Gestational diabetes can ask a lot of you – patience, perseverance and lots of positivity. And for most of us, just getting our heads around the GDM diet is hard work enough. But what about when you are also asked to start injecting insulin from one day to the next? Here Meaghan talks about her reaction to this news and how she ended up getting the hang of it.
Additional information is provided by Natasha Leader (Accredited Practising Dietitian & Credentialled Diabetes Educator and GestationalDiabetesRecipes.com In-Kitchen Dietitian).
For more information read our article Myth Busting Insulin for Gestational Diabetes.
GDRecipes: You were pregnant with your first child when you were diagnosed with gestational diabetes (GDM). After one week of trying to manage your blood glucose levels (BGLs) with diet alone, you were put on insulin. What was your reaction?
Meaghan: I was totally upset and devastated. I tried my hardest to eat the right foods to control my sugar levels but it just did not work.
GDRecipes: Did it take you long to get used to injecting insulin? Did you have any false starts or mishaps along the way?
Meaghan: It took a few tries to get it right. The first few times I injected, I obviously did it wrong and it hurt. The one problem I came across was if I accidentally injected in the same place too many times it was quite painful. So what I needed to do was alternate which leg I injected into each day.
(Natasha notes: Injection site should be rotated. It is usually recommended that the belly is used rather than the leg as the leg can give a variable supply of insulin due to possible movement after injecting).
GDRecipes: What did a typical day in your life look like at that time?
Meaghan: When I first woke up I had to check my blood sugar levels by pricking my finger and using my blood glucose meter. I then had to inject myself with insulin and could then eat a healthy breakfast and. Two hours after breakfast I had to check my blood sugar level again. Before lunch I had to inject another lot of insulin and then again 2 hours after I had to check my blood sugar levels. Before dinner I had to inject again and 2 hours after had to check my blood sugar levels again. During the time of needing insulin I was not working and could do it in the privacy of my own home. If I was out I would just go into a toilet and do it there.
GDRecipes: Were your friends, family and colleagues understanding of your need to inject? Was it something you felt like you needed to explain to others?
Meaghan: At first I needed to explain to my family/friends about why I needed to inject insulin. They were very supportive and would remind me if I forgot. They also helped cater to my dietary needs during this time.
GDRecipes: Did you feel more in control of your GDM while taking insulin? Did it make the experience easier in any way?
Meaghan: Yes I did feel in more control because I knew the insulin would help regulate my blood sugar levels and it did allow me to be able to eat more of a variety of food. Also if I decided to be naughty and have something with a bit of sugar in it I was able to inject a couple more units of insulin so my blood sugar levels would be kept at an acceptable level.
GDRecipes: During this time you saw a diabetes educator, an endocrinologist (once) and a midwife. Did they each have a different approach or focus on GDM? How did their support differ?
Meaghan: It was generally just the diabetes educator that focused on my GDM. I saw her once every 2 weeks so we could go over my diet and look at my logbook for my blood sugar levels and see where I could improve them. The endocrinologist I only had to see once to show him my logbook of blood sugar levels and he was pleased I was doing so well keeping it under control and he advised me the only time I might see him again would be on the day of my daughter’s birth if she had any complications due to my GDM.
GDRecipes: Could you give readers any advice about getting the most out of these visits?
Meaghan: I feel the most important person I saw regarding my GDM was the diabetes educator. She is the one who helped me figure out what foods I was allowed to eat, what size portions I should have of each food and she also provided me with the insulin. The midwife and endocrinologist didn’t really play a big part in the management of my GDM.
When going to see your diabetes educator make sure you bring a diary of all the food you have been eating for each meals, what portion sizes you had and remember if you have any questions write them down before you go as with all you will be talking about there is no doubt that you will forget to ask something.
(Natasha notes: Ideally all women with GDM should be referred to a dietitian, as this is the person who is trained and qualified in medical nutrition therapy. However this may not always occur so diabetes educators may provide some basic dietary recommendations instead).
GDRecipes: You mentioned that your diabetes educator gave you some practical tips on managing your blood glucose levels. Can you share these?
Meaghan: Her main tip was portion control. Do not each too many fruits as they contain natural glucose, but if you want fruit just ensure you only have a small portion. Drink skim milk instead of full fat and have grain bread instead of white or wholemeal.
GDRecipes: You had GDM at Christmastime. How did you get through this traditionally high-carb season?
Meaghan: My diabetes educator told me to inject a couple more units of insulin before I ate Christmas lunch that way I could have a small amount of all the yummy foods including trifle which is my favourite. Although you are allowed to inject more insulin you shouldn’t do it too often, but as a one-off my diabetes educator said it was okay.
GDRecipes: What were the biggest changes you had to make to your lifestyle at the time you had GDM?
Meaghan: Diet was the biggest change for me. I had to cut out most sugars which was very hard for me as I was craving lollies and everything sweet.
GDRecipes: As a women who now has a 50-60% chance of developing type 2 diabetes within 10 years of her pregnancy, is there anything you are doing in terms of health/ wellbeing/ fitness/ nutrition to help decrease this risk?
Meaghan: Since giving birth I have maintained the diet I was on to manage my GDM. This is the only thing I have really done apart from exercise and just generally trying to be healthy.
GDRecipes: What’s your ‘one way to look at it’ piece of GDM advice for other mothers?
Meaghan: Think of it as a lifestyle change for the better. Don’t look at it as a burden. It’s the best thing that ever happened to me as I was forced to eat healthy and change my lifestyle, which I have now continued after birth and I am feeling great.