Conundrums During Pregnancy: Gestational Diabetes Class

It’s been a whirlwind the past few days. Beau came down with some mysterious illness Saturday night, which elicited a trip to the pediatrician Sunday morning, who referred us to the local children’s hospitals for lung X-rays that afternoon. Turns out, the X-rays came back clear and the pediatrician thinks he had a cold virus where the fever lasts a few days. Apparently something like this is going around.

When he woke up Monday morning, his fever had lowered and he seemed to be feeling great. So I took that as a cue that I could attend my gestational diabetes class that afternoon as planned. (I failed the 1-hour screening and refused the 3-hour test, so my punishment is education 🙂  ) My brother graciously agreed to watch the boys for an hour or two when James had to head to open the gym that afternoon. When I called him to let him know I was heading home and fighting Atlanta traffic, I could hear the boys being their crazy selves in the background. Only when I finally made it home and walked through the front door, I could immediately tell Beau had fever, despite the fact that he was chasing James Michael through the house.

Turns out his fever was the highest he’s ever had at 103.6 degrees, which prompted a panicky mom call to the pediatrician on call and loads of guilt for being gone while Beau’s fever was climbing and climbing. Thankfully, Beau is doing much better but it’s been a crazy few days. I’m just now starting to process the gestational diabetes education I received, and thoughts on it are swirling around in my head as I try to make sense (or non-sense) of things.

That was a really long intro to segue into my thoughts on the class, but it might explain why I’m all over the place.

After an hour-long process of checking in, getting insurance information, taking a pre-test and filling out loads of information about myself, the gestational diabetes class (in which I was one of three attendees) began and went full force for more than three hours. The first half was led by a nurse who formerly worked in Labor & Delivery, and one of the first things out of her mouth was, “I know some of you are in denial about being here diagnosed with gestational diabetes.” Way to hit the nail on the head 🙂 Technically, I’m not considered a gestational diabetic since I refused the three-hour test, but more aptly labeled a non-conformist (or to teachers, a troublemaker). But I silently vowed to relax, listen to the information presented and try not to ruffle any feathers.

I found parts of the nurse’s curriculum very interesting. I know very little about diabetes and how insulin affects our bodies. So learning about the roles of the liver and pancreas were very enlightening.

She did touch on food just a tad before the dietitian took over for the second half of the course. She was trying to teach us about carbs and explain good and bad carbs. She held up two boxes of Triscuits and asked one women which was healthier. The woman correctly chose that the box that was higher in fiber was healthier. She held two yogurts in front of me and asked which was healthier. One was a carbmaster yogurt and the other was regular yogurt. I think I was supposed to answer based on the amount of carbs, but I couldn’t help myself and said, “Whichever one doesn’t have artificial sugar.” Wrong, according to the ADA. That encounter pretty much set the tone for the food portion of the class.

The dietitian was super nice and rather knowledgeable, but the catch is she follows ADA guidelines for everything. I told her I follow a loose paleo diet, which might be more aptly called a loose primal diet. I try to eat gluten-free and I do consume full-fat dairy. (Of course I splurge and enjoy plenty of foods, especially sugary ones, but I’ll touch on that later.)

I realize I’m probably not the norm when it comes to the type of women who attend these classes. Even though my diet is far from perfect, I do understand that a high sugar or carb diet is not optimal. I just know how much my body can get away with to feel good, feel energized and maintain a healthy weight (when not pregnant). But just because I understand cause and effect, don’t think that I don’t overindulge as well.

But getting back to the story, I was told so much nutritional information that it has my head swirling. Here are a few examples that didn’t sit right with me. Some were said specifically to me, some were said in general. Actually, most all were directed at me 🙂 :

• Because you prefer a paleo diet, you will get most of your carbs from fruit.
• Cinnamon has no effect on blood glucose levels.
• You should eat no more than 4 egg yolks a week.
• You should switch from full-fat coconut milk to light coconut milk. (Good thing I didn’t bring up coconut cream!)
• You should switch from raw honey to agave nectar.
• Cheese and yogurt are excellent sources of protein.
• You should switch from plain full-fat greek yogurt to 2% or less.
• You should switch from whole milk to almond milk.
• Don’t look at the sugar content on labels, only the carbs.
• Sucralose/Splenda is safe during pregnancy (and FDA approved during pregnancy) because it doesn’t pass through the placenta.

At the end of the class, we were given a daily meal plan laying out how much carbohydrates, protein and fat to consume. I was given a 2,200 calorie diet with a carb range of 180-200 grams, a protein range of at least 10 ounces a day, and told to eat fat with all three meals. Besides a mid-morning and mid-afternoon snack, I was also told to eat a night snack.

Tuesday was my first full day attempting to follow the meal plan. I made it up to roughly 130 grams of carbs, assuming I counted correctly. I’ve never carb counted so this is all very new for me. I skipped the bedtime carb loading because a) I don’t think my body needs it, and b) who wants to wake up to eat? Well, my husband does that, but he truly needs the extra food fuel.

Yesterday, I had a routine 30-week OB appointment and my new midwife said not to worry about the meal plan, but to eat as I normally do and record my levels. Gotta love mixed signals.

Overall, I’m trying to look at the situation as a fun experiment to see how certain foods affect my body. I’ll measure my blood glucose levels four times a day for the next week, then I’m hoping that at my follow-up dietitian appointment next week, I’ll be given an ‘all clear.’ Hopefully that’s not wishful thinking.

As tedious and time-involving as this process has been, it’s also been good for me. I’ve been pregnant and/or breastfeeding all but one month out of the past 3.5 years, so in many ways, I’ve been able to eat whatever I want without regard to how it will affect my weight. I’ve never had to worry about gaining too much weight while pregnant and when I’m breastfeeding, my body is burning so many calories that it’s all I can do to try to maintain my weight.

But, just because I’m at a healthy weight doesn’t mean I should disregard the quality of food I’m eating. Sure, I eat a ton of really healthy food: lean meats, veggies, fruit, nuts and fats, full-fat dairy. But…I also have a huge sweet tooth. And if I don’t have a dark chocolate bar stashed in the pantry, then it’s no problem for me to whip up a quick batch of cookies, a loaf of sweet bread or the like. Whatever I cook is always gluten free, and half the time I use nut flours, but still, coconut/palm sugar, maple syrup, honey and dark chocolate are all still sugar.

This experience is bringing to light just how much sugar (even the ‘better for you’ unrefined sugars) sneaks into my diet. By pleasing the ‘sugar monster’ one, two, even three times a day, all I’m doing is creating a neverending craving cycle where I have to come back for more, and soon. So I’ve cut back drastically on my sugar intake this week, and you know what, it’s not a big deal (so far!). My sugar has come from fruit mostly (though I’m not going to eat 5 pieces of fruit a day to count as my carb intake) and raw honey–though instead of a tablespoon I’ll use a teaspoon.

So far, my blood sugar levels have tested well below the 120 limit; mine have averaged 87 and my fasting level averages 77. I’m also tracking my ketones, which has me much more worried than my actual sugar levels, according to what is seen as healthy during pregnancy. Luckily, I have to record my ketone levels right when I wake up, and at that point they are low or just a trace.

Right when I purchased the ketone strips, I just wanted to test them out, and did so about an hour or so after I had worked out. My level was moderate, which of course freaked me out a bit. I also tested it again two hours after a workout on another day and got the same result. I guess I need to test around the same time on a day I don’t workout to see what I get.

I’m still trying to learn as much as I can about ketones and pregnancy, but I have a feeling I’m in a ketonic state (pregnant and not pregnant) a decent amount of the time. And it doesn’t necessarily mean I’m starving myself or that I have gestational diabetes and am eating too many carbs, instead, I’m thinking (hoping) that it means that my body is used to burning fat as fuel. When I told James about my test, he didn’t seem concerned and simply commented that my body at the time was in a fat burning state. Obviously, I’m not trying to lose weight, but I do CrossFit a couple days a week and chase after my kids all the time.

Does anyone else have any experience with or knowledge of pregnancy and spilling ketones or ketosis? 

Here are some recent eats while trying to follow the meal plan. I’ve tried to eat more fruit (since I’m not eating as many sugary carbs), and have tried to eat (not that it’s hard!) gluten-free waffles and toast once a day to help get in more carbs.

Kudos to you! If you’ve made it to the end of this long rambling post, I commend you!