Thursday, 21 April 2011

A Diabetic Pregnancy...and Some Healthy Eating Tips

Today I went for a blood test, my gestational diabetes(GD) follow up.  You may be wondering what this has to do with you if you are neither pregnant with gestational diabetes, nor suffering with type 1 or 2 diabetes.  Well,if you are looking to lose a few pounds let me tell you that the principles of a diabetic friendly diet are broadly the very same principles for losing weight, so scroll on down to the end of the post ;-)

Photo Credit: M daras
I had GD during my first pregnancy which you can read about here, but this time round I had sugar in a pee sample at 16weeks and was duly referred for a glucose tolerance test.  Thankfully it was a false alarm but I was now already on the radar and was asked to repeat the test at 20wks.  Sadly this time I was not so lucky, and failed the blood test miserably.  Although shocked at such an early diagnosis I consoled myself in the knowledge that I coped last time, and I would again...this time I knew the ropes.  Or so I thought.

My body had other ideas.  After four days it became  apparent that unless I was to adopt an Atkins style diet, with no carbs at all, I was destined to fail my finger prick tests at every turn, so back to the diabeteic clinic I traipsed, to be started on insulin.

Managing GD on insulin is vastly different to both diet controlled gestational diabetes and non pregnant insulin dependent diabetes.  When you are pregnant, the effects of high blood sugar on the baby are serious, and I mean thirty times more likely to have a stillbirth type serious.  Even if you deliver a healthy baby, they can have serious problems in maintaining their blood sugar levels and need the services of Special Care on delivery.  As you can imagine, the pressure is on to keep your blood sugar as low as possible.  So low in fact that the antenatal diabetes clinic consider frequent hypos to be a good thing (for more information on hypos see here).  The particular difficulties in maintaining tight blood sugar control when pregnant are twofold.  Firstly, the amount of insulin you need increases as your pregnancy progresses.  You may think that you know how much insulin you need for a particular meal one week, but the next week it probably won't be enough.  Secondly, the rate at which you use the sugar in your blood depends not only on how active you are but also how active the baby is, over which you obviously have no control.

The basic strategy for managing GD are that you have your insulin injection before your meal, and test your blood an hour after your meal to ensure that your blood sugar is within the required range.  If it is too high, a further injection of insulin is needed.  But this is classed as a 'fail' and means the baby has been subjected to too much sugar.  At your monthly visits to the antenatal diabetic clinic more than a handful of these and you will be subject to the wrath of various consultants!

I was determined that my baby would be fit and well, and so managed my diabetes with a rod of iron. By 28 weeks it was hellish.  I had on average two or three hypos a week, which are themselves hellish.  I became effectively housebound as I was too worried about having a hypo either when driving or when out and about with Star in my care.  I found it enough of a challenge taking care of myself when I was having a hypo, let alone being away from home with a two year old in tow.  Stress also plays havoc with blood sugar levels, and through this period my father's illness became significantly worse and he was admitted to a nursing home, and passed away 9 days before Moonbeam was delivered.  So much stress, and more stress worrying about what the stress was doing to my unborn child.

Despite all this Moonbeam arrived by elective section on 17th Jan weighing 8lb 7ozs, with an Agpar of 9.  Despite having to have his blood tested twice within his first 7hrs he was fine and dandy and has been a joy ever since.  On reflection I do wonder whether a little less severe management would have been more approriate as 8lb 7ozs may sound like a good weight, but factor in a 99th centile head circumference and the fact that he was so skinny he had stick arms and legs and no bum cheeks and I think a little more sugar in my blood may have been more comfortable for both of us.  Hindsight is of course a marvellous thing.  He was healthy, and that's what counts.

And so to hints and tips.
  • Eat 3 meals and 3 snacks a day.
  • Protein ie meat/fish/nuts/yoghurt/cheese down the absorption of sugar so ensure there is some protein in every meal and snack.
  • Fat also slows down the absorption of sugar, so provided your GD isn't due to excess weight, ditch the low fat versions of everything and go full fat all the way.
  • Sugar is the enemy, don't eat it.  This obviously includes cakes and biscuits, but if you eat pre prepared food stuff, always check the label.  Sugar goes by lots of names...glucose, fructose,'s all sugar.  Take care with fruit too.  
  • All carbohydrate is converted into sugar but wholemeal/wholegrain carbohydrate is converted much more slowly that refined/white carbohydrate which should be avoided.  This means granary bread, brown basmati rice, wholemeal pasta, wholewheat noodles.  
  • Fibre also slows down the absorption of sugar, which is why wholegrains work.
  • Your insulin requirement will be higher in the mornings and reduce as the day goes on, so go carb light at breakfast, and eat your biggest carboydrate portion for dinner in the evening.
  • A portion is basically the size of your first, or palm of your hand.
  • Some people are more sensitive to certain types of carbohydrate than others, so if something doesn't seem to be working for you try something else.  I could only have half a small jacket potato and porridge was out of the question.
A typical day's menu for me was....

Poached egg on a small piece of buttered granary toast

A satsuma and a handful of nuts

A chicken drumstick, guacamole, houmous, veg sticks, a couple of oat biscuits.

Half a banana and a handful of nuts

Spaghetti Bolognese with wholemeal spaghetti

Hopefully, if you or anyone you know are ever diagnosed with gestational diabetes this will help.  Frustratingly nobody gave me all this info either from the start, or in one go.

If you are reading this with an interest in weight loss, check back soon, when I will explain why sugar, rather than fat, is the key to losing weight without going hungry.

Tuesday, 19 April 2011

Getting Into Shape - Mind The Gap!

After an enforced break due to poorly children and technology issues I am finally able to bring you my first post on rolling our sleeves up and getting on with getting into shape, part of reclaiming our Fit, Foxy and Fabulous former selves.

On a previous post I very broadly outlined how I plan to do it, but felt that before encouraging you to jump right in it was important to issue a word of caution.

I think for most mum's the tummy area is the one that is often the most stubborn and causes the most frustration and disappointment when trying to get our pre baby figures back.  The obvious answer is to launch into endless crunches/situps in all their various guises but WAIT! Did you know that you could be making your mummy tummy worse rather than better?  The reason is a condition called Diastasis Recti, or a separating of the tummy muscles which can effect up to 66% of mums.

So how do you know if you're suffering from this?  Well the good news is that it's easy to diagnose  yourself.  Simply lie on your back with your knees bent & your feet flat on the floor and rest your finger tips (palm facing you) two inches above your belly button.  Now raise your head and shoulders slightly off the floor & press your fingers down into your tummy.  If your fingers sink in and you feel the muscles close in around them as you raise your head and shoulders notice how many fingers fit in the gap.  Now do the same directly over your tummy button, and again two inches below.

The gap caused by the separated muscles, or the Diastasis Recti gap is measured in finger widths. A gap of up to 2 finger widths is completely normal, but anything more, and it can be ALOT more, and you are suffering from this condition.  But fear not, however large the gap, and however long ago you had your babies, it can be fixed with dedication to some simple but effective exercises.

I'll leave you now to go prod your tummies, leave me a comment and let me know what you find...