Gestational diabetes: poke, pee, and eat your carbs.

For the first time in my life I had to watch what I ate. Results of a glucose tolerance test at 22 weeks of my first pregnancy revealed that I had gestational diabetes mellitus (GDM). Thereafter, I was caught up in an intense regimen of medical intervention, which included • up to 7 blood glucose tests a day, • ketosis check 3 times per day (read: peeing on a stick), • 20 minutes of exercise after each meal, • injecting insulin up to twice a day, • laboratory tests (read: peeing in a cup) on average once per week, • nonstress tests twice a week toward the end of the pregnancy (still peeing in a cup), and • of course, appointments for dietary counseling. I worked hard every day to control my blood glucose levels, faithfully following the schedule of poking, peeing, injecting, and exercising. I wanted to be a compliant patient: if I could not do what was necessary to ensure the health of my unborn child, what kind of mother would I be? With a diagnosis of GDM, my score as a good mom was on the line. What exactly were the target blood glucose levels? Interestingly, what seemed fine for one family doctor concerned another. Then there was the obstetrician who disagreed with both family doctors. I found different approaches to target blood glucose levels and different approaches to insulin dosing. The only topic I could be sure to get agreement on was diet.