Managing a Pregnancy With Gestational Diabetes
Cathy shares how gestational diabetes changed her outlook on pregnancy.
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Cathy was looking forward to an uneventful second pregnancy when she was diagnosed with gestational diabetes (also known as GD or GDM).
Marked by high blood sugar levels, GD is a form of diabetes that first develops during pregnancy, often without any symptoms. Women with GD need special care both during and after pregnancy. The condition can put mom and baby at long-term risk for type 2 diabetes.
Cathy knew she had to change her diet and lifestyle to keep herself and her baby healthy. In this edited interview, she explains how she did it.
ACOG: When were you diagnosed with gestational diabetes?
Cathy: It came up after the routine glucose screening in my sixth month of pregnancy. My blood glucose (blood sugar) levels were high, and I went back for a follow-up.
It was a total surprise. I had no symptoms. My first daughter had been born at 9 pounds and that was a risk factor – though I didn’t know it at the time.
My midwife told me GD was serious and could affect the baby’s health. But she also told me it was controllable. And we just rolled with it from there. I felt like I got very good care.
ACOG: What was your treatment plan?
Cathy: We started with lifestyle changes, mostly to my diet. I ate low-carb, watching my carb and sugar intake and balancing it with protein.
At first, I was really overwhelmed because both my husband and then-3-year-old daughter have pretty severe food allergies. I dreaded adding another level of complication to our family meal-planning. I met with a nutritionist who helped me plan meals that would work for all three of us.
It turned out to be totally doable. I just had to adapt our existing system for my new diet with GD. I remember eating a lot of vegetables and lean protein, which we all could enjoy.
The other part was that I used a glucose meter to stick my finger and test my blood sugar after every meal. I kept track of my carb intake and blood sugar levels and sent the results to my endocrinologist every week.
ACOG: But then your blood sugar levels were still high. What happened next?
Cathy: The doctors could tell from my charts that my healthy eating wasn’t working on its own. So I started insulin injections. I had never given myself shots before – but there I was, doing it once a day. And that did the trick, getting my blood sugar levels to where they needed to be.
ACOG: Was there any impact on your delivery or the baby’s health?
Cathy: I had more frequent nonstress tests in the last trimester. And it was best for me to deliver on or before my due date because GD can cause babies to be born larger. I had an induction scheduled for the latest date possible, but Willa came on her own in a quick, intense labor and delivery.
She was actually born on the small side, under 7 pounds, but with no complications. One of the delivery nurses mentioned I must have done a good job controlling my blood sugar! Now Willa’s a healthy 9-year-old.
ACOG: How did GD affect your feelings about your pregnancy?
Cathy: What you do when you’re pregnant has a direct effect on your baby. Having GD made me so much more aware of that.
If I ate too much or the wrong things, it wasn’t just going to make me sick, it was going to make her sick. For example, if I ate a yogurt with a little too much added sugar – yep, 20 to 30 minutes later, my blood sugar would be high.
I remember splurging on a small piece of cake at my baby shower at work. I had been watching my diet so carefully for weeks, and that cake made me feel so physically terrible. My heart was pounding!
I was fascinated with the instant feedback, learning how certain foods would impact my body. Having that information gave me a sense of progress and made the whole thing feel easier. (I aspire to keep eating that way!)
ACOG: What would you tell someone who has GD?
Cathy: It seems like a lot, and it is. Take it one step at a time. Tackle what you can. Everyone wants a good outcome, and there are many treatment options available to help ensure that.
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Published: November 2020
Last reviewed: November 2020
Copyright 2020 by the American College of Obstetricians and Gynecologists. Read copyright and permissions information.
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