Friday, February 8, 2008

Gestational Diabetes

My maternal grandmother died of diabetes when I was 11 years old. I don't remember a time when she wasn't sick. I used to spend a lot of time at her house, especially when my mom was pregnant with my sister and was on bed rest, so I have lots of memories of her. She gave herself insulin shots all the time and this was quite normalized for me. But later she got sicker and sicker and smaller and smaller, and she was hospitalized and weak and couldn't really talk or move and I didn't get to see her anymore. It was very scary to see her in her hospital bed, it wasn't the way I wanted to remember my Gran. On August 20, 1986 she passed away - that's more than 20 years ago now.

In 2004 I decided to join Team Diabetes in memory of her. I raised $5500 for diabetes research and walked a marathon in Rome. The training, the fundraising, and the walk itself were all immensely challenging, but of course these challenges are miniscule compared to what she dealt with in her daily life, managing her diabetes.

All this by way of saying that I have known the word "diabetes" for way too long, and it has a lot of scary implications for me. My uncle has diabetes as well, and as a result he can no longer walk without a walker, and he can't use his hands very effectively (can't open a can of pop or cut his meat). In the early 2000s, after a lifetime of being overweight, I worked really hard to lose fifty pounds and learn how to eat healthily. I did this not only for my vanity and self-confidence but for my health - to protect myself against the terrifying diabetes, among other things.

This week Lillian asked me if I wanted to get the gestational diabetes test done. Now, one of the very first things I asked her, ages and ages ago in my first pregnancy, was if I had to do that "nasty glucose drink" test, because I'd heard for years how dreadful it was. Being a midwife, she assured me that there were no "have-tos" and I happily banished the test from my mind, resting comfortably in the knowledge that if there were any kind of problem, it would show up in my monthly urine tests. But in discussing it with her this week, I learned several new things.

  • A problem would not necessarily show up in the urine test;

  • If gestational diabetes went undiagnosed, I would likely continue to feel well, but my baby could end up growing to gigantic proportions, making delivery difficult and possibly increasing the chances of a C-section birth;

  • If gestational diabetes were diagnosed, it would be managed with diet for the third trimester in hopes of avoiding a gigantibaby;

  • And finally, that there was a way of testing for it that didn't involve the nasty glucose drink, and would probably be more accurate than the nasty glucose drink test.

With all of those factors, and her pointing out my maternal grandmother and my age as factors that would suggest testing would be pertinent, I felt I owed it to my potentially gigantibaby to say yes. It was only that evening as I lay in bed that I realized the depth of my desire to stick my head in the sand and ignore any potential link between diabetes and my life. I was nervous about getting the test, because what if it was positive? What then?

Chris, as is his habit, said all the right things - that gestational diabetes did not mean I would get "real" diabetes, that even if I did we would manage it (his exact words were, "We would be so on that"), and that no matter what the test results were it didn't make me a bad or irresponsible person. (How did he know that's what I feared the most?) I went and did the test yesterday morning and am now somewhat anxiously awaiting the results, especially since I kind of think I screwed it up. More on that in the next post.


OHmommy said...

Way to go! :) What a great cause!

Anonymous said...

I'm curious as to how you can check for GDM without the drink?

Also, while a positive glucose test does not necessarily mean you will get diabetes later, there is a significant association between the two (ie those who are positive are more likely to develop type 2 later in life) - thus, many people will use a positive result to make lifestyle changes....though, you've already done that....

I would love to know the details of her informed choice discussion, ie how she explained it....please fire off an email with the pertinent info....


Anonymous said...

Interesting... As a "gigantibaby" myself (and my sister) it's fairly certain now that my "95 pounds when she got pregnant with me and put on 65 pounds!" mother had gestational diabetes.
I was a 9.5 pound baby, my sister 9.8 pounds. (my mother delivered fine, vaginally, though I was forcepped).

However, there is no history of diabetes in my family and I was told that her gestational had no indication of getting it later (and she never did, though she only lived to 56)...

:p personally i'd do EVERYTHING I could to mitigate against Gigantibaby. Though here I am and I was certainly a healthy baby.

adequatemom said...

Hey Jess, thanks for the insight of your mom's experiences! I love hearing about women who had this risk factor or that issue or whatever, and were still able to deliver vaginally. Good for her. Also interesting to hear that you were a forceps baby - that is something that sounds terrifying, yet obviously you turned out just damn fine!

sarapants said...

The first paragraph made me cry....I miss playing UNO with her.

And a note to reepicheep (Jess?), my firstborn was 9.7lbs and I didn't have gestional diabetes (or any other diabetes) so sometimes the gigantibaby strikes from nowhere! And, as you know Laura, I delivered that sucker vaginally!


adequatemom said...

Sorry I made you cry sarapants! I think your gigantibaby may have struck thanks to your gigantihusband? Also, your great big FIVE-YEAR-OLD son is probably old enough to learn Uno now! :-)


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