Gestational Diabetes
GDPregnancyDiary
Posts: 5 Member
Hi everyone!!
I have a family history of diabetes but have never suffered it myself. I'm 5lbs overweight but otherwise healthy. Currently 15 weeks pregnant and have been diagnosed with gestational diabetes, which usually disappears after birth.
I am to follow a low carb diet. I've been reading the information given to me by the diabetic unit and dietician, regarding food pairing. Being pregnant it is important that I do not produce ketones. So it's trial and error finding the right amount of carbs to keep my blood from spiking but also out of ketosis.
Just curious if anyone else has gestational diabetes, I would love to follow some others and get ideas.
Sarah
I have a family history of diabetes but have never suffered it myself. I'm 5lbs overweight but otherwise healthy. Currently 15 weeks pregnant and have been diagnosed with gestational diabetes, which usually disappears after birth.
I am to follow a low carb diet. I've been reading the information given to me by the diabetic unit and dietician, regarding food pairing. Being pregnant it is important that I do not produce ketones. So it's trial and error finding the right amount of carbs to keep my blood from spiking but also out of ketosis.
Just curious if anyone else has gestational diabetes, I would love to follow some others and get ideas.
Sarah
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Replies
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Ketones aren't harmful in any way. And certainly not compared to any level of high blood sugar. It sounds like this thinking is coming from a misunderstanding regarding ketosis and ketoacidosis. You don't have to worry about ketoacidosis because you're not a type 1 diabetic so it's impossible to get it.
Ketones are actually an amazing fuel source for a growing brain. Any brain for that matter. Babies are born in ketosis. It's our natural state before we are fed our professed foods of civilization.2 -
@baconslave - Any advice as a fellow GD survivor?1
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Being pregnant you are at a greater risk of ketoacidosis than the average type 1 or type 2 diabetic...your body becomes IR on purpose during pregnancy because you need a higher glucose level to support the placenta.
It's still a very low risk, so don't be worried. Try to stick to slow acting complex carbs like whole grains and vegetables, while avoiding highly processed carbs like white sugar, white flour, and polished rice. Eat those carbs combined with protein and fat. Don't alter your carb level too much too fast. And keep your salt/electrolyte levels up.
I was not GD, but the opposite, hypoglycemic. Log what you eat at each meal and how it makes you feel 1-2 hours later, or what it does to your glucose levels if you are monitoring. Listening to your body is probably the biggest key.
And congratulations!!!!1 -
tcunbeliever wrote: »Being pregnant you are at a greater risk of ketoacidosis than the average type 1 or type 2 diabetic...your body becomes IR on purpose during pregnancy because you need a higher glucose level to support the placenta.
What? Greater risk of ketoacidosis than T1 or T2? T2 aren't even at much risk unless it's so advanced that beta cells are burned out.
Ketoacidosis doesn't happen until blood sugar is very high (over 250, usually waaaaaay higher) AND ketones are above 10mmol AND blood PH becomes acidic. No body that produces insulin can create that cocktail.
Maybe metabolic acidosis could occur. But then you'd need severe dehydration, for an extended time, at least a few days. That is easily prevented by staying hydrated and keeping sodium levels up. Plus, symptoms of thirst, headaches, dizzy upon standing, muscle cramps, nausea and more all have to go ignored before it would even get to that point.
Either way, the presence of ketones isn't the danger. The ketones are there to basically save you. In the first scenario, the very high blood sugar from lack of insulin is the problem that then leads to extreme dehydration.
In the second scenario, it's the lack of replacing sodium and fluids that's the problem.
I'm not advocating for ketosis though. I'm just saying ketones aren't to be feared. They aren't an issue assuming you make insulin and stay hydrated. Insulin resistance comes with elevated insulin production, so it's safe to say she makes insulin.
Again, I'm not saying anyone should or shouldn't do keto while pregnant, but saying someone is in danger, at greater danger than even a T1D of ketoacidosis isn't correct. Information like that could unnecessarily scare someone else away from it that is interested. Or that frankly needs it for best health.
Your body can make all the glucose it needs even if demand is higher. It's made to function exactly in that way. It's not an unnatural process or anything. The important thing is keeping protein up so that any glucose needed can come from those amino acids instead of lean tissue. You don't ever have to eat a single carb if you choose not to. But, there's also nothing wrong with choosing to do so.2 -
KnitOrMiss wrote: »@baconslave - Any advice as a fellow GD survivor?
Right. I developed GD with my last child. They put me on the diabetic diet. I avoided insulin, but I still had to take a med, which they had to increase the dose. After the birth, my A1c was still prediabetic. It only went down when I stopped following the diabetic diet and went less than 100g of carbs. I'm convinced that if my dr had known what he was doing, and told me to count carbs and get them that low to begin with, I would have been able to stay off meds during the pregnancy.
I don't know whether or not they have put her on meds or insulin yet, as OP didn't say.
If she's not on meds or insulin yet:
I recommend keeping your carbs around 120-130g. Doctors, ones that know what they are doing, are starting to recommend that diabetics keep their carbs, even while on insulin, at or below that threshold. At that level, you have room for a serving of fruit, some beans, and moderate-carb dairy like yogurt, occasional dark chocolate, and plenty of veggies. That would be my recommendation.
Any time I had something made with flour, pasta, potatoes or something like juice, my blood sugar would still be up 2hr pp (post-prandial: after the meal). Avoid those things, avoid high sugar fruits, eat plenty of veggies, beans paired with fat and protein might be ok (YMMV) and a good amount of protein and fat. Make sure you eat to your meter. So if a food shoots up your sugar, you'll need to pair it with a mitigator (protein and fat) or avoid it.
It seems overwhelming, but you'll get the hang of it.
As far as ketones, listen to the ladies above. Everybody goes into ketosis sometime and produces ketones here and there and never notice. At 120g, you'd only end up in ketosis overnight, maybe, or after strenuous exercise. Then it would only be a dip in and out. There are women who go through whole pregnancies keto (50g or lower) or even zero carb and have very healthy pregnancies and very healthy babies. I don't recommend just diving into keto mid-pregnancy however, but staying under 120-130g would be perfect. Do remember to not fear salt, as even at that level, electrolyte needs may increase. Salt your food, eat nutrient dense foods, stay hydrated, and eat enough and you'll come through it just fine. Remember, though you may need to go a little lower than 120g if your blood sugar does not respond. I wish I had known then what I know now, but despite the med I took, my baby is now a 6-year-old evil genius.
Off-topic: but after the birth I breastfed my kiddo until 21 months. I didn't count carbs per se, but I ate only meat, fat and veggies, so I'm pretty sure I was keto level (50g) the whole time.6 -
If you have had morning sickness which prevented you from eating, significantly limited how much you ate or caused what you did eat to come back up, it is highly likely you were in ketosis at that time. Ketosis occurs when there is not enough glucose in your blood to provide all the energy needed throughout your body. This will happen when fuel is significantly restricted such as during the morning sickness just described.
Look at the composition of human breast milk, and you will see it is mostly fat with a large amount of medium chain triglycerides which means your baby will spend at least part of the time in ketosis if you breastfeed.
If you go more than 12 hours between the last meal of the day and the first meal of the next day, which EVERY study shows is the healthiest way to eat, you will be producing ketones. This could happen within as little as 6-8 hours depending on what you ate, your activity level, how much you ate, etc.
If you have the upper end of healthy BG (100), that equates to between 4 and 5 grams of glucose depending on your total blood volume which will match your size. If you think about that, it is easy it is to expect your body to switch over at least partially to ketones from time to time. Every healthy person, regardless of diet, will produce ketones. The only way it you could possibly avoid this would be to have an IV drip of glucose to make sure you always had a steady supply. There is no way to make the argument that is healthy given we didn't even have that option for the majority of history and we survived and thrived.
I realize I am not a doctor and neither are the others here. However, as has been made abundantly clear in all the research I have done since being diagnosed as T2 in 2015, doctors, in general, do not keep up with research. They simply regurgitate what they were told in medical school like a parrot with blind faith.
Research does show if you have GD, your child is much more likely to end up IR and eventually diabetic and is far more likely to be obese. Getting your BG levels down to normal levels is the responsible thing for you to do. This means doing so without adding insulin as adding insulin above normal levels produces the same outcome as high BG levels.
Congratulations on your pregnancy. Parenthood is awesome. It is something that just can't be described. You will never know how much you can love until you have a child. This is why I get so passionate about this. I know you want what is best for your child. I don't want you blindly following bad advice and 10 years from now regretting it. Please please please do some quality research on this. Also, ask questions of your doctor(s). When asking, ask "Why" and not just "What" questions. If the answer is vague or just something about standard of care, then you know they are just parroting what they learned in med school without looking at any actual research.
As @Sunny_Bunny_ stated, there is a huge misunderstanding that ketosis and ketoacidosis are the same when that could not be further from the truth.4 -
Thanks everyone. Really interesting and inspiring.
No I'm not on meds or insulin, I'm aiming to control with diet for as long as possible. Although it is possible I could need meds further on in the pregnancy.
The dietician gave me a lot of information but wouldn't discuss numbers. For example how many carbs to aim for. So the 120g bench mark is useful. For the past 3 days I've finished the day on 100g carbs, haven't felt deprived and my levels have been fine. Apart from when I had oats yesterday morning. I only had a small measure 30g uncooked weight, but my levels remained elevated for 3 to 4 hours afterwards.
I think it anything....it felt a scary concept. A lot of planning, organising and thinking. But 3 days in and I already have a better understanding.
@baconslave Did you track your food on here for the duration of your pregnancy?
I'm in the UK. Having gestational diabetes automatically puts you in the 'high risk' category. Which means you get extra scans throughout your pregnancy. So I see that as a positive at least.0 -
@Sunny_Bunny_
That's really interesting about the ketones. I 100% need to do some further reading and figure it all out. When I asked at my appointment she mentioned I shouldn't be losing any weight, so ketones in the urine would be counter active to the goal. She did also say they are dangerous for the baby. So I will do some research and figure it out for myself. Thanks again.0 -
GDPregnancyDiary wrote: »@Sunny_Bunny_
That's really interesting about the ketones. I 100% need to do some further reading and figure it all out. When I asked at my appointment she mentioned I shouldn't be losing any weight, so ketones in the urine would be counter active to the goal. She did also say they are dangerous for the baby. So I will do some research and figure it out for myself. Thanks again.
Having ketones doesn't equal weight loss. I wish it was that easy! I haven't been able to lose a single pound in well over a year! lol
But ketones are most certainly NOT dangerous to any human being except in the complete absence of insulin. Which you and your baby do not have.
Even my T1D daughter eats keto and she makes zero insulin. Her pancreas is totally kaput! Keto has proven to be the best way to actually prevent her from developing ketoacidosis and she is someone that can get it and has been in ICU SEVERAL times for it. But only when she ate high carbs and lost control of blood sugar.1 -
http://ketogains.com/2016/12/keto-dangerous-pregnant-breastfeeding-children/
Just a short piece to give you a little info.1 -
GDPregnancyDiary wrote: »Thanks everyone. Really interesting and inspiring.
No I'm not on meds or insulin, I'm aiming to control with diet for as long as possible. Although it is possible I could need meds further on in the pregnancy.
The dietician gave me a lot of information but wouldn't discuss numbers. For example how many carbs to aim for. So the 120g bench mark is useful. For the past 3 days I've finished the day on 100g carbs, haven't felt deprived and my levels have been fine. Apart from when I had oats yesterday morning. I only had a small measure 30g uncooked weight, but my levels remained elevated for 3 to 4 hours afterwards.
I think it anything....it felt a scary concept. A lot of planning, organising and thinking. But 3 days in and I already have a better understanding.
@baconslave Did you track your food on here for the duration of your pregnancy?
I'm in the UK. Having gestational diabetes automatically puts you in the 'high risk' category. Which means you get extra scans throughout your pregnancy. So I see that as a positive at least.
No. I didn't know about MFP 6 years ago. I followed a 3-page copy of a Diabetic Diet that told me to go by exchanges: protein, dairy, starches, and etc. The starches I was allowed was scandalous. But I soon began to avoid many of them after watching how I responded on my meter. I had to write them down in a log and keep a blood sugar log that I had to turn into my doc. He never mentioned anything about ketones or ketosis either. I didn't even know it was a thing until I went low-carb for life in 2014.
I did appreciate those extra scans. They put GD into high risk as well here. Or did back then. But I was due in Feb with him, which is what I refer to as Frozen Hell month. And true to form we got lots of snow and our mountain roads were awful. I had to go in twice a week the last month. We had to park at the bottom of our long driveway and I had to slip and slide down it to get to the car and drag the kids out with me on dangerous curvy roads. That was so stressful. So I was glad when they scheduled an induction the week he was due.
Here's a couple articles:
http://ketogains.com/2016/12/keto-dangerous-pregnant-breastfeeding-children/ (
looks like I got beaten to that one)
http://www.lowcarbdietitian.com/blog/guest-blog-post-is-it-safe-to-go-low-carb-during-pregnancy
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