To Be or Not to Diabetes: A Look at Gestational Diabetes

When I read that I would need to be screened for something called gestational diabetes at the beginning of my pregnancy, I didn’t give it much thought. It did not seem like something that deserved a wealth of my attention. My thinking pattern was, “Well, I don’t have diabetes now, so this must just be some sort of routine test that I’ll pass with flying colors.” So, imagine my surprise, when I found out that I was considered at-risk when I was 3 mg of sugar over the standard of 140mg of sugar per 100 milli-liters of blood on my one-hour screening exam. This is how it goes generally: Around 28 weeks of your pregnancy you will be instructed to drink about 60g of sugar in the form of a glucose beverage, grape juice, or a bunch of Twizzlers an hour before your blood test. Then you’ll get a sample of blood drawn at your lab, midwife, or obgyn visit. You’ll get the results back within a day or so and if the number is over 140mg (depending on where you live and who you see) then you may be instructed as a standard of care to take the 3 hour glucose test. When I asked, I found out that my mom also had the very same situation occur when she was pregnant with me. She had “failed” her screening test, but then passed her 3 hour test without problem. And the same occurred to a lot of my other friends and family who had been required to take the 3 hour test. This made me a bit indignant. And of course I wanted to sleuth and understand the real nature of this gestational diabetes so I asked my midwife, who reassured me that I’d pass the test, and my doula who sent me a very informative article that I want to pass along to you now: http://www.drbrewerpregnancydiet.com/id33.html.

Turns out I did pass my 3 hour test; in fact, I almost passed it TOO efficiently. I had a resting glucose level of 72 (range of 70-94 mg/dL), a one hour of 103 (70-179 mg/dL), a two hour of 79 (70-154 mg/dL) and a three hour of 48 (70-139 mg/dL). When I reported these findings to my main midwife she said that it is what she expected and not to worry about the low number after 3 hours. What I had done to make sure that I kept my glucose levels at what I perceived to be “normal functioning” was I followed some of the suggestions laid out in the abovementioned article. I walked one mile or 20 minutes between each blood draw in a nearby subdivision to the lab, I drank lots of water, and I tried to keep my stress down by doing a 10 minute guided body scan before each blood draw following the calming voice of Tamara Levitz in the Calm phone app. If it seems like a lot of work, perhaps it was, and after 10 hours of fasting and another 3 hours of only consuming some generic sugar beverage, I don’t necessarily think that it was the best for my growing Rose to have to subject her and my body to such a strange rigmarole. I’m grateful that I passed and that I did not undergo any dizziness or nausea while fasting for so long.

The subject of gestational diabetes is contested and the standards have changed. What that means is that over time, pregnant women who were not at once considered to be affected, if tested today, would suddenly have a problem. And I say problem because this could be the difference between a low-tech birthing experience and a highly-monitored one, meaning that if your test says you are diabetic gestationally, you may have to take hourly blood pricks and insulin treatments. And then your baby may also undergo more ultrasounds as well as monitoring during a hospital-based birth and heal pricks following the labor. Surely, this could be necessary if the mother has “poorly-controlled clinical diabetes” (Jones article), but “no study in any of the medical literature indicates adverse effects from ‘gestational diabetes.’”

I think my friend said it best when he messaged me to calm my worry, saying, “Honestly, it seems to me that gestational diabetes is a dynamic concept and an inexact science.” In fact, this phenomena could be attributed to the fact that research has been done mainly on under-nourished women, for a healthy pregnant woman may store her glucose for later use, thus indicating a higher glucose level on the screening test, she may have more in her blood because the blood is filtrating itself differently during pregnancy, and the hormones involved in growing a babe might also play a role. That’s why I think it is important to take into consideration if a pregnant woman was diabetic before her pregnancy and if she maintains a relatively balanced diet and exercise regime. Otherwise, we could be diagnosing a whole population of pregnant women and subjecting them and their babies to unnecessary, stressful, and costly interventions.

Now, I’m not trying to advise you better than your midwife. I simply want us all as a community to be equitably informed and understand our options at any given moment. I think more than anything, I’m advising you to understand your body and what is happening to it from a multi-faceted, evidence-based plethora of sources. Ask more than one doctor. Read articles. Talk to your doula. Do a little qualitative research with your friends. And then figure out what is best for you and your baby. (Free Birth Society has a very informative blog and one of their posts was on this subject as well as ultrasound technology, group B strep, and Rh negative blood testing. Have a listen: http://freebirthsociety.libsyn.com/gestational-diabetes-gbs-ultrasound-technology-and-rh-negative-a-new-perspective)

If any of you have been diagnosed with gestational diabetes (without being diabetic before pregnancy) and have found the interventions after pregnancy to be necessary and helpful, please feel free to post and share your experience. Also, if you have been mis-diagnosed through screening and passed your 3 hour test or were considered to have gestational diabetes but without any other symptoms or effects, please share your story, as well. 

Namaste,

Katie

Me and Rose at 35 weeks