Diabetes During Pregnancy

Gestational Diabetes

When my little girl turned 2, I was happy to conceive with my third baby again. However, this time I was diagnosed with diabetes when I was 5 months pregnant. While I have no family history of diabetes, I started to suspect that it was due to my eating habits. I have switched back to eating white rice for a few months after picking up a new job. I work from 8.30 to 6pm this time hence making it very hard for me to cook dinner at night. When eating out, brown rice is not easy to get. On top of this, my new job required me to test different cakes and muffins and sweet bread almost everyday!

They called this type of diabetes (diabetes during pregnancy) gestational diabetes. I have checked online (https://www.babycenter.com/0_gestational-diabetes_2058.bc) and it says that if we fall into below categories, we are more likely to get a gestational diabetes:

While I considered myself "lucky" as I only checked point number 1 and not eight of the rest, I was still diagnosed with gestational diabetes! Doctor consoled me that it was not a big deal getting diabetes during pregnancy but these are the risk:

RISK of gestational diabetes (diabetes developed during pregnancy) 

1. Tendency of getting a large baby increases, this lead to difficulties during delivery
2. Too much amniotic fluid (polyhydramnios) which can cause premature labour or problem at deliver
3. Premature birth (giving birth before 37th weeks)
4. High blood pressure during pregnancy (pre-eclampsia) which can lead to pregnancy complication if untreated
5. Our baby developing low blood sugar or jaundice after he/she is born
6. Baby heart beat suddenly stop (stillbirth) during pregnancy (due to the condition is not optimum for baby growth in the womb)
7. Mummy has at an increased risk of developing type 2 diabetes in future.

How was gestational diabetes diagnosed and monitored during pregnancy

I was diagnosed with gestational diabetes after failing the glucose test (we were asked to fast from10pm to 8am and get our blood tested, after that drink a cup of glucose syrup and get our blood tested again after 2 hour). To pass the test, fasting blood sugar has to be below 5.6 while 2 hours postprandial (after drinking glucose syrup) need to fall below 6.7. 

Once we are diagnosed with diabetes, we will need to get our blood tested for sugar level every  bi-weekly. And this time, we need to check our blood 2 hours after breakfast, 2 hours after lunch and 2 hours after dinner plus early in the morning (4 times a day). If we do not own a kit to test blood glucose ourselves, we will need to spend long hour waiting in the clinic to get our blood tested during the appointment for sugar test. 

An example of record of Blood Sugar Profile (BSP) test; we are advised to make note of what we eat when we fail each test so that we can take precaution not to eat similar food in future. I failed in many BSP tests after dinner and was advised by doctor to take insulin injection if this persist. I eventually took control of my BSP by controlling amount of rice eaten at night and taking a walk after dinner. It really helps!

It almost took us the entire day to monitor our BSP in government clinic. The good thing is that for government clinic, they offer us to borrow a BSP test kit with a deposit of around RM50 (refundable) provided we buy the accessories including the needles or lancets and test strips ourselves. Since I am working and will not be able to report at the clinic often, I decided to buy a BSP test kit myself. After surveying online, I found an affordable test kit at www.11street.my. 

Review- Accu-Chek Performa Blood Glucose System

Accu-Chek Performa came with a lancing device, a reader, 10 test strips and 1 lancet  drum (with 6 needles or lancets). The good thing about this lancing device is that you can adjust how deep you want to prick your finger when taking blood (I am using 3.5 setting) and this resulted in less pain than a normal lancet (used by Klinik Kesihatan). The reading device came with lifetime warranty! To use it, you only need to on the reading device, place a test strip in place, clean your finger with alcohol swap and then prick your finger and get a small drop of blood staining on the other end of the test strip. Reading will appear within seconds! The whole test will take you less than a minute!

I got myself an Accu-Chek Performa (with 10 test strips and 1 lancet drum which contains 6 lancets inside) at the price of less than RM100. It was a good deal from my point of view as I found similar item selling at Watson for more than RM200! I have also purchased additional test strips at the price of around RM58 for 50 strips (50 tests) at 11street. I have left out the lancets during purchase and hence got a box of 100 lancets in Watson at the price of RM50 plus. 

Accu-Chek lancing device with lancet drums (you only need to change lancet drum for every 6 tests and no needle is exposed from the lancet drum). The adjustable lancing device making finger pricking a less painful experience

Counselling by Dietitian (diabetes during pregnancy)

Once we are diagnosed with gestational diabetes, Klinik Kesihatan will arrange us to get a counselling (in group) given by a dietitian. The session took us around 2 hours and it is very beneficial from my point of view. During counselling, the dietitian explained to us what is a gestational diabetes, what is the risk of getting it, and how should we eat to control it during pregnancy.

We were introduced to this plate called "Pinggan Sihat Malaysia" as a guide on how should we control our diet during the counselling session

An example of suggestion for breakfast at Mamak stall. We are advised to order chapati or tosay instead of roti canai and every meal must come with vegetables

Another example of meal suggestion. We are advised to take half a plate of vegetables for each meal and grill chicken instead of fried chicken should be selected. For drink, we are advised to drink plain drink or drinks without sugar.

A brochure containing some advises was shared to us during the counselling session. You may refer to this if you have diabetes and do not have time to see a dietitian.

Well, I think Kementerian Kesihatan (Ministry of Health Malaysia) has done a good job in offering a free dietitian counselling session for all pregnant mum who is diagnosed with diabetes. We should appreciate the service and take good advantage of it. :)

P/S: I have finally able to control my diabetes by diet throughout my pregnancy without having to take any insulin injection. I am glad that my baby and myself is free from diabetes now. If you get diabetes during pregnancy, don't worry too much but watch out for your diet. I am sure you will be able to control it well with diet and walking exercise like me :).