Lifestyle change:
- Low-carb, low-sugar, high vegetable diet. Lean meats. Whole grains. Limited fruit.
- Exercise at least 30 min a day (if not there yet, work on getting there)
- Lose weight
I think if I do the first two, weight loss is inevitable.
Medication:
- Metformin
Now I understand message boards full of ladies talking about PCOS and pre-diabetes taking metformin and suddenly having successful pregnancies. It's not only to control sugar but it also takes care of insulin as a happy side effect without anyone actually realizing. Another simple blood test they can take at the beginning of fertility treatment to get information before waiting for a loss to occur.
I asked the nurse if I was pre-diabetic and the answer wasn't clear. I understood her answer to say that I'm pre-pre-diabetic. In other words, if left untreated and things continue to deteriorate then I may become pre-diabetic and then eventually develop diabetes.
I opted to try the lifestyle change first. I'd much rather eat healthier and exercise (something I should be doing anyway) rather than take more medication that comes with its own slew of side effects. I also want to address the issue instead of putting a bandaid on it. I always knew I could do better with diet and exercise but it's disturbing to hear that a blood test confirmed I'm failing at taking care of myself. Maybe it's not what the results say but that's what it feels like.
Google isn't helping at all. Results all link insulin issues with high glucose and pcos but I don't have either issue. For the record, I also never drink anything nearly remotely similar to the vile drink they gave me so how accurate is that test anyway. I eat plenty of crap and I know that's a defensive excuse, but it still feels counterproductive. They should have me bring a regular breakfast that I'd normally eat.
I may contact a nutritionist for some clarification. I'm not planning to "cheat" but I want to understand what happens when I'm not on top of my food 100% of the time. Such as, if I go on an appropriate diet and then go out for a celebration dinner - will that kill a developing fetus? If I eat well, exercise, and possibly lose weight but my insulin levels still test high would that mean I still have to continue that diet AND go on metformin?
The nurse said they generally don't retest but I requested having another test in a few months, before we do a transfer. Just so that we know. I think it's important to have all the information before risking an embryo.
So... more things to make this summer interesting. Egg white omelettes, here I come.
So my (many more than) two cents from being pre-pre-diabetic (+PCOS) to now dealing with gestational diabetes (and still somehow barely managing with lifestyle):
ReplyDelete- I think of the oral test more as a measure of your body's capability to process glucose rather than what it's actually doing (which is also based on what you eat/exercise)
- My understanding is that the harm to the fetus comes from glucose spikes, not from whatever the insulin level is at.
- A good nutritionist is super helpful!
- Occasional spikes in sugar are fine. Of course this depends on the level of the spike but a celebration dinner isn't too big a deal.
- Glucose monitoring is really annoying but incredibly helpful in working out what foods spike sugar vs not for me. (And this isn't always the same for different people).
- Carb counting at meals is also helpful (if also annoying and kinda stressful). But I think doing it for a few weeks helps get a grasp of what a good meal for you/your sugars is.
- Exercising/walking IMMEDIATELY after meals helps a huge amount in bringing down blood glucose. My endo basically described it as exercise is like a shot of insulin. Doesn't have to be much - just a 15 min brisk walk.
- Check with them what your caloric intake should look like? Also your carb intake per meal?
- Smaller meals + lots of snacks helps distribute the carb load that your body is handling at any point in time.
- Is the aim to control your blood glucose levels? or improving your body's insulin response? Everything I'm recommending is for the former. The best answer I've been able to find for the latter is strength training (build muscles which are then more effective at consuming blood glucose). If you find anything to help with that, do share!
I'm happy to share more of the specifics of what I've learnt in practical strategies over email if that would help.
Also - YOU ARE NOT DOING ANYTHING WRONG. You are taking care of yourself. Just that your hill is higher than other's that you see.
Oh and also, check about what your fat intake should be. This might be different pre/during/post pregnancy but basically, I intentionally opt for higher (healthy) fats foods : whole milk>skim; whole eggs>egg whites, etc.
DeleteThank you for this. It's still all pretty new and the more I think about it the more questions I have. I think I might take the nurse up on her offer to connect me with a nutritionist. I know in theory what needs to happen but when I think about the details it starts getting overwhelming. I think the goal is to improve insulin response (because glucose response is normal) but it's treated the same way glucose issues are. Need to clarify.
DeleteOh interesting. Do share what you learn about improving insulin response! I've found very little information about that.
DeletePlease feel free to delete/ignore this, but the whole "egg whites" craze is one of my pet peeves, haha. Fat is not only not a problem when it comes to blood sugar issues -- it's super important. Good fats like in eggs, avocadoes, butter, olives, etc help regulate blood sugar. Egg yolks have all the nutrients as well as all the flavor, so leaving it out is a double bummer.
ReplyDeleteOK, off my egg yolk soap box! :P
Good luck with it all. I hope this is your silver bullet! One of the few things I changed with my successful transfer was to significantly cut carbs (virtually all sugar and most grains other than corn) while eating all the veggie carbs (like sweet potato fries baked in the oven), berries, proteins, and fats I wanted. I had polenta veggie soup before my transfer and Irish stew after. Good eatin'!
Haha I totally agree. I tried to think of the most bland, awful breakfast and egg whites are what came to mind. I always use at least one yolk and am a complete believer that fat is what keeps you full and satisfied and would never cut out the good stuff completely. I think the key is lots of vegetables, limited sugar, and everything else in moderation.
DeleteThank you. I've stopped thinking of silver bullets since there have been so many that disappointed, but I do hope this bring us closer.