It's been about a week and a half since I went to meet with a dietician and nutritionist to learn how to manage having gestational diabetes. It's been a bit of a science lesson but, more so than anything, an education in food and how what we eat gets translated into nutrients for the body. I generally understood the concept that with diabetes, you aren't able to regulate your sugar intake because your ability to produce the right amount of insulin is affected, and as a result you had to be careful about eating sugar and carbs.
But I didn't really understand why a glycemic diet would help with managing sugar, and definitely didn't realize that there was a difference between starchy vegetables and non-starchy vegetables. And I see the results in my blood pricks, also - white rice and rice noodles makes my blood sugar remain high for longer, protein and veggies keep it very low, if I have fruit too soon after my meal or along with my meal it raises my blood sugar. Exercising or moving around after a meal makes a huge difference.
GD is an increased risk with twins because certain pregnancy hormones impair the action of insulin in your cells as it works to transport glucose from your bloodstream to your cells. With double (or at least a significantly increased!) amount of pregnancy hormones, my body is unable to handle it. The standard measurement here in Hong Kong after an OGTT (oral glucose tolerance test) is a post-test reading higher than 8.5 mmol/L, and I failed it because I got a reading of 8.7 mmol/L.
The diet that has been suggested to me is tricky because it involves a lot of well-timed meals with snacks interspersed throughout the day. Because I am carrying twins, I also tend to get hungry faster and need slightly more calories. It's been a really tough balance when I'm busy at work, especially days when I am testing my blood sugar levels, because I really have to keep an eye on the time.
Basically, I test my urine for ketones the first thing in the morning when I wake up - this is to indicate to me if I'm eating too little carbs. Apparently one can go too far the other way with restricting carbs and that's also not good. I often forget this step because it's Lola's habit to rouse me out of bed and drag me in a stupor into the living room to play with her first thing in the morning.
I then test my blood sugar level, dutifully record it, and then eat breakfast. I usually have an omelette, or else savory oatmeal (paired with anchovies and sardines), and maybe a slice of cheese or two.
Two hours after breakfast, I test my blood again, and then have a snack. I am encouraged to have a small piece of fruit, dairy (yogurt) and some protein (nuts, peanut butter on wheat bread).
Then for lunch I usually try to have a salad with a power protein, like quinoa, lentils, chickpeas or salmon. I'll mix up the salad with steamed broccoli/cauliflower/beetroot/brussels sprouts, feta cheese, tomatoes, cucumbers, carrots. Two hours after my lunch, I once again test my blood.
Mid-afternoon, usually around 3 or 4, I aim to have another snack. Then usually by the time I get home for dinner around 7, I am already hungry again. Dinner tends to be brown rice paired with fish, stir fried beef and veggies, and another green vegetable. Last night it was steak, potatoes and broccoli. Tonight it was a whole fried tilapia with ginger and tomatoes, stir fried beef with yellow and red peppers, and sweet potato leaves stir fried with shrimp paste, over a small bed of brown rice.
Two hours after dinner, I test my blood again.
And then I'm supposed to test my blood one last time, before I have a bedtime snack and go to bed, but sometimes I'm really not hungry and other times my day has gone on for so long that by this point I just need to go to sleep. But the bedtime snack is supposed to be along the lines of dairy and fruit, and maybe a small serving of carbs.
I have tested my blood roughly every other day since I got the kit and I don't think there has been one time that I have managed to test 7 full times and at exactly the right times. I have become somewhat inured to the brief pinprick of pain that the blood pricker exerts on my finger, so that's an improvement. I have also gotten much better at squeezing the right sized droplet of blood out of my finger (much harder than you'd think) and timing it right so that I don't waste my strips (I think the first two days I wasted two or three needles and at least 5 or 6 strips). I also know now which of my fingers are more tender (more easily pierce-able) and that the sides of the fingers tend to produce better results.
The biggest challenges for me have been around ensuring I have good food on hand when I suddenly get an uncontrollable case of hunger, and making sure I eat fast enough so that I can get a good reading 2 hours after my meal. Because I test my blood sugar from 2 hours of when I commence eating, if I stretch my meal out over an hour to an hour and a half, I get higher readings.
It felt really horrible when I first found out about this, and I am still not happy about it, but it feels a little more manageable now than when I first found out. I am at a slightly higher risk for type 2 diabetes post-pregnancy, but hopefully if I keep myself on a strict diet and manage it well I will return to being able to process sugar properly after the twins are born.
I still have moments of panic where I am not certain if I should eat something or having to check myself from eating too much of something that's supposedly "healthy" but too high in sugar (like a lot of grapes all at once). The nice thing has been that I am still able to have fruit and some carbs - I don't know what I would do if I had to cut all of that out of my diet as well!
I really, really long for a chocolate chip cookie though, or a fresh croissant, or heck, even unlimited amounts of bread - and it seems particularly cruel that for this pregnancy I have more of a hankering for fresh orange juice and frozen yogurt. Today I happened to walk by a bakery that was giving off such delicious smells of butter, sugar and cake that it should have been illegal.
But hopefully soon...
But I didn't really understand why a glycemic diet would help with managing sugar, and definitely didn't realize that there was a difference between starchy vegetables and non-starchy vegetables. And I see the results in my blood pricks, also - white rice and rice noodles makes my blood sugar remain high for longer, protein and veggies keep it very low, if I have fruit too soon after my meal or along with my meal it raises my blood sugar. Exercising or moving around after a meal makes a huge difference.
GD is an increased risk with twins because certain pregnancy hormones impair the action of insulin in your cells as it works to transport glucose from your bloodstream to your cells. With double (or at least a significantly increased!) amount of pregnancy hormones, my body is unable to handle it. The standard measurement here in Hong Kong after an OGTT (oral glucose tolerance test) is a post-test reading higher than 8.5 mmol/L, and I failed it because I got a reading of 8.7 mmol/L.
The diet that has been suggested to me is tricky because it involves a lot of well-timed meals with snacks interspersed throughout the day. Because I am carrying twins, I also tend to get hungry faster and need slightly more calories. It's been a really tough balance when I'm busy at work, especially days when I am testing my blood sugar levels, because I really have to keep an eye on the time.
Basically, I test my urine for ketones the first thing in the morning when I wake up - this is to indicate to me if I'm eating too little carbs. Apparently one can go too far the other way with restricting carbs and that's also not good. I often forget this step because it's Lola's habit to rouse me out of bed and drag me in a stupor into the living room to play with her first thing in the morning.
I then test my blood sugar level, dutifully record it, and then eat breakfast. I usually have an omelette, or else savory oatmeal (paired with anchovies and sardines), and maybe a slice of cheese or two.
Two hours after breakfast, I test my blood again, and then have a snack. I am encouraged to have a small piece of fruit, dairy (yogurt) and some protein (nuts, peanut butter on wheat bread).
Then for lunch I usually try to have a salad with a power protein, like quinoa, lentils, chickpeas or salmon. I'll mix up the salad with steamed broccoli/cauliflower/beetroot/brussels sprouts, feta cheese, tomatoes, cucumbers, carrots. Two hours after my lunch, I once again test my blood.
Mid-afternoon, usually around 3 or 4, I aim to have another snack. Then usually by the time I get home for dinner around 7, I am already hungry again. Dinner tends to be brown rice paired with fish, stir fried beef and veggies, and another green vegetable. Last night it was steak, potatoes and broccoli. Tonight it was a whole fried tilapia with ginger and tomatoes, stir fried beef with yellow and red peppers, and sweet potato leaves stir fried with shrimp paste, over a small bed of brown rice.
Two hours after dinner, I test my blood again.
And then I'm supposed to test my blood one last time, before I have a bedtime snack and go to bed, but sometimes I'm really not hungry and other times my day has gone on for so long that by this point I just need to go to sleep. But the bedtime snack is supposed to be along the lines of dairy and fruit, and maybe a small serving of carbs.
I have tested my blood roughly every other day since I got the kit and I don't think there has been one time that I have managed to test 7 full times and at exactly the right times. I have become somewhat inured to the brief pinprick of pain that the blood pricker exerts on my finger, so that's an improvement. I have also gotten much better at squeezing the right sized droplet of blood out of my finger (much harder than you'd think) and timing it right so that I don't waste my strips (I think the first two days I wasted two or three needles and at least 5 or 6 strips). I also know now which of my fingers are more tender (more easily pierce-able) and that the sides of the fingers tend to produce better results.
The biggest challenges for me have been around ensuring I have good food on hand when I suddenly get an uncontrollable case of hunger, and making sure I eat fast enough so that I can get a good reading 2 hours after my meal. Because I test my blood sugar from 2 hours of when I commence eating, if I stretch my meal out over an hour to an hour and a half, I get higher readings.
It felt really horrible when I first found out about this, and I am still not happy about it, but it feels a little more manageable now than when I first found out. I am at a slightly higher risk for type 2 diabetes post-pregnancy, but hopefully if I keep myself on a strict diet and manage it well I will return to being able to process sugar properly after the twins are born.
I still have moments of panic where I am not certain if I should eat something or having to check myself from eating too much of something that's supposedly "healthy" but too high in sugar (like a lot of grapes all at once). The nice thing has been that I am still able to have fruit and some carbs - I don't know what I would do if I had to cut all of that out of my diet as well!
I really, really long for a chocolate chip cookie though, or a fresh croissant, or heck, even unlimited amounts of bread - and it seems particularly cruel that for this pregnancy I have more of a hankering for fresh orange juice and frozen yogurt. Today I happened to walk by a bakery that was giving off such delicious smells of butter, sugar and cake that it should have been illegal.
But hopefully soon...
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