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How to Manage Gestational Diabetes

I was pregnant with my first child when I went to my doctor's office for the routine screening for gestational diabetes at 28 weeks. I drank the sugar solution, and the nurse tested my blood sugar. I failed. Then I had to take the three-hour glucose tolerance test, but the nurse told me, "Your sugar isn't too high. I'm sure you'll pass." I didn't.

I remember feeling scared and wondering what this meant for me and my baby, but a diagnosis of gestational diabetes doesn't have to be scary. It just means some extra monitoring, changes to your diet and perhaps some additional medication to keep your blood sugar stable and your baby safe.

Gestational diabetes is quite common. Two to 10 percent of pregnant women develop the condition. According to the Mayo Clinic, the placenta, which connects your baby to your blood supply, produces high levels of various hormones. Almost all of them impair the action of insulin in your cells, which raises your blood sugar. As your baby grows, the placenta produces more and more insulin-blocking hormones. For most women, this isn't an issue because their pancreas just secretes enough insulin to keep their blood sugar stable. But when a woman has gestational diabetes, her pancreas can't keep up with the rise in blood sugar, which can affect the growth and welfare of her baby.

After my diagnosis, I wanted to know what I needed to do to keep my baby safe. My doctor first referred me to a nutritionist, who taught me how to adjust my diet in order to eat a specific number of carbohydrates to keep my blood sugar stable. I was also encouraged to exercise because it lowers your blood sugar by stimulating your body to move glucose into your cells, where it's used for energy.

I also learned how to monitor my blood sugar. My doctor told me to test four times a day—first thing in the morning on an empty stomach and after every meal. I recorded my blood sugar levels and shared them with my doctor at every appointment. For some women, including me, changes in diet aren't enough to keep blood sugar levels stable. I had trouble with my fasting numbers, which were taken first thing in the morning. My doctor eventually had me take a small dose of insulin every night before I went to bed.

If you end up having to take insulin or oral medication, don't worry! For many, the thought of giving yourself a shot is a bit scary, but it's actually very easy and painless. But it will likely mean that your doctor will require additional monitoring for you and your baby. I went in twice a week for non-stress tests. It's a simple test where a technician monitors your baby's heartbeat, first while the baby is resting and then while he's moving. Just as your heart beats faster when you're active, your baby's heart rate should go up while he's moving or kicking. Some doctors also like their patients to have more frequent ultrasounds to check on baby's growth and development.

Those who don't control their gestational diabetes can cause complications for their baby, such as excessive birth weight, low blood sugar, preterm birth and Type 2 diabetes later in life, and for themselves, such as high blood pressure, preeclampsia and developing diabetes later in life. But if you follow your doctor's instructions, your chances of having complications drop dramatically. My first baby was born perfectly healthy, and even though I have developed gestational diabetes again with my second pregnancy, I'm confident that my doctors and I will do our best to keep this baby healthy too—and so can you.

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