Gestational Diabetes: Are you too sweet?

As pregnant women approach their third trimester, it is standard protocol to test for Gestational Diabetes (GD). This is a form of diabetes that is developed and/or first diagnosed during pregnancy. Those with GD run the risk of increased medical emergencies at birth and birthing larger babies who have a higher risk of birth injury, the need for C-sections, hypoglycemia at birth, jaundice, and permanent metabolic changes they must tolerate for life. Now, I'm not sharing any of this information to scare you, though I do feel it's important to be informed that the foundation of your child's health is determined in utero.

In pregnancy, it is normal for certain metabolic adaptations to occur that make it difficult for the pregnant woman to regulate her blood sugar. If a woman previously had some level of insulin resistance, it is possible for it to progress into GD once she becomes pregnant.

One common misconception is that because it develops during pregnancy, we assume it goes away after pregnancy.

We know that those diagnosed with GD have a higher chance of developing prediabetes or Type 2 Diabetes later in life. Actually, within 5 years of giving birth, 70% of women with GD will develop Type 2 Diabetes. So, we can conclude that pregnancy didn't CAUSE the diabetes, rather it shed light on the fact that the woman was already insulin resistant to begin with and if she doesn't make any changes, it will likely progress into Type 2 Diabetes after birth.

How do I find out if I have Gestational Diabetes?

I recommend working with a provider who is encouraging and takes the time to help you through all of your pregnancy concerns. Both OBs and Midwives are qualified to assist you in your prenatal visits. Some providers will require you to take a 2-hour Oral Glucose Tolerance Test (OGTT) which entails drinking a 75g sugar/glucose solution and measuring your blood glucose 2 hours afterward. This tells us your body's ability to remove that sugar from your bloodstream . For someone who has sufficient insulin sensitivity, her levels should be below 140 mg/dL at the 2-hour mark.

If you feel like you have a healthy diet and lifestyle and that your risk for Gestational Diabetes is rather low, you can ask your provider if you can observe your blood sugars using an alternative method. This can not be used to diagnose GD, but it can quite clearly confirm that you don't have it. Personally, I wouldn't volunteer to drink 75g of pure sugar if I didn't absolutely have to.

For myself, I chose the alternative option. Though I have family members who do have diabetes (Type 1 and Type 2), my blood sugar has been quite well-regulated for several years and I know that I was not insulin resistant going into my pregnancy (lifestyle > genetics). My midwife was on-board with having my use the alternative method. For one week, I chose to measure my fasting blood glucose (FBG) upon waking and to measure my blood sugar before and 2-hours after meals. My FBG was 86 mg/dL most days and averaged around 90 mg/dL 2-hours after meals. The highest measurement I had after a meal during the week I measured was 123 mg/dL.

To give some context, the meal that showed the highest 2-hour post-meal BG was right after a 5 mile hike and looked like this:

  • 2 sprouted corn tortillas
  • 2 eggs
  • 1 tbsp butter
  • 1/4 cup lobster mushroom
  • 1 tbsp goat cheese
  • 1/4 cup eggplant with garlic
  • 1 cup grapes
  • 3 figs

As you can see, they were all real, whole foods but still had significantly raised my blood sugar after the meal. Thankfully, I was able to quickly shuttle away that glucose to help me recover from the hike. I'm showing this because it's very easy to throw your blood sugar off, especially if you are consistently eating foods like bread, pasta, sugary drinks (including juice), etc.

2 hours after breakfast one day (most days). (Disregard the time stamp, it's about an hour off.)

2 hours after breakfast one day (most days). (Disregard the time stamp, it's about an hour off.)

So what can I do if I have Gestational Diabetes?

The beautiful thing is that a diagnosis of Gestational Diabetes is not a life sentence! Through making the proper dietary and lifestyle changes, you can control your blood sugar during pregnancy and birth a perfectly healthy baby! I highly recommend enrolling in one of my 21-Day Sugar Detox Coaching groups and/or working with me 1-On-1 to prevent GD or get yours under control. The 21-Day Sugar Detox Program is the ideal program, filled with whole, nourishing foods, to help you manage blood sugar in a way that will help you develop a metabolically healthy child.

 

My Pregnancy Self-Care: Circulation

As a pregnant woman retains more water due to her need for more blood volume, circulation can become an issue. Often times, especially in the third trimester, many women retain water in their lower legs and ankles.

If we imagine the blood supply to be like a river and we wanted to improve water flow through that river, we wouldn't just focus on a small segment of that river would we? Of course not, we need to think about that river as a whole system; Where is the water source? What changes can we make to help water flow easier?

Skin Brushing

Skin brushing is a traditional practice used to enhance lymphatic circulation. A few times a week, I practice skin-brushing to move the lymphatic fluid from my extremities back toward my heart. As I progress through the rest of this pregnancy, this practice will be so helpful for minimizing ankle swelling as well as improving general circulation to the muscles of the lower leg. On that note, if I do experience any ankle swelling, we have a MarcPro electrical stimulation machine on stand-by. However, I am in my third trimester now and haven't yet experienced it. Prevention is key.

Skin brushing at 29 weeks

Skin brushing at 29 weeks

Contrast hydrotherapy

River soaking in August

River soaking in August

Contrast hydrotherapy is a wonderful way to promote circulation and to rebalance the nervous system. I take a warm bath with lavender essential oil 1-2 times per week with my partner to simply relax and recover from the day. If I feel myself getting too hot, I'll take a cold shower then get back in, always ending these rounds with cold water. When I shower in the mornings, most days I end my shower on cold to help stimulate blood flow. When possible, we try to get out and soak in our local (freezing- 54 degree) rivers which is always so refreshing and rejuvenating! To me, there's nothing else that makes me feel more alive than contrast hydrotherapy.

When the science of medicine reaches perfection, treatment will be given by foods, aliments, fragrant fruits and vegetables, and by various waters, hot and cold in temperature.
— `Abdu'l-Baha

Movement

In my personal opinion, movement is a cure for just about everything: aches, pains, stagnant blood, etc. For my post on movement during pregnancy, click here.

Warm and Spicy foods

In Eastern cultures, it is highly encouraged to eat warming foods, especially when pregnant or postpartum. As I enter my third trimester, we are also transitioning into Fall so I'm making a solid effort to include foods like garlic, ginger, turmeric, chili peppers, soups, broths, and kimchi in my diet regularly. I like to think I get double points for making foods that have all of the above ingredients ;)

If you struggled with increasing blood flow during your pregnancy, what methods have you found helpful? Share in the comments below!

My Pregnancy Self-Care: Movement

Exercise

Exercise during pregnancy is essential for proper circulation and nutrient flow to the placenta so I have remained "active" aiming to get at least 10K steps per day and doing "organized" exercise 2-4 times per week. Experts recommend keeping the intensity of exercise at a level of "somewhat hard" on Borg's scale of Perceived Exertion (RPE) and always maintaining correct technique during lifts. Not much has changed in how I work out other than moving in ways so my growing belly doesn't get in the way. As you read this, remember that I am maintaining the level of exercise intensity that I had before I got pregnant, so I'm not implying that everyone needs to go out and lift heavy weights just because you're pregnant. The key is, is it somewhat challenging for you?

I know many people have been asking how my workouts have changed. I had an injured thumb for a little while in my first trimester so I naturally stopped doing heavy-grip-dependent exercises like deadlifts and pull-ups and focused more on bodyweight/lighter weight exercise. Now that my thumb has healed, I'm back to doing some heavier lifting. See the videos below. Since I'm planning to have a natural birth (God willing), I need to prep my body to have both the strength and the stamina necessary for holding a deep squat and tolerating discomfort, so I'm training for those goals.

In this video I'm comfortably doing back squats 5x5 of 155lb while 17 weeks pregnant. Feeling strong!

Deadlifting my final set of 5 at 185lb at 16 weeks pregnant

I've been doing a mix of exercises, including but not limited to deadlifts, squats, dips, pullups, overhead press, kettlebell swings (high rep), kettlebell deadlifts (high rep), box step ups, running sprints (at 80% capacity), rowing/bike sprints etc. In the photo below (right), you'll see me doing isometric biceps curls. I started by using 5 lb dumbbells and have progressed to 8 lb for 3 min so far. If you've ever held a baby, you'll know your back, arms and shoulders get tired. This is my version of progressively training to hold the baby for prolonged periods without having to compensate my posture.

Bodyweight (+ baby) ring dips, sets of 5

Bodyweight (+ baby) ring dips, sets of 5

Isometric biceps curls (8 lb) for 3 min.

Isometric biceps curls (8 lb) for 3 min.

In some cultures, it is traditional to discourage women from movement especially exercise. But the way I think of it is this: If a pregnant woman was in the wild and was being chased by a predator, would she act weak and allow the predator to win the race? Or would she step into her God-given power, one that gives her the strength and capacity to overcome anything that stands in the way of her life and the baby's? Pregnancy increases her blood volume such that she can perform at levels similar to an athlete blood-doping. Why shouldn't she take advantage of this and concurrently enhance nutrient delivery to the baby?

Now of course, this wild woman lives in the modern day and no longer has these built-in stressors throughout her day. However, as women, we still need to behave in this way. We have to build these controlled stressors into our life for the sake of our health and the health of the baby. With that being said, below is a video of me doing a 100m sprint at 80% capacity.

Below is the Partner WOD Mark and I did on the 4th of July (19 weeks pregnant) at SnoRidge Crossfit (great place!). I modified the burpees, doing pushups on plates instead of the floor (since belly would touch first) and instead of doing toes-to-bar, I just brought my knees up to 90-degrees. Everything else (KB swings, power snatches, and wall balls) I could do without modification. Thanks to Rob Wilson, we got some nice photos too!

Non-Exercise movement

Working out in a gym environment or doing other organized exercise only takes place maybe and hour or two out of the day. What about the rest of the time? If humans were made to move, then why should I be sedentary the rest of the day? Of course, we don't need to be moving ALL the time; it's okay to rest. The key is to be constantly varying the forces gravity applies to the body.

With this philosophy in mind, I aim for lots of non-exercise movement as well such as squatting and floor-sitting.  Here's a little of what biomechanist Katy Bowman has to say about the topic on a podcast about transitioning to floor-sitting, "Getting to the chair and getting back up again: That’s one range of motion. Not stopping at the chair level and continuing all the way to the floor just increases the range over which you are using your body. So it’s not only move more, it’s move more of you. So you’re using different body parts, using your same parts but to a different extent when you travel that full range."

If it were up to me, my house would be furniture-free. Instead, I use small floor pillows and do my work at the coffee table (constantly changing positions) or we sit on the floor and read, talk, or watch TV. It's amusing how many people try to offer me a chair specifically because I'm pregnant. I understand it's well-intended, but what is actually better for my body and well-being is being on the floor! :)

berrysquatting

Squatting is easy to incorporate into your day-to-day life if you try to get outside and into the wilderness. It's actually recommended by midwives as a way for women to prepare for birth, since no woman in nature chooses to birth on her back. Fun fact: The pelvic opening becomes 30% larger during a squat than when lying on your back. A couple days ago, I probably did over a hundred squats to pick berries off the hiking trail after gardening (above is a photo of a different time berry picking at a farm). One step to take if you're not used to squatting is this: Every time you check your phone to scroll through social media or email, get into a squat. It's a great way to limit your screen use because eventually you will get uncomfortable. Two in one ;)

Now all this talk about movement makes me want to get up off the floor, go into the forest and pick some berries! Join me?