In the Blood

As you may recall, when I was pregnant, I had a pretty rough case of gestational diabetes (GD). I was on insulin (Humulin N and  R [N = long acting, R = short acting]) twice a day. Once I had the baby, everyone told me to stop testing my blood sugar. In fact, a nurse got mad at me when I paged her for it; I’d checked and my meter said 180 (this was after labor but before they even gave me a liquid diet- I was on ice chips and IV fluids). She rolled her eyes at me and rechecked. She got 140. See? Everything’s fine.

But it wasn’t, really. And isn’t now, either.

Diabetics use glucose meters to check blood sugar after meals and first thing in the morning. A normal reading two hours after eating is less than 120. Fasting should be less than 100 (although less than 90 [or even less than 80] is better). Some sources give higher levels; for example, some say there’s nothing wrong with a post-meal reading if it’s less than 180. However, from what I’ve read, you realllllly want to be less than 120.

Okay! Any questions about blood sugar levels? It’s not that complicated, but it is something most of us don’t have to think about. I never did until I had GD. It’s advised that women with GD have a glucose tolerance test (GTT) a few weeks or months after giving birth.

No one mentioned it to me.

So at first after giving birth I mostly ate whatever I wanted. I wonder now if this contributed to my high blood pressure. I can’t over-state how divine it was to have a piece of cake after months of carefully restricting and pairing carbs and sugar with protein and fat. But I knew that eventually I’d have to begin testing my blood sugar again.

In December (two months postpartum), my primary care physician checked my A1C (this test measure blood sugar levels over the past three months and gives an average). It was 5.6, which is “normal.” Prediabetic is 5.7 though (above 6.5 is considered diabetic). My doctor basically patted my head and said “Okay! No problems here! But your cholesterol is crazy high, girl? WTF. Lolz!”

Okay, so that’s not at all how he talks? But that’s basically the sentiment. I’m going for feel, you know? Not accuracy. Anyway, so he was concerned about my high cholesterol and I am not. Why? Because high blood sugar has been much more seriously linked with heart disease than high cholesterol. Also, high cholesterol is normal while breastfeeding (I’m helping build baby man’s brain, you know?). It was strange to me that my doctor completely dismissed my obvious blood sugar issues, but, if I hadn’t been breastfeeding, would’ve started me on statins.

After that appointment I started using my glucose meter. The results I got were upsetting. After two pieces of pizza I got a 214 – a diabetic response. After what I would’ve considered to be a healthy vegetarian Indian lunch I got a 185 – prediabetic.

I realized I needed to make pretty drastic changes to my eating habits. Since then I always make sure to pair carbs with protein, but more than that, I’ve been very much restricting carb intake. I aim for less than 100 grams a day. Some days I’m much less than that. At first it was hard. Carbs often make up the larger portion of a meal. And as I mentioned, I’m breastfeeding, so I’m basically never not hungry. Like ever.

I gave up my vegetarian diet when I was pregnant. It was much too hard to eat a diabetic diet sans animal protein. I’m still eating meat, and I have days when that bothers me, but in order to be healthy, this is the choice I have to make. I’ve read some good results from people who switched to a vegan diet, but at this point, that just isn’t going to work for me. I’m one of the 1/5 of people with insulin resistance who are an average weight. More on eating animals in a later post.

Oh, right, insulin resistance. This is what I have. My endocrinologist (I see her because of my thyroid issues) told me I self-diagnosed as such when I informed her about my post-pizza 214 reading. Being insulin-resistant means my body doesn’t use insulin well; the sugar levels in my blood rise because the sugar is not processed efficiently. It’s possible I have PCOS as well – this can cause insulin resistance and Type II Diabetes. I’m not sure about the PCOS, but I have had an ovarian cyst, my cycles have always been unpredictable, and my testosterone levels are higher than they should be. But! Who needs a diagnosis, right? The fact that I was able to get pregnant and now breastfeed means that if I do have PCOS, it’s mild.

Fun fact. I got pregnant after going on an elimination diet recommended by my acupuncturist. I know. In my dotage, I have become a true hippie. But anyway, this speaks to my blood sugar issues. I wasn’t testing then, but going on that diet would have to have had a positive effect.

Why am I telling you all of this? Who even cares? Diets and diseases are boring, yeah? Honestly, I’m not entirely sure. It’s just I’m fascinated. Concerned. I want to encourage you to ask your doctor to check both your fasting and A1C during physicals. 

And, really? The best thing to do, if you can stomach it, is to check your levels after eating. This is especially important if you have family history. It’s no fun, true, but it could save your life.

I’m worried because baby man has an elevated risk of Type II due to my GD. Also, I don’t, you know, want to die before he goes to college. So! Making these dietary changes now will hopefully help that. On Wednesday I’m asking my doctor to check my A1C again. I’m curious to see if it’s gone down after a few months of diet change.

Maybe you can tell this stuff scares me. Most days I try not to obsess about it, but I’ve taken my blood sugar three, four, even five times when I get a high reading. The other day I tried two meters at once, because maybe my regular one has just been defective. Nope. Regular meter gave me 150. New meter 163. (I have two because my perinatologist gave me two- the meters are cheap, but test strips are expensive.)

The tips of my fingers are covered in little red dots from my fantasicism. I’m trying to be okay with it. Maybe that’s also what this blog is about.

Do you have any questions? Corrections?Feel free to comment. 


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