The Great Saga of the Diabetic, Gestational.

  Last week I got a little ranty.  It’s been 3 weeks since I was diagnosed with gestational diabetes and things are finally, finally starting to level out.

  When I first posted last week, I was still trying to follow the diet the dietitian recommended for me.  That lasted for all of 24 hours before I felt horribly, horribly sick and got my first high blood sugar reading.  I immediately retook it to be sure (I was following their diet after all, shouldn’t it stay in the right range?) and it came back even higher (by 20mg no less!).  Obviously the suggested “low-carb” diet wasn’t working for me.
  I went back to eating how I normally eat.  I felt better and my blood sugar levels dropped.
  Until they didn’t.
  I eat essentially the same thing for breakfast every morning.  I make myself a pot of tea (with only 2 teabags to 5 cups of water, because pregnant or not, I have a crazy sensitivity to caffeine), some honey and some milk.  To go with my tea I typically have a slice of whole grain toast with peanut butter or some granola mixed with Greek yogurt.  Since I’ve been out of granola, it has been toast all week.  This breakfast works out to right around 30 g of carbs, which is the minimum they asked me to eat in the morning.
  Now, to understand what I’m going to say next (and why I flipped out) I need to give you a little bit of back information.  When we met with the dietitian and she walked me through the diet and explained how the blood sugar monitor worked, she mentioned that there were target blood sugar levels I needed to keep below, and that if I didn’t, I would be removed from my regular OB’s practice (where I went through my entire pregnancy for G and have been for the entire first 30 weeks of this pregnancy) and transferred to a high risk office.  The comment was that this would happen if there were two or more high blood sugar scores.  The scores, btw, for those who are curious, are 140 mg after a meal and 90 mg when fasting (first thing in the morning before I eat).
  I do not want to be transferred.  On top of the whole “I don’t like the idea of being labeled high risk” issue, there’s also the fact that I don’t know anyone at that office.  I’ve been frustrated with how the staff has handled this diagnosis, but I’ve always been happy with my actual OB.  With only ten weeks left to go, I don’t want to start from scratch building a relationship with a new doctor.  Also, from an entirely practical point of view, the high risk clinic is an extra 20-30 minute drive beyond where my current office is.  Trying to find times to make my appointments that I don’t need to hire a babysitter for G and that he won’t melt down mid-appointment is difficult enough without an added hour getting there and back home again, especially now that I’ve hit the 30 week mark and will be going twice a month instead of once a month.
  So I already had one “failing” score from attempting to increase my carbs to the level they wanted them at when I ate my usual breakfast (that had been yielding blood sugar levels in the low 130s or lower) and got a 147.  I took it again…because, wtf, I’m eating the exact same thing! and it came back as 127 mg.
  Oh I got mad.  Two failing scores and both had a 20 mg margin of error when I took them again…one of which the second test made me passing.  I was not about to be considered high risk because of a score that was high due to error margins!
  I called the office, and, hallelujah, actually got to talk to a doctor.  I explained to her what was going on, how angry I was, and that I’d really like to know what to make of the jumps in blood sugar numbers when I was taking them so closely together.
  Seems I’d run face-first into another instance of scare tactics that are used to get the average Joe to take the situation at all seriously, freaking me WAY out unnecessarily.  The doctor reassured me that, unless there was a new, seriously militant dietitian that she wasn’t aware of, there was no way the scores I was getting were going to move me to a high risk situation.  That yes, there was some margin of error in the machines, but that also, sometimes blood sugars just change that fast…and that they take that into account when they look at the scores.  She said that unless I started getting regular scores closer to 180 or 200 mg that any issues in this first week would be ones we would look at diet adjustments to address before doing anything more drastic.
  Whew.  I feel better.
  So because I keep talking about how crazy low-carb I eat, I want to give you guys some numbers.  Lets get mathy.  I’ve kind of been a brat about this ordeal, but it’s because nobody is believing me when I tell them how I eat.  …that’s because it’s not usual.  I do not want any other pregnant mamas out there to read my account and wind up angry and indignant about being told to change their carb levels until you first take a good, hard look at what you’re eating.  I am not a doctor and I’m not suggesting that what they’ve been trying to do with me wouldn’t work for plenty of people.  It just doesn’t work with my body.
  To figure out how many carbs you consume in a day, obviously you’re going to have to count.  Packaged foods, check the side of the box.  Non-packaged foods you can find charts online.  Things like fruits usually have a range because the amount of sugars (and thus carbs) in them changes as they ripen.  If what you’re eating has 5g or more of dietary fiber per serving you can subtract half of them from the total carbs (ie, 5g you subtract 2.5g).  I haven’t bothered, since the numbers I have are already way lower than the dietitian wants and I expect I’d get yelled at for even longer if I started subtracting them from my totals.  Make sure that you’re using the number from the “total carbohydrates” line, not any of the ones below it.
  Current dietary recommendations say that you can get up to 65% of your daily calories from carbohydrates.  That’s something like 400g.  I’m pretty sure I’d go into a coma.  The suggested diet for a woman who is not looking to lower her carb intake is a range of 180-230g.  The low carb diet the dietitian suggested for me (as a pregnant woman, I expect a non pregnant woman’s suggestion would be lower) was 165-210g a day.
  Based on the totals I’ve added up from the days that I’ve eaten what I’ve wanted, not increasing my intake, I average around 115g a day.  That number is a little squishy because the way they had me calculating left out carbs in things like peanut butter and carrots.  For whatever reason those foods are “free”.  Regardless, it’s safe to say, my levels are lower than normal.
  Don’t you dare go giving me the st
ink eye for being too skinny, starving my baby and start typing up a comment about an eating disorder, I’m not finished yet.
  If you’ve been reading my recipes for a while, you’ve noticed that I put cheese on nearly everything and cream in the rest of it.  “Low-fat” is a slur in our house.  I may be running low on the carb count, but calories are not an issue.  Each gram of fat you consume is 9 calories where each gram of carbohydrate is only 4.  That means that I can easily make up the 200 calories I’m missing out on from not eating those 50 g of carbohydrates.  A single ounce of cheese gives me 110 calories, and I find it far more satisfying than trying to shove more bread and sugar down my throat. 
  We eat low carb and high fat.  It’s not normal, and it’s not really something that the medical community even recognizes an option, but it works for us.  I suspect that it would be a diet that would be really hard for a lot of people.  Most folks really like their carbs.  I can’t really blame doctors for not looking at it as valid…you can’t exactly keep eating all the carbs that most Americans do AND eat high fat and stay healthy.
  Anyhow, that’s where things stand for now.  My sugar levels seem to be in a healthy range and so hopefully there won’t be any further drama in this ongoing saga.  If you have any questions about any of what has been going on, or questions about how/what we eat, I’d be happy to answer them. 
 Anybody out there who really understands diets and who could explain to me any reason that less carbs could be a problem at this level, I’d love to hear it.  So far the main answer I’ve gotten has been basically “just because you need more”.*
  Miss the start of the story?  You can read it here.
  So NOW what am I eating?  Here’s how I’m successfully managing my gestational diabetes with diet.
*I’ve since found at least ONE compelling reason.  If you’re pregnant and already eat low carb, PLEASE click and read.
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