. In starchy veg (peas, lentils, corn,  etc). In pasta and potatoes and bread and cake and anything made from wheat.  In nuts.  In candy and chocolate and milk and yogurt.  In fact, carbs are liberally spread through everything, especially prepackaged things.  Again, it's been cool to have a reason to push forward and try to make things from scratch, but sometimes when you're massively pregnant, dealing with two delightful boys that make life full, you'd like to order a pizza. But you've done the carb count, and you can only have two pieces. And that sucks.  But you can have salt and pepper squid salad! So that's something.  And all the other veg you could want.  Although, it does have some carb in it, so you have to think about everything that goes into your face.

(I just pricked my finger - 5.3.  Dinner was chilli-cheese sausages and pea salad - peas, celery, cashews, mayo and italian dressing.  It's surprising, but it hurts everytime.  Next time you see someone with diabetes, kiss their poor fingees.  Or offer them some bocconcini.)

[What is a unit of carb? One piece of bread. A medium-small potato, but as they have a high GI, eat them only occasionally.  A 125 mL glass of milk. A small tub of natural yogurt - which I now prefer to any sweetened.  A quarter cup of dried fruit and nuts.  One large cracker with peanut butter. A teaspoon of sugar.  Good luck getting that medicine down.  Half a cup of cooked pasta.  Half a cup of cooked rice (basmati or brown, please). 3/4 cup of oatmeal. 1 medium or 2 small fruits. 3/4 cup of grapes. Still hungry? Load up on proteins and non-starchy veg.  It's good gear.  Who doesn't want a poached egg with that? Oh - the trick to a perfect poached egg:  Add enough water to a low-edged pot to cover an egg.  Bring to a boil.  Add a splash of vinegar and a pinch of salt.  Crack an egg and drop in the water as closely as possible.  Cook for 4 minutes for soft.  10 for pregnant ladies hard-style.]

That, in a nutshell, is gestational diabetes.   If the nutshell was the size of a commerical airplane.  Any questions? Bueller?


  1. 1 unit of carbs also = 15 g of carb, for those interested...and bocconcini is delicious!! Now I would love some...
    Hugs to you, dear sister--taking care of your bambinos--I'm proud of calculations arre time consuming for sure--but you are doing admirably well! lotsa love, Ev

  2. quiche with one piece of phyllo--smart! Sounds yummy--can I have some?!! Eggs were my fave when I was preg with Karl..scrambled, boiled, quiched, delish! I wish I could come visit like Na! Love you!
    Ev (again)

  3. You do amaze one, you know that? Thank you for sharing your newly found knowledge, for the empathy that you share. Love you! Looking forward to some tasty-ness!