Thursday, September 8, 2011

Gestational Diabetes: What's it all about?

I am now 3 weeks in to my gestational diabetes and I am finally settling in to it.  I didn't know much about it before being diagnosed but I am a semi-expert now!  Gestational diabetes (GD) is caused by a hormonal imbalance that occurs in a woman during pregnancy.  Large amount of hormones are built up in the placenta to help grow the baby.  Sometimes these hormones will do goofy things to a woman's body (most of the time actually!)  One of these goofy things is how the woman's body deals with sugars in the blood and the production of insulin.  Women with a family history of diabetes or some extra weight on their bodies are more susceptible to having it.  I am lucky enough to have BOTH of those factors in my favor!

So, you may ask, what's the big deal? There are 2 major reasons to keep your blood sugar levels in check.  The first is baby size.  All of the extra sugars in the blood that are not processes quick enough can end up as fat deposits in the baby, leading to large infants.  A recent example of this is the 16 lb. baby that was born to Texas woman.  She let her GD go unchecked and got a very large gift for it!  The second reason is to prevent low blood sugar after the baby is born.  My baby already has his own this pancreas that is secreting insulin to process the sugars in the blood that passes from my body to his.  If those levels remain high for an extended time he will be making lots of insulin to deal with the sugar.  As soon as the umbilical cord it cut he won't be getting the extra sugar, but his body with continue pumping our insulin.  This can cause his blood sugar to drop which can cause jaundice and even seizures in extreme situations.

There are several different ways to treat GD.  The main one is through diet and exercise.  Every woman has different limits for the number of carbohydrates she can consume and still maintain proper blood sugar.  This is were a very tricky balancing act comes in to play.  You must eat enough carbohydrates to prevent ketones from building us in your body, but not too much that your blood sugar gets too high.  Ketones are kind of complicated so I won't explain them, but they are bad for a baby!  I have to pee on little strip each day to check my levels!  Many women are able to control their blood sugar with diet alone.  Other have to use insulin injections to assist (this is me!)  The amount and frequency of shots is dependant on each persons insulin resistance.  Below is a picture of all my GD gear!

The bottle on the left is the ketone strips that measure the number of ketones in my urine.  In the upper center is my finger pricker.  The upper right bottle is the diabetes test strips and the glucometer is below that.  I have to test my blood sugar 4 times per day, when I wake up and 1 hour after each meal.  On the bottom on the picture is my insulin pen and needles.  I was VERY nervous about this at first, but it hasn't been too difficult.  All I have to do is screw on a new needle each time and pull and twist the knob at the end.  Right now I only have to take one shot at night before I go to bed to help with my morning numbers.  This is nice because I don't have to worry about carrying the pen and needles around with me!

One thing I have enjoyed about this process is finding new recipes that meet my carbohydrates needs (45-60 grams per meals) and modifying favorites to fit as well.  I made a new recipe tonight that took a little tweaking, but was so delicious.  The original recipe is below and my special notes are below that.

Southwest Chicken Pile-Up (4 servings)

1 1/3 tbsp. Mexican or Southwest seasoning
1 lb. boneless, skinless chicken breasts, trimmed of visible fat
4 whole-wheat pitas (6 1/2" diameter)
1/2 cup tablespoons hummus, preferably red-pepper flavor
1/2 cup canned black beans, drained
Red onion, chopped
Red bell pepper, cut into strips
1/2 cup chopped tomato
1/2 cup chopped fresh cilantro leaves
1/2 cup finely shredded Cheddar Cheese
1/4 cup guacamole or fat-free sour cream (optional)

Preheat the oven to 450°F.  Preheat a grill to high heat.  Sprinkle the seasoning evenly over the chicken.  Place the chicken on the grill rack.  Reduce the heat to medium. (If it is not possible to reduce the heat, cook the chicken away from direct heat.)  Grill for 3 to 5 minutes per side, or until no longer pink and the juices run clear. Transfer to a cutting board and let stand for 5 minutes. Chop the chicken into bite-sized pieces. Set aside.

Meanwhile, place the pita on the grill rack. Cook for 1 to 2 minutes per side, or until lightly toasted. Place the pita on a nonstick baking sheet. Spread evenly with the hummus. Top evenly in layers with the beans, the reserved chicken, onion, red pepper, tomato, cilantro, and cheese.  Bake for 6 to 8 minutes, or until the cheese is melted. Let stand for 5 minutes. Transfer to a serving plate. Slice into 4 wedges. Top each wedge with a teaspoon of guacamole or sour cream, if desired.

As mentioned I made a few adjustments.  First, I opened and split the pitas so I only piled up on half the pita.  This way I was able to cut the pita carbs in half and have more room for the carbless chicken and low carb veggies.  All of the toppings are fairly low in carbs except the black beans.  This is nice because I really only had to measure the carbs in a couple things to make the meal.  I also added some canned corn to mine because we had some left over and I like the sweetness it adds.  Corn is also a higher carb (starchy) vegetable so you need to be careful how much you use.  Lastly, I cut up some lettuce and topped them with it after baking.  The great thing about this recipe is that is can be fun for the whole family too!  Everyone can build their own pita to suit their tastes.  You could also add other things like jalapenos or squash.

I hope you enjoy this recipe as much and we did and learned a little about GD!  Happy Eating!

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