updated 4 Jun 2012, 13:57
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Wed, Jan 25, 2012
Philippine Daily Inquirer/Asia News Network
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Pregnant? Congratulations! - but watch what you eat
by Audrey Tan-Zubiri

Being pregnant in our country is such a treat. At the first sign of a baby bump, everyone rushes to offer you their chair or assist you in carrying whatever you are struggling with. Such is the advantage of living in baby-loving Philippines!

Even the traditional belly-rubbing by complete strangers can be fun, especially when you see how genuinely excited they are for you.

But the best part of being pregnant here is the food! Because, who do we Filipinos love to feed the most? Next to little kids, that would have to be the women who are supposed to be eating for two.

When I was pregnant with my first child a few years ago, I remember well-meaning aunts sending me delicious cakes and pastries.

In the beginning, I enjoyed all of them because it feels so good to eat when you're pregnant. It is easy to forget that there are hidden risks, until I was reminded by my OB and warned against taking too many sweets.

I immediately switched to fresh fruits and fruit shakes. I thought I was being so clever-hitting two birds with one stone. I was eating healthily while satisfying my sweet tooth.

I was in my 28th week or so when my OB announced that I would have to undergo a routine Screening Glucose Challenge Test. This was to check if I had gestational diabetes.

It sounded fairly simple-an eight-hour fast before heading to the hospital to drink a solution which reminded me of Royal Tru Orange. Afterward, I stuck around so they could measure my blood levels about an hour after I had drank the solution.

Scary surprise

I didn't think much of the test because I was confident that I was fine. My pregnancy had inspired me to be as healthy as possible. I was eating a very healthy and nutritional diet and exercising moderately on a regular basis.

Imagine my surprise when my doctor informed me that my blood sugar levels were above average and I would have to go and take the Oral Glucose Tolerance Test, which consisted of taking the same solution but, this time, recording my blood levels before I drank the solution and then again after an hour, two hours and then three hours after.

When the results confirmed that I did indeed have gestational diabetes, I immediately consulted with my doctor on what this meant.

Gestational diabetes is a form of diabetes that occurs only during pregnancy when the body is unable to produce the necessary amount of insulin (a hormone that allows the body to turn blood sugar into energy) to balance the increased blood sugar that comes with pregnancy.

Fortunately, it goes away once you give birth, but take it as a warning that you are at a higher risk to develop type 2 diabetes.

Unfortunately, it is not just the mother who is affected. The unborn baby is affected as well, because when the pregnant woman's insulin levels are too low to convert the sugar into energy, the baby is exposed to higher glucose levels which, in turn, can lead to his/her increased insulin levels.

Insulin has a growth-stimulating effect, which is why babies born to mothers with gestational diabetes have a higher chance of growing too big for their gestational age, and that can be a problem during delivery.

The problem continues even after birth when they are separated from the high glucose environment but their bodies continue to produce more insulin than necessary, leaving them susceptible to hypoglycemia or low blood sugar levels.

Like their mothers, studies show that these babies also grow up to have an increased risk of developing type 2 diabetes, which leads one to believe that genetics really does play a big role in all of this.

Not as uncommon

GD is not as uncommon as one would think. Many women are at risk-though those who are overweight and above 35 have a higher chance of developing it.

Young, slim pregnant women can develop it just as easily, though usually through a bad pregnancy diet or through genetics. A quick check through your family history can tell you already if you will develop it or not.

In my case, I should have known from the beginning considering how prevalent diabetes is among the women in my immediate family. But the thing is, it doesn't really have many symptoms.

Frequent urination is supposed to be something to watch out for, but don't we go to the bathroom every hour on the hour when we're pregnant?

In the beginning, after learning all of these, I was a little scared, but my doctor assured me that if carefully controlled and monitored, it posed little danger to me and my baby. My GD was managed through careful diet and continuous moderate exercise.

But other women may need insulin shots. The first thing you will need when you are diagnosed with GD is a glucose monitoring meter and a small notebook to take note of your readings and results.

It is necessary to test your blood sugar level on a regular basis through finger pricking (your endocrinologist will give you a specific schedule) so that you can monitor your body and its reaction to the different kinds of food you eat.

Eventually, you will learn how much your body can take and what you should stay away from in order to keep your GD under control.

Calorie-modified diet

In my case, the Diabetes Care Center of Makati Med gave me a calorie-modified diet plan. As I recall, the vegetable and meat portions were perfectly doable, but I almost had a heart attack when I saw the rice/substitute portion.

I know, what part of DI-A-BE-TES did I not understand? But for someone who loves rice, half a cup of rice was pure torture for me.

The fresh fruits portions were equally cruel. One portion of fruit per meal meant 12 small grapes or one "face" of a medium mango but even that would send my sugar levels flying, so I usually stuck to just half a face of mango.

Fresh fruit juices were out of the question, too, except for unsweetened fresh buko ( quarter cup meat and half cup juice). But the nutritionist did tell me that I could have as much calamansi juice as I wanted-provided it was unsweetened.

Eventually, I got used to my new diet and had my baby without any complications and with a normal birth weight.

As expected, the GD disappeared after a few weeks, but did return with my second pregnancy, despite the precautions I took such as immediately returning to my modified diet upon learning that I was pregnant.

My son was also born with a normal birth weight and again, I am diabetes-free. But now, despite the fact that I do not currently have GD, I make an effort to stay away from what I know will contribute to the development of diabetes in later life.

If you are currently pregnant, enjoy every moment but watch what you eat. It's no fun having to monitor your blood on a daily basis so if you can avoid it, do so. But if you find that you can't avoid it and get stuck with it, don't worry.

Under your doctors' guidance and supervision, with a little patience, and a whole lot of control, you can get through it with no complications.

However, I have to warn you now that the bad mood over not being able to have some of that delicious chocolate cake is a normal symptom of GD. Perhaps a slice, or two, after you give birth, can alleviate this particular symptom.

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