At the beginning of my third trimester, I failed the glucose tolerance test. Every pregnant person takes it and the grade is either pass or fail.
I failed the super glucose tolerance test, too. I spent a whole morning at a lab, where a phlebotomist would draw my blood four times. Once when I got there, and three times after that, each an hour after drinking that extremely sugary drink (which ironically I loved!).
I wish I could say that my diagnosis didn’t come as a surprise, but it did. I didn’t know very much about gestational diabetes so I didn’t know I was as at-risk as I was. My BMI classifies me as overweight. My grandmother had diabetes. COVID lockdown turned my active lifestyle into a very inactive one. I ate all of my feelings – the fear, the sadness, the loneliness – two Oreos at a time.
Looking back, it was not a surprise that I spent the rest of my pregnancy living with gestational diabetes.
Here are a few things I wish I knew about living with and managing gestational diabetes that I hope help you, dear reader. Please note that I am not a doctor and none of this constitutes medical advice.
Gestational diabetes is not your fault.
Gestational diabetes develops when hormones in the placenta change how your body metabolizes glucose, or sugar. Every pregnant person is at risk, especially if a relative has or had diabetes. My grandmother developed diabetes late in life and, even though she died before I was born, her medical history still affected me. Don’t underestimate the power of genetics.
Other risk factors for developing gestational diabetes according to the Mayo Clinic are:
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- Having a BMI that classifies you as overweight or obese
- Not being active
- Having prediabetes
- Having had gestational diabetes during a previous pregnancy
- Having an immediate family member with diabetes
- Having previously delivered a baby weighing more than 9 pounds
- Being Black, Hispanic, American Indian, or Asian American.
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The glucose tolerance test is not a test to be bamboozled, manipulated, or otherwise falsified. It is an extremely important measure of how your body is handling pregnancy. This is not shameful. Having diabetes of any kind is not shameful.
I wish I had known that. I wish I had been able to tell myself that. I didn’t share my gestational diabetes diagnosis with many people because I was ashamed of it.
The opposite of shame is pride. How can you be proud to live with gestational diabetes? You recognized your body needed help and now you’re getting it. That’s something to be proud of.
The severity of your diabetes is not a reflection of who you are
Some people will manage their gestational diabetes through diet and exercise and other lifestyle changes. Others will manage it through insulin or other prescription medications. My morning blood sugar readings were the highest. Every night at bedtime I injected myself with insulin. Because my OB said that needing insulin is the worst-case scenario of being able to live with gestational diabetes, I thought I had really messed up.
But here’s the thing: we are not our bodies. Our bodies are merely vessels for our hearts and spirits. Our hearts and spirits are our true selves.
How we respond to things is a reflection of who we are. We can let adversity knock us down or we can get up and brush ourselves off. I wish I had done less of the former and more of the latter, which brings me to my next tip.
Try to find some joy in the experience
This one was super duper hard for me, I won’t lie. I was already having a difficult time with my pregnancy with COVID’s unknown threat and hating being pregnant.
I’m not quite ready to say that living with gestational diabetes was awesome, but it was a distraction I needed at the time I needed it.
I threw myself into learning about living with gestational diabetes. I learned a lot about nutrition, which came in handy when it was time to introduce my son to solid food. I read a lot of gestational diabetes cookbooks (although any literature about GD is surprisingly hard to find). Remember that education is the first step toward empowerment.
My dog and I started taking several walks every day. A nice long one in the morning after breakfast, before it got too hot (my third trimester was June to August 2020). And a shorter one after dinner as the sun set. It was great for both of us, a nice way to spend our time that wasn’t lying in the air-conditioned bedroom propped up on a pregnancy pillow watching Grey’s Anatomy. Truly, though, I watched the whole series in three months.
I had weekly ultrasounds and many non-stress tests. Living with gestational diabetes can be dangerous for the fetus, especially if the mother’s diabetes is mismanaged. My son could have been too big for my birth canal. He might have been born jaundiced or with low blood sugar (he was, but that’s a story for another time). Both of us are at greater risk for developing Type 2 diabetes in the future. Chances are 50/50 that I develop gestational diabetes in subsequent pregnancies.
My weekly visits to the OB’s office were a real joy for me. It was something to look forward to. But mostly they were opportunities to see my baby in two dimensions and hear his heartbeat on the monitor. He was lively and active then. He’s lively and active now.
Listen to your doctors, but also advocate for yourself with them
I was referred to dieticians and doctors specializing in diabetes. We had video meetings. I kept a daily log of everything I ate.
In an effort to be the perfect patient and the perfect mom-to-be, I took managing and living with gestational diabetes a little too far. I denied myself a lot. That was not psychologically healthy for me. Restriction is a form of disordered eating. I became too attached to the idea of as few carbs as possible when, in fact, every body needs carbs to operate properly. Carbohydrates are part of a balanced diet even when we’re learning how to manage our blood sugar.
There were two times in the entirety of my third trimester that I ate ice cream. Even though I was very pregnant during a pandemic during a very hot summer. I cried when I finished, idling in the air-conditioned car with my husband in the driver’s seat. I cried not from the pleasure of satisfying a craving but from guilt. I ate all this sugar; will my son be too big to fit through my birth canal? Will he be born with dangerously low glucose levels? Will he need to be admitted to the NICU? Will he die?
I wish I could go back and have the presence of mind and self-awareness to speak up for myself with all the doctors I was shuffled between. I wish I had said, “This daily food log is not healthy for me. Is there another way?” I feel reasonably sure the answer would have been “Yes.”
If the answer had been “No,” I could ask for a second opinion or be referred to another doctor or another practice or both.
There’s nothing wrong with talking to a therapist
Let me say that again for the people in the back. There’s nothing wrong with talking to a therapist. Mental health is health care, and it matters. There’s a lot going on in our bodies during pregnancy. We’re high on all kinds of hormones. Our emotions are in a tailspin. It can be challenging to figure out how we feel about things, especially when those things engage many facets of who we are.
Living with gestational diabetes was a profound psychological, emotional, and physical experience for me.
I did talk to a therapist during my pregnancy, as well as other times. I wish, however, I had been able to be more honest with myself and with my therapist. No one could help me before I helped myself.
I felt a lot of things during my pregnancy. Discomfort, sadness, joy, hope, just to name a few. But when it came to living with gestational diabetes, I was really angry.
I was angry because this was not how I thought my pregnancy was going to go. I felt doubly, then triple, trapped. First by being pregnant. Then by COVID. And finally, the cherry on top, the pièce de resistance, was living with gestational diabetes. I felt very disconnected from my body and the world, both rendered uninhabitable by forces beyond my control.
The COVID-imposed isolation made it hard for me to connect with others at a time I needed that support the most. I found some private groups on Facebook for first-time expecting moms and pregnant people with gestational diabetes. It was hard for me to find a way to connect through a computer screen. Too much human emotion gets lost in the virtual world for me to feel comfortable there. Because of COVID, though, there was no other option for me.
But there is for you. Find a place where you can share your entire complex array of emotions. Be sad. Be resentful. Be angry.
Find your voice for living with gestational diabetes. Find your people. Find your community. And if you can’t, then find me on Instagram @the_grand_nathalie or comment below to get in touch.
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