I was around 21 weeks pregnant when I was diagnosed with Gestational Diabetes (GD). To be honest, I wasn't really prepared for that. I was very active during my pregnancy. I walk a lot and exercised a lot too. So, when the test result came, I was honestly quite taken aback.

I thought Gestational Diabetes can only occur to pregnant women with a family history of Diabetes. As long as I know, there is no one had a diabetes both from mine and my husband's family. However, life must go on. I had to accept the fact and dealt with it. I determined to have a good control of it, so that it doesn't affect the health of my baby.

So, what exactly is Gestational Diabetes?

Gestational Diabetes is a type of diabetes that occurs to pregnant women. The placenta produces certain hormones that makes the insulin doesn't work optimally in processing the sugar in the body. That makes the glucose level in the body is high.

How did I know I had Gestational Diabetes?

In Singapore, it is mandatory for every pregnant women to be tested for Gestational Diabetes. My gynae scheduled me for the test on my 22nd week of pregnancy. The test name is OGTT (oral glucose tolerance test). I had to fast around 9 hours before I took the test. I was not allowed to eat or drink anything from the night before.

On the day of the test, I was scheduled for an early slot. Firstly, the nurse draw my blood to test for fasting glucose. Then, I was given a bottle of glucose syrup to drink. For the record, to some friends it tastes horrible. But to me, it's yummy. Haha! I mean, I could finish it in just 5 minutes. After drinking the syrup, I had to wait for 2 hours. The nurse took a blood sample at one and two hour mark. The result was informed through a phone call at the same day. My glucose level was high. I had a Gestational Diabetes.

How did I handle Gestational Diabetes?

In the first week after I was diagnosed with GD, I was overwhelmingly down. After a few research and meeting with my doula, I was rest assured that if I handled it correctly, I will be just fine. Having a gestational diabetes turned out to be a wake up call to me. Only after I had it, I seriously managed my diet and did exercise properly. Gestational diabetes can be managed by adopting healthy eating plan, regular physical activity and close self-monitoring of blood glucose level.

Healthy eating

As food intake plays a great role in causing a high blood glucose, the most important thing to do in gestational diabetes is a strict diet. I went to a dietitian that was recommended by the hospital I had my GD check with, and we went through my meal plan together.

Basically, I had to limit sugary foods or drinks as they will cause spike in the blood glucose level. I also needed to control my carbohydrate intake, as its amount and type will affect my blood glucose level. Here is my altered meal plan in one plate:

• 1/2 portion of fruit and vegetables
• 1/4 portion of brown rice/ wholemeal bread
• 1/4 protion of meat/fish/tofu/ others

Another changes that I made in my diet are:

1. Replace white rice with brown rice
2. Replace bread with whole grain bread / low GI bread
3. Milk: unsweetened soy milk (because I don't like full cream milk)
4. I stop having sweet drinks, and drink lots of water instead
5. Eat lots of green veggies
6. Drink green juice everyday

Oh, what I realised from having a gestational diabetes, snacking is important (yeah!). So, the idea is to maintain the level of blood glucose to be stable by not letting ourselves to be too hungry. What happen when we are too hungry is, the blood glucose level is so low, and when we eat, it spikes drastically. As for my snacks, I usually have fruits ( 1 apple or pear) or whole meal crackers.

Physical Activities

Another important thing in handling gestational diabetes is to stay active. Especially after each meal, we need to spare 30 minutes to do exercise to help reducing the blood glucose. I my case, I did squats, dumbell lifting, marching around the house, or birth ball exercise.

Aside from post meal exercises, these are few other exercises that I did:

1. Brisk walk minimum 4 KM a day. Usually I did it either in the morning or in the evening before sleep.
2. Pregnancy yoga at home twice a week (15 minutes per session)
3. Birth ball exercise whenever possible. Instead on sitting on a sofa, I sit on my birth ball and did circling motion when I watch TV.
4. Starting third semester, I squat 50 times a day. Not 50 times straight. I did few squats here and there throughout the day.
5. Take the stairs. I live on the fifth floor and I took the stairs to go down to level 1. To go up, I just take stairs for 1 or to level, then continue with elevator :D

It is important to highlight that I did these exercises after consulting with my gynae that my pregnancy is healthy (both I and my baby are in a good state). There is no risk imposed from having these exercises.

Glucose monitoring

Aside from having a healty food intake and exercises, blood glucose monitoring is important too. Target blood glucose during pregnancy should be between these ranges [^1]
Before meals: 4.4 - 5.5 mmol/L
2 hours after meals: 5.5 - 6.6 mmol/L

I need to monitor my blood glucose reading 2 days per week with 7 points per day, from the day I was diagnosed with it until my delivery. The nurse handed my a monitoring sheet that I need to fill in. And I need to bring this sheet everytime I see my gynae for check ups.

To have a slef-check of blood glucose level, I use a device called glucose meter. The device consists of three main parts: blood glucose reader, injection, and test strips. To give an idea, it looks like this:

Basically, I need to prick the tip of my finger using the needle (fast clix) to draw small sample of blood and put the blood into the test strips. Then insert the test strip into the reading device. In a few seconds, the blood glucose level will appear on the LCD. For someone who is afraid of blood and needle, the whole process of monitoring GD was quite stressing at first. But as it went on, I began to get used to it.

Is Gestational Diabetes curable?

Gestational diabetes usually dissapear after delivery. In my case, I asked the nurse to check my glucose level as soon as I gave birth to my baby. Thank God, it's normal again. Furthermore, I did another OGTT 6 weeks after delivery, and my boold glucose is normal. For the record, my sweetness level changes after having a controlled sugar for the past few months. The glucose syrup that tasted yummy to me in the first OGTT, became horrible on the second test, to a level that I want to throw it up. Well, I guess it's a good sign, isn't it?

[^1] "Healthy eating for Gestational Diabetes", Dietetics Department, Singapore National University Hospital.