by Susan Moore Daniels, CNM, MSN
“I am sure the test result is wrong!”
“This result has to be a mistake.”
These and other similar comments are heard by our nurses at Dar a Luz almost every day when they make the phone calls to report abnormal glucose testing results to our pregnant clients. I said these comments myself when I received some recent test results indicating diabetes. I want to give you some information in this article regarding typical testing in pregnancy, as well as some good strategies for dealing with the diagnosis — which are also good strategies for taking care of any human body at any time. Some of the things I will share with you about managing blood sugars have worked well for me personally, and they are surprisingly simple measures with remarkable impact.
Diabetes diagnosed during pregnancy is called Gestational Diabetes Mellitus (GDM). This type of diabetes impacts about 10-20 percent of all pregnancies. Pregnant individuals who are at low-risk for developing GDM in the U.S. are less than 10% of the population, meaning almost everyone has a risk for GDM; therefore it is recommended that “universal screening” occurs during pregnancy (meaning everybody gets testing during pregnancy). This is the case at Dar a Luz, where we do a preliminary test during the first trimester, and a full glucose challenge test at the start of the third trimester.
Why does this happen? There are many normal metabolic and healthy hormonal changes that occur in the body during pregnancy that change our usual ability to maintain normal blood sugar levels. During pregnancy, there is also more resistance to insulin, which is our hormone that metabolizes blood sugar. Some of us are more vulnerable or sensitive to these changes, which can tip the balance and result in GDM. This could be through our genetics (family history), lifestyle issues, or other health factors or circumstances.
The good news for many is that, for healthy low-risk pregnancies, it is quite possible for many with GDM to be successful in managing their blood sugars naturally. This also means that most of our Dar a Luz clients diagnosed with GDM are able to remain under our care and to be able to birth at the Dar a Luz Birth Center!
The natural measures indicated below might seem overly simple at first, even a little cliché… yet they include some basic life-style changes, which can require a lot of mindfulness and conscious changes in our habits to be able to incorporate. These challenges are very important to acknowledge and to honor, in order to carry out change with kindness to ourselves during the trying. The commitment to change is a big deal, especially in something as personal as how we choose to nourish ourselves.
Not to over-simplify, but it mostly boils down to three things:
When someone gets results on their GDM screening that indicate GDM or other issues with impaired glucose metabolism, it is required that we intervene with some level of nutritional counseling as soon as possible. For many years, we have referred clients to a few outside practices to meet with Certified Diabetes Educators and to have GDM Counseling appointments. We respect these wise colleagues and have learned a great deal from them.
We are also happy to announce that we are starting our own nutritional counseling program at Dar a Luz. This is an idea that came from requests from our clients. We want to be able to keep more of your care with us when it is safely appropriate for us to do so, and to share with you with some of the first-line natural measures shown to be helpful in dealing with GDM. These visits with one of the Dar a Luz midwives are called Medical Nutritional Therapy visits, and represent a new path for certain aspects of GDM care at our birth center. These measures will be appropriate for some of our clients with GDM, or possibly for those with some borderline blood sugar lab result situations. These visits will help to provide instruction and individualized guidance for the first-line natural measures helpful in managing GDM without medications.
In those infrequent situations where medication management is indicated (such as insulin injections), or for some lab results requiring a higher level of diabetes expertise, we will continue to refer out to our Certified Diabetes Educator colleagues in the private perinatology practices.
We’d also like to share a book we have found helpful, called Real Food for Gestational Diabetes. You might be interested in checking it out from our Dar a Luz library, or in purchasing your own copy. You don’t have to wait until your third trimester GDM screening testing results to read it. It is basic good nutritional information for many in their 2nd trimester, too, especially if you might have higher risks or habits for developing GDM.
There is growing research showing that during pregnancies with GDM, those who are able to bring their blood sugars down to normal ranges with natural measures have no higher risk of complications than those without GDM. And to put a nice positive spin on it, pregnancy provides a reason to put self-care as a higher priority. It also provides a chance to learn more about nutrition — and that can be long-lasting and life changing!
Reach out if you have questions. We are here to support you!
Yours in health and harmony,
Susan was raised in Albuquerque and received her undergraduate degree in 1983 from UNM, majoring in nursing and minoring in psychology. She worked in a local birth center as a midwife’s assistant and caught her first baby there when she was only 21 years old. She attended midwifery school at Yale University, where she received her Master’s Degree in 1988. She returned to Albuquerque where she has attended somewhere approaching 3000 births over 30 years, mostly in hospitals, but covering the spectrum including some home births, and many water births in various birthing locations. New Mexico has the highest rates of midwifery-attended births in the U.S., and she is proud of her influence over the years of her career in building this success. Her hobbies and personal interests include a strong involvement in many aspects of community arts, a love of astronomy, and studies in clinical musicianship. She has been married a really long time to the same wonderful man, and they have two daughters who were born at home, breastfed long through their toddlerhood, cloth-diapered and homeschooled, and are now successful women in the world.