Dealing with prediabetes after Gestational Diabetes
September 7, 2016 11:18 AM   Subscribe

It seems I am prediabetic based on my current A1C results from the doctor. I am so frustrated with all of this! There is no diabetes in my family on either side and several of my family members (like my dad) eat honey, syrup, and jelly beans all day!

I feel like I have been eating so much better during pregnancy and postpartum after being diagnosed with Gestational Diabetes. No more breakfast cereal; I eat an egg or greek yogurt. Much less bread, pasta, rice. No sugary fruits, like grapes, papaya, mango. No soda! No chips. No cake. No candy. No bites off my kids' plates of food every day...and I have been taking walks each day, too. I went to the doctor because I feel like the weight is coming on rather than staying stable or going down (I weigh as much one year postpartum as the day I delivered my son last year?!!) so I thought maybe my thyroid was off. Nope.
I am thinking of asking about going to a dietician....Thought I'd ask all of you for input/advice, too, because I appreciate all the insight-thank you in advance!
posted by tangomija to Health & Fitness (14 answers total) 3 users marked this as a favorite
The obligatory question: are you doing any calorie counting?
posted by Baethan at 11:22 AM on September 7, 2016

I recommend a low carb, high fat, moderate protein diet. Otherwise known as the ketogenic diet.

If you head over to the reddit thread xxketo, you can learn more about it from women who follow the diet, many of whom have found it helpful for diabetes and/or PCOS, some of whom have recently given birth, just a real variety of women who may have a lot in common with you.

The thing about the diet is, there are a lot of enjoyable foods that are high fat and delicious and help you feel satiated for a long time, even while cutting calories.

I found it right here on metafilter, when someone recommended it. I lost 35lbs in 4 months by eating high fat, low carb, moderate protein and eating at a 20% calorie deficit. I decided I'd lost enough and have been eating at maintenance calories and staying within 2-3lbs of that 35lb loss, for the past 8 months.

I'm no longer prediabetic, according to my HA1C. And it seems to have pushed two autoimmune diseases into remission (my specialist agrees with this attribution) or -- fingers crossed -- effectively cured them. I get far fewer migraines, too.

My husband lost 25lbs and all of his cholesterol numbers have improved dramatically. His good cholesterol is in the normal range for the first time in years, his bad cholesterol is one point from normal and better than it's been in years, and his triglycerides went from over 500 to double digits (89, if I remember correctly).

And I'm happy. I enjoy what I eat. I look 15 years younger. My doctors are happy. I don't crave sweets. FOR REAL. I DON'T CRAVE SWEETS. Just walk right by them in the staff kitchen.

The downside is not so much the ways in which the foods you eat are limited (because I love what I can eat), the challenge is that it takes project management skills to learn the new way to shop, I'm cooking most of my meals from scratch, and -- when I was counting calories -- it took a lot of effort to count the exact calories, net carbs, protein and fat to make sure I was proceeding in a healthy way (that would also lead to weight loss.)

Also -- I didn't exercise at all to lose that 35lbs. But exercise is easier now that I've lost the weight! And I'm perimenopausal -- I'm not a young 20 year old who can make a few small changes and drop weight.

*I'm not saying people shouldn't exercise -- I should! For health and strength reasons! But not for weight loss. You can't really exercise enough to counter excess calories. That way lies madness. (From my point of view.)
posted by vitabellosi at 11:45 AM on September 7, 2016 [8 favorites]

Some form of intermittent fasting might work for you.
posted by flabdablet at 12:02 PM on September 7, 2016

You should definitely ask to see a dietitian. There are really specific eating descriptions that can help you control this issue. You may need medication to help you control it in the future, but the cornerstone is going to be diet either way.

Dietitians are trained to help you figure out what may be keeping you from losing weight or controlling your A1C. Lots of any type of fruit can be detrimental and other weird sneaky things. These ladies are specifically trained and there to figure this out for you. Let them do it.
posted by Kalmya at 12:29 PM on September 7, 2016

I just read that 16.000 steps a day will lead to weight loss, if you eat your maintenance calories. And I realized that was exactly how I lost weight (30-40 pounds) after both two pregnancies (walking with the stroller to interesting places for me and child).
Now that I have gained weight because of a stressful work situation, and have too high blood sugar if not actually diabetes, I am trying to combine the 16.000+ steps with eating far more vegetables, as in a 80% vegetarian diet. For social reasons, I can't go 100% vegetarian, but my experience is that it is really hard to eat too many calories of vegetables, even including avocados, if you don't compensate with too many carbs. I haven't cut out carbs, but restricted them. Added sugar is out.

My doctor has recommended that I go to a hilly place for my walks to help get up the pulse, because yes, this is all happening in a dialogue with my doctor. I've only just started three weeks ago, and I've lost 4 pounds, which is fine.
posted by mumimor at 12:43 PM on September 7, 2016

Response by poster: Thank you, everyone! Maybe I should get a pedometer.
I am nervous to start calorie counting, because I feel like as an obsessive person, it will make me more obsessive..
My mom has an eating disorder, so I don't want to go down that road.
posted by tangomija at 1:14 PM on September 7, 2016

I'm also prediabetic, and never had good luck with dietitians. I found every dietitian that I interacted with to be pretty judgmental and fairly rigid in their approach. I'm sure there are dietitians out there who are not like that, but I went through three, which left me not a pound lighter but with greatly diminished self esteem.

What worked for me was following basically the same ketogenic diet described above (lots of veggies, all the protein I want, not worrying much about fats in the protein), but also rigorously (and I do mean RIGOROUSLY) tracking my blood sugar numbers along with what food I had eaten (I use an app for this). For the first three months I was checking my glucose at least ten times per day, sometimes more. Because of this, I was able to get hard data on what foods made a difference in my own blood sugar. (For example, potatoes are typically off the menu because they have a pretty high glycemic index, but roasted potatoes don't seem to push my blood sugar up by much at all. French fries are another story, however.) This hard numbers, real time feedback was super helpful in seeing what "hidden" high glycemic foods were in my diet.

Once I was able to reliably keep my blood sugar levels below about 154 60 minutes after eating I started to see significant weight loss, and have lost 15 lbs since March. (My goal was to stay under 140 at all times, but I'm not there yet.)

I don't really exercise. We walk a lot as part of our regular lifestyle (and go camping and stuff) but I don't go to they gym and I don't have an organized exercise program. However, I did get super interested in how short bursts of physical activity could help when my blood sugar levels were out of whack (notably, I ate a yogurt at lunch which drove my bgc up close to 200 (which was alarming) and managed to bring the number down really quickly just by going up and down the eight flights of stairs at my workplace) so now I do make an effort to try and be active during the hour or so after I eat. After dinner walks have become a thing in my house, at least until the snow starts.

There are also a number of studies showing that cinnamon as a dietary supplement can bring down fasting blood glucose levels, and adding 2000 mg of cinnamon (in caplet form) to my daily routine (1000 in the morning, 1000 at night) does make a measurable difference in my bgc numbers.

Also, are you still nursing? Nursing can inhibit weight loss, but once your body realizes "yes, she's seriously done, no kidding" many women drop a significant amount of weight all at once.
posted by anastasiav at 1:18 PM on September 7, 2016 [2 favorites]

Response by poster: Thank you!
Guess I need to pull out the horrible glucometer from pregnancy again. Horrors! I can't stand that awful thing!
Not nursing anymore. It didn't offer the awesome weight loss results this time around as it did with my first two children, however.
posted by tangomija at 1:22 PM on September 7, 2016

Pre Diabetes makes a lot of money for the medical establishment. A high A1C at this time of year, might mean you have been dehydrated for the whole last 6 weeks of summer. You might also have a high red blood cell count, and it might be a fluke. So, that said, drink at least six, eight ounce glasses of water per day. Cut out things ridiculously high in sugar, like soda, snack cakes, granola bars and power bars, sweet coctails, keep your empty, no fiber carbs down to nothing. Eat whole grains, corn in half cup portions, whole grain pasta. No more than 15 grapes at a time, 2 apricots, a few cherries, one peach, no fruit juice. When you are suddenly needing sweets, drink a glass of water first. If you are dehydrated sometimes the longing for sweets is because your blood is too dense to allow for good absorption. Don't worry, worry causes sugars to rise. The fight or flight mechanism causes sugars to rise. Lower your intake of high sugar foods, and read up on the glycemic index of foods, to see which ones jump on as sugar in your bloodstream the quickest. Boil or steam potatoes instead of baking them, that leaves them less elemental. Eat a bowl of plain oatmeal made with the milk of your choice, with pecans and blueberries each breakfast. Skipping breakfast is the cause of much impulse eating later in the morning. Best to you.
posted by Oyéah at 2:43 PM on September 7, 2016 [2 favorites]

I'm seconding vitabellosi's advice to try a ketogenic diet. I had gestational diabetes, ate carefully during pregnancy, then in post-pregnancy sleep deprivation and stress I gained a bunch of weight. Let me tell you, I did not feel good at 265 on a 5'-3" frame. Constant back ache, sore knees, feeling exhausted from climbing a flight of stairs.

A few months of eating keto with minimal exercise and I was down to 215 with way more energy, more stable mood. I still have a bunch of weight to lose, but now I know that I can do it. My fasting A1C last month was the lowest it's been in 10 years, since long before the pregnancy.

I have not found dietitians to be helpful. The ones I met with for gestational diabetes management were judgmental and condescending, while advising me to eat what now seems like a shocking amount of carbohydrates. The dietary guidelines that the dietitians at our clinic gave my husband when he was diagnosed with type 2 diabetes led to him steadily gaining weight and increasing his medication; since he has started eating lower-carb with me (but not strictly keto) he has lost a dramatic amount of weight and his blood sugar is very well controlled.

A good resource to get started is the FAQ in the Keto subreddit. You have to be sort of careful for the first week or two to make sure you stay hydrated and get enough electrolytes - that seems to trip people up. If you can make it through those first couple weeks, your body will adapt and you'll start to feel much better. Like vitabellosi, when I am strictly observing my keto diet, I don't crave sugar; it's really amazing. I eat wonderful meals with protein and extra fat, and I don't find it a hardship to skip the carbs.

Send me a memail if you'd like to chat; I can dig up a bunch more resources if you're interested.
posted by beandip at 3:06 PM on September 7, 2016 [3 favorites]

A friend of mine swears by: regular glucose monitoring, weight lifting, and endurance swimming. She's not slim by any means, but her diabetes is controlled immaculately. She is also very much against a lot of the advice from dietitians and online about controlling diabetes (aka her loathing for anyone suggesting oatmeal for breakfast).

Also, gestational diabetes does predispose you to type 2, in terms of the way it damages your system (I think that's the cause, my GP explained it to me but I have forgotten it). I have regular A1C tests (along with thyroid and a half dozen other things because holy shit pregnancy was bad for me) because of that.
posted by geek anachronism at 5:51 PM on September 7, 2016 [2 favorites]

One more suggestion for giving a ketogenic diet a try! I read about it a while back but had decided it wouldn't work for me as it's very meat-heavy and i'm a lifelong vegetarian. But i also had lots of sugar-related issues and i've done great on a vegetarian keto diet. Yes there are lots of foods i no longer eat, but my overall health, happiness and relationship to food has greatly improved. I also used the resources from reddit and youtube to get me going.
posted by PardonMyFrench at 2:22 AM on September 9, 2016 [1 favorite]

Response by poster: Ok last question/ comment- how can I have prediabetes if my blood sugar with glucometer has been within normal range four times a day for three days including morning fasting number?
posted by tangomija at 2:28 PM on September 10, 2016

It really depends on when you are testing, which is why I ended up testing 10+ times a day at the start. I would typically test:

- when I woke up (before getting out of bed) (fasting)
- before each meal (including any snacks)
- about 1 hour after each meal
- about 90 min - 2 hours after each meal
- around bedtime

What was the A1C your doctor reported to you? Also, have you calibrated the glucometer with the "known value" solution stuff?
posted by anastasiav at 10:43 AM on September 12, 2016

« Older Best way to wirelessly connect two sets of...   |   Book recommendations needed Newer »
This thread is closed to new comments.