Transcript: Gestational Diabetes: Managing Your Blood Sugar

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Preggie Pals
Gestational Diabetes: Managing Your Blood Sugar
Episode 100, April 7th, 2014

[00:00:00]

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

DR. FRANK GOICEOCHEA: Can be a scary time when you get the phone call from your doctor that your test came back indicating that you have gestational diabetes. However, there are many things you can do to control your diabetes and still have a healthy, happy pregnancy. I’m Dr. Frank Goiceochea and today we’re talking about how to manage your blood sugars when you have been diagnosed with gestational diabetes.

[Theme Music/Intro]

ANNIE LAIRD: Welcome to Preggie Pals broadcasting from the birth education center of San Diego. Preggie Pals is your weekly online on the go support group for expecting parents and those hoping to become pregnant. I’m your host Annie Laird and its episode 100 today. As my oldest daughter would say pop the roof. I don’t know what that means.

SUNNY GAULT: It’s like raise the roof a little bit.

ANNIE LAIRD: Raise the roof yeah I guess pop the roof. Yeah pop the roof, episode 100. So if you haven’t joined our Preggie Pals club then you’re missing out on exclusive bonus interviews after each show, transcripts and also special giveaways and discounts. See our website www.preggiepals.com for more information. Another way for you to stay connected is by downloading our free Preggie Pals app. That’s available both in the Android and the ITunes marketplace. And you can also subscribe to our monthly newsletter. Now our producer, Samantha, is going to tell us more about the virtual panelist program.

SAMANTHA EKLUND: Thanks Annie. If you do not live in San Diego but you like to be a panelist on our show, you can still participate through our virtual panelist program. Simply like us on Facebook and follow us on Twitter using #preggiepalsvp. We’ll post questions throughout the week prior to our taping and we’d love for you to comment so we can incorporate your thoughts into our episode. You can also submit your questions directly to our experts. Learn more about our virtual panelist program through the community section on our website.

ANNIE LAIRD: Thanks Samantha. Well, let’s go around the table here and introduce ourselves and the panelists that we have in the studio today. I’m Annie. I’m 35. Government contractor during the day, panelist...

SUNNY GAULT: Rockstar host and producer on weekend.

ANNIE LAIRD: Exactly. Yeah by weekend that’s what I do. And early in the morning I was on the fox show for the mocktails and that was a lot of fun.

SUNNY GAULT: Yeah.

ANNIE LAIRD: So I have 3 kids. 3 little girls. Crazy busy all of the time but we have a great time. So…

SUNNY GAULT: You want me?

ANNIE LAIRD: Yeah.

SUNNY GAULT: Alright I’m Sunny, I am actually the owner of New Mommy Media which produces this show as well as Parent Savers, The Boob Group and Twin Talks. I am a mommy of 4 kids and my oldest is about 3 and a half years old. My middle guy is about to enter his terrible two’s, he’s floating around the terribleness right now. And then I have identical twin girls who are about 5 months old.

ANNIE LAIRD: I’d say this is the first time they’re not in the studio since they were born.

SUNNY GAULT: I know. Crazy, crazy.

ANNIE LAIRD: I know it’s so quiet in here.

SUNNY GAULT: Yeah I know. I’m actually much less stressed when they’re not around. I do miss them by the way. Yeah.

ANNIE LAIRD: Yeah you know when they were first born it’s I think it’s a lot easier because they’re so sleepy.

SUNNY GAULT: Yeah.

ANNIE LAIRD: But they were starting to definitely get into they’re oh we’re awake and…

SUNNY GAULT: And where is momma?

ANNIE LAIRD: Yeah. There’s milk around here somewhere, too many lactating females around here anyways. So Aran go ahead and introduce yourself.

ARAN TAVAKOLI: Hi I’m Aran. I am 36, I have to think about that I just had a birthday.

ANNIE LAIRD: Happy Birthday!

ARAN TAVAKOLI: Thank you so much. I am a nurse and I had my little man September 2nd on Labour Day. I think he was playing a joke on me. I have to make my mom labour on Labour Day. He is our first and as far as the type of birth we had, awesome midwife birth hospital setting. It was fabulous.

ANNIE LAIRD: Great.

ARAN TAVAKOLI: Yeah.

[Theme Music]

ANNIE LAIRD: Alright well today on Preggie Pals we are going to be looking on over an app. This is free as most of them are that we do our app reviews are in the iTunes market place and it’s called Baby Countdown. And that’s pretty much I’m looking at it right now on my phone that’s pretty much what it is. So you can go on here you can do a count up or countdown. So I guess you can do a count up if you want to set the date to whatever your baby’s first birthday is or if you want to do a countdown to the day to the delivery day of your baby. You can do that as well so it’s very cute. There a little baby cake and then some baby shoes on top and says until my bundle of joy comes. I put in here a client of mine I’m a labour doula I guess I forgot to mention that in the a... So this gives me 24 days 1 hour 31 minutes and 20 seconds until my client goes into labour.

SUNNY GAULT: That’s actually that might be helpful for you actually.

ANNIE LAIRD: Yeah, maybe, yeah. So, I mean, I guess that’s you know I guess that’s helpful of going okay when’s my next client due? But I guess the down side of it is you know unless you’re getting induced to having you know a C-Section…

SUNNY GAULT: Right.

ANNIE LAIRD: On a certain day…

SUNNY GAULT: Right.

ANNIE LAIRD: Who knows what I mean [inaudible]

SUNNY GAULT: Yeah.

ANNIE LAIRD: Why you didn’t know you’re twins where coming. You thought you were going like I’m a going to 37 weeks.

SUNNY GAULT: That app wouldn’t have really helped me too much. Although you know I will say the more kids that you have the more the dates all become confusing and you know how many weeks pregnant am I and all this kind of stuff.

ANNIE LAIRD: Yeah.

SUNNY GAULT: This is a really simple-simple app. I mean I actually didn’t set it up but I’m assuming what it just ask you for your due date in the beginning and that was it and up came a clock.

ANNIE LAIRD: Yeah you can put it in here. Let me go to the settings here. So I can put it a date and time so I put in I mean I put in a certain time but who knows. I mean you know like I said…

SUNNY GAULT: Yeah.

ANNIE LAIRD: Who knows when the baby is coming?

SUNNY GAULT: Oh yeah.

ANNIE LAIRD: Now you can do that for you know when my child next birthday is coming.

SUNNY GAULT: Right.

ANNIE LAIRD: Which with more children you kind of lose track. I mean I lose track of my toddler the other day. So she walks out of the store and the security guard. How embarrassing is this. So I’m shopping, I tell the oldest watch her. And she’s watching Frozen in which of course turns her into like a zombie I guess kind of. And a security guard comes in with my toddler and is like who’s baby is this? That’s my baby, she was like she was playing in the alley.

SUNNY GAULT: Oh my gosh!

ANNIE LAIRD: Yeah. So that went off topic there. That’s nothing to do with the app but the point is you lose track of stuff including your children.

SUNNY GAULT: Yeah.

ANNIE LAIRD: When you have multiple children.

SUNNY GAULT: So it’s nice because it’s just a single screen pops up countdown count up whatever you want. So I guess if you know if you forget that kind of…

ARAN TAVAKOLI: And it’s free?

SUNNY GAULT: It is free.

ANNIE LAIRD: It’s free.

SUNNY GAULT: Can you change the background at all. It looked like it had a little baby cake or something.

ANNIE LAIRD: Yeah let me see although here phrases, until my bundle of joy comes, until my baby is born and until my sweetie pie arrives.

SUNNY GAULT: So those are all phrases that can be on the screen right?

ANNIE LAIRD: Yeah. And then you can update to premium but then type your own phrases, multiple countdowns.

SUNNY GAULT: But it really is just about the countdown.

ANNIE LAIRD: Yeah.

SUNNY GAULT: I know a lot of these apps have like kit counters and contraction timers kind of all of that.

ANNIE LAIRD: Yeah.

SUNNY GAULT: Yeah. So it really is about the countdown.

ANNIE LAIRD: Yeah.

SUNNY GAULT: For this

ANNIE LAIRD: Yeah. Aran what you think about? You just saw it is.

ARAN TAVAKOLI: Yeah. I think it’s really simple and the only thing is if it’s showing the piece of cake and our discussion today is on gestational diabetes. Might not be the best…

SUNNY GAULT: Might not be the best if you’re if you have gestational diabetes. Just a second did you change the background at all?

ANNIE LAIRD: Well I’m trying and I don’t know. Oh here we go, photos.. baby feet.

SUNNY GAULT: Okay, so you can do multiple things.

ANNIE LAIRD: That’s so cute.

SUNNY GAULT: So some minor modifications, just kind of tailor it to your style.

ANNIE LAIRD: Yeah.

SUNNY GAULT: But it’s all about the countdown. I mean you know if that’s how you want from it and you just know you just go to this one place on your phone and you can find it instantaneously, I don’t have a problem with that. And it’s free. And I don’t’ think you can really go wrong.

ANNIE LAIRD: Yeah.

SUNNY GAULT: It’s free so I would recommend and I give it a thumbs up.

ANNIE LAIRD: Sure I would give it a thumbs up too. What about you Aran?

ARAN TAVAKOLI: Yeah. Easy.

ANNIE LAIRD: Alright, 3 thumbs up.

[Theme Music]

ANNIE LAIRD: Today we are talking about gestational diabetes and some practical things you can do to keep your blood sugar at the right level. Joining us today is our expert is Dr. Goiceochea.

DR. FRANK GOICEOCHEA: That was excellent.

ANNIE LAIRD: Okay, alright great. In addition to caring for his patients at Sharp Grossmont Hospital, he’s previously served as the hospital’s OBGYN department chairman. Dr. Goiceochea, welcome to the show. Thanks for joining us.

DR. FRANK GOICEOCHEA: Thank you for inviting me.

ANNIE LAIRD: Now to start off with what is gestational diabetes and what makes it different from traditional diabetes?

DR. FRANK GOICEOCHEA: Well a woman who’s pregnant, who has never had diabetes and who has very high levels of sugar or glucose during the pregnancy, that would be considered somebody diagnosed with gestational diabetes.

ANNIE LAIRD: Okay. So you could be totally not have diabetes before the pregnancy and then be diagnosed with diabetes. I take it that once the pregnancy ends that it goes away generally?

DR. FRANK GOICEOCHEA: You’re correct. If you don’t have diabetes before pregnancy and you have it during the pregnancy itself that’s gestational diabetes.

ANNIE LAIRD: Okay.

DR. FRANK GOICEOCHEA: When the pregnancy ends, unfortunately there’s a 20% risk of women with gestational diabetes may end up having diabetes later on.

ANNIE LAIRD: Oh wow.

SUNNY GAULT: So it’s later on in life?

DR. FRANK GOICEOCHEA: Yeah.

SUNNY GAULT: Or is it so… But it could go away right after you have the baby right?

DR. FRANK GOICEOCHEA: Correct.

SUNNY GAULT: Yeah.

DR. FRANK GOICEOCHEA: Right.

SUNNY GAULT: But you could…

DR. FRANK GOICEOCHEA: But there are high risks for 20% having it so it’s important that they follow on afterwards with the evaluations to make sure they would not continue going out.

ANNIE LAIRD: Oh wow.

DR. FRANK GOICEOCHEA: And be treated properly then.

ANNIE LAIRD: Yeah. So what causes the increased blood sugar in the first place?

DR. FRANK GOICEOCHEA: We don’t know exactly, we do get some clues. We think that the placenta produce a lot of hormones and products that made the baby grow. The same compounds can actually affect or cause insulin resistance on the mother. Meaning that these products cause the insulin in the mother not to be as effective and for the mother to have the same metabolism like sugar in their body she needs [inaudible 00:10:16] 3 more times as much insulin as she were already require. So because you cannot produce so much that’s why your levels go up high.

ANNIE LAIRD: Oh okay. Now what are the kinds of symptoms that you would have of gestational diabetes if it got out of control?

DR. FRANK GOICEOCHEA: Actually at the beginning you don’t have any. And that’s why we diagnose or run a screen on everybody in the pregnancy.

ANNIE LAIRD: Okay.

DR. FRANK GOICEOCHEA: There is no symptoms in people have those who have [inaudible 00:10:48] diabetes in regard to insulin we know that they have a they become very thirsty, they are the go to the bathroom very frequently because of the high sugars in the urine. But they usually do not see that early in the pregnancy.

ANNIE LAIRD: Yeah. As was it say wow going to the bathroom pretty frequently I mean that’s…

SUNNY GAULT: That’s every pregnant women.

DR. FRANK GOICEOCHEA: Every pregnant who had diabetes [inaudible] that’s not a …

ANNIE LAIRD: Yeah. Aran you said that you got tested for. I know that during my pregnancies I was got tested for like 28 weeks you know where you drink the kind of orange crushed soda and some woman love it and some woman think it’s really disgusting. And then you get your blood drawn. But you said you had testing done earlier for it so what you have done?

ARAN TAVAKOLI: Yeah I was tested and they did the haemoglobin A1C which essentially measures kind of how your blood sugar levels have been over a period of about 3 months. Am I correct?

DR. FRANK GOICEOCHEA: You’re correct yeah.

ARAN TAVAKOLI: And so that was slightly elevated. It put me in this category called pre-diabetic?

ANNIE LAIRD: Now how pregnant were you when you had that done?

ARAN TAVAKOLI: This was my first trimester screening…

ANNIE LAIRD: Oh wow.

ARAN TAVAKOLI: And lab work.

ANNIE LAIRD: Okay.

ARAN TAVAKOLI: Yeah. So really early…

ANNIE LAIRD: The one where they have like 20 vials of blood all lie down

ARAN TAVAKOLI: Yes.

ANNIE LAIRD: And like are you afraid of needles? Well I am now.

ARAN TAVAKOLI: Exactly. So…

ANNIE LAIRD: Yeah.

ARAN TAVAKOLI: Just during that one was when my level came back slightly elevated and they said you have gestational diabetes.

ANNIE LAIRD: Oh wow. So and then you basically had to just do what you have to take insulin or something like that?

ARAN TAVAKOLI: No. So from that they then sent you to the educational class then I’m sure there are probably other moms that have gone to this exact same thing were you go and meet with the diabetes educator. They tell you about diet and diet modification. And they talk about how you do the blood sugar testing after each meal and the time frames and then reporting back to the clinic as far as how you are doing on your blood sugar. So I went through all of that education and started testing my blood sugars and found out that after each meal when I tested, they were absolutely fine. They’re within the normal limit every time that I tested. So from that, this is from my experience, from that I went back and was like all my blood sugars are within the normal limit. Do I need to continue doing this and they’re like no, we’ll retest you again when you come in for your glucose tolerance test, the orange soda. So…

ANNIE LAIRD: Yeah. Yeah.

ANNIE LAIRD: Yeah doctor, what kind of how does gestational diabetes, how would that affect a woman’s baby if she was diagnosed with that?

DR. FRANK GOICEOCHEA: Well if you are diagnosed with it on time and you treat it properly you can most likely end up with a normal baby. That’s the good part about it, if you’re diagnosed it early and that’s why we encourage all the women to be screened for that.

ANNIE LAIRD: By normal baby do you mean like their blood sugar is within normal limit…

DR. FRANK GOICEOCHEA: Correct.

ANNIE LAIRD: or size?

DR. FRANK GOICEOCHEA: Size, not having any problems later on when they are born because when the baby is born with a with the when a mother who’s diabetes pretty controlled to be very big can be have problems with their own sugar, their own calcium, so they had a lot of problems. But the good news about it is that if you’re diagnosed on time and be treated properly, most women will have a relatively normal pregnancy and normal delivery…

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: And a nice baby.

ANNIE LAIRD: Yeah. And I know that was something when I had my first baby, my mother was like well they must have misdiagnose you know misdiagnosed you. You had gestational diabetes. My first baby was 10 pounds 4 ounces but then again my husband is a big guy and I’m not exactly petite either. You know I’m rather tall. So I kind of wonder if that had probably more to do with than my mother just…

SUNNY GAULT: Well I know your babies have been bigger babies too so then…

ANNIE LAIRD: They have I just don’t have 6 pound, yeah I just don’t have 6 pound peanuts so yeah. Yeah. Oh well. So and Sunny you said you were diagnosed, which of your pregnancies did you have a…

SUNNY GAULT: Number 2…

ANNIE LAIRD: Okay.

SUNNY GAULT: My first you know I passed with flying colours on everything never thought you know I was ever going to have an issue with it. But my baby was over 9 pounds when he was born and so for baby number 2 right at my first appointment, my first prenatal appointment, they told me I needed to get some blood work to see just because the first baby was bigger and that came back fine. And then when I went for whatever the 28, 24 weeks then I had one of my levels were was a little high so then I had to come back for 3 hour. And that was questionable like it didn’t confirm me as gestational diabetes but they basically said we need to modify your diet and we’re going to test you again in you know 4 or 5 weeks.

So when I came back and had to do that 3 hour test again then another level was high and they have forewarned me listen most people were you know two were their levels were high the next time we test it’s 3 and you’re probably going to be classified with having gestational diabetes during this pregnancy. So eventually I was and I did have to go to all of the classes and do all that kind of stuff but really I wasn’t classified as having gestational diabetes until I was 34 weeks pregnant and I delivered at 38 so I really didn’t have that much experience you know time to really I mean I did have to change my diet and I had to test my sugars, I didn’t have to you know have anything you know beyond that. But what that was really crazy is that my next pregnancy was twins and I thought for sure there is no way I’m not going to have gestational diabetes.

ANNIE LAIRD: Yeah. Remember you’re talking about that in the studio like oh well I’m coming up for the test.

SUNNY GAULT: Oh Yeah. Yeah.

ANNIE LAIRD: Yeah.

SUNNY GAULT: Yeah because I think that the time we…

ANNIE LAIRD: Once you got over the total shock of having twins.

SUNNY GAULT: Totally. Yeah. Yeah. After whatever that is in your first trimester you know when you’re doing your screening stuff…

ANNIE LAIRD: Right.

SUNNY GAULT: That came back a little bit high and I thought oh no you know you felt like I got away with it.

ANNIE LAIRD: I remember that.

SUNNY GAULT: Pretty much for you know baby number 2 but I though oh no this whole pregnancy is going to be gestational diabetes and I caught early so I’m going to be miserable this whole pregnancy.

ANNIE LAIRD: Yeah.

SUNNY GAULT: But then yeah. So I you know I did the necessary testing and had to do a 3 hour again and then but it came back fine so you know like sometimes they kind of like scare you in to thinking that if you have it once you’re going to have it to all of your kids and that wasn’t the case with me.

ANNIE LAIRD: Yeah. Well doctor in your experience, does if a woman has a pregnancy and it is gestational diabetes for any subsequent pregnancies is their risk higher that they’re going to have it the next time?

DR. FRANK GOICEOCHEA: It is higher but doesn’t necessarily means as you’re saying that you’re going to have it. I think the fact that you already have had it before what that does is triggers for you to be tested in the first visit. So instead of having the one test or around 22 weeks we’ll make you go through that and everybody dislikes that especially in the first trimester you have all the nausea to [inaudible].

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: But it is because of that. But it doesn’t necessarily mean that you’re going to have it but you are on high risk of having it.

ANNIE LAIRD: Oh okay. When we come back we’ll talk about how to control your gestational diabetes.

[Theme Music]

ANNIE LAIRD: Welcome back, today we’re talking about controlling your blood sugar when you’ve been diagnosed with gestational diabetes. Doctor now we were talking a little bit in the break here about has there been like a change of what the tolerances as far as what level as far as blood sugar that triggers a diagnoses of gestational diabetes? It sure seems like, you’re mentioning this Sunny, that over the years from like my first pregnancy to now I hear that diagnose. It’s kind of like with breastfeeding kind of like with tongue tied…

SUNNY GAULT: Yeah.

ANNIE LAIRD: I hear tongue tied all the time…

SUNNY GAULT: Right.

ANNIE LAIRD: With breastfeeding and it kind of like with pregnancy I hear…

SUNNY GAULT: Gestational diabetes.

ANNIE LAIRD: Gestational diabetes a lot more than I did a decade ago with my first born. Has there been a change in that doctor?

DR. FRANK GOICEOCHEA: Yeah there seemed to be a changed as for years ago the breakpoint for that so to speak was like a 135 sub sugar if we do the one Glucola test it was coming down to 130. So it’s mostly coming down [inaudible] behind that is that it was felt that by using the higher levels that you’re missing some patients who might have diabetes, gestational diabetes that is. It’s not a 100% embraced by everybody because some people think that if you make it so long that you’re going to be over diagnosing and which is not as good. But in most cases now, in most laboratories is 130 depending on the lab to135 seems to be the right base line study I mean base line level for treating you for Glucola test.

ARAN TAVAKOLI: I think too as far as being overly diagnosed. I feel like I kind of fell into that category and I think what comes with that and that we haven’t really addressed is the psychological impact of it, of the fear related to having you know having gestational diabetes or like I said I feel like it was very in pressed on me that if you’re diabetes isn’t under control you can have foetal demise. If you’re not doing your kit counts you’re going to have foetal demise.

SUNNY GAULT: Oh wow.

ARAN TAVAKOLI: Like I feel like that came up quite a bit…

SUNNY GAULT: It’s scary…

ARAN TAVAKOLI: In my education…

SUNNY GAULT: Yeah.

ARAN TAVAKOLI: And that was a bit scary so I’m wandering too like does that happen to other women and how are they dealing with that? You know in their monitoring their sugars and they’re all fine.

DR. FRANK GOICEOCHEA: It can be scary but I think it’s up to us to present those in a non-threatening way.

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: That can be also embraced by the moms because it’s already as stressful as it is.

ARAN TAVAKOLI: I agree.

ANNIE LAIRD: Well how is it treated? Is insulin a normal thing that is moms are putting on insulin or is it all having to do with control of diet and exercise?

DR. FRANK GOICEOCHEA: I think the most of the gestational diabetes say the first time or even the second time are that can be treated by diet and exercise.

ANNIE LAIRD: Okay.

DR. FRANK GOICEOCHEA: If you I don’t know, maybe I would say that at about 40% or 50 maybe put on an oral medication like Glyburide which is common used. And in small percentage 2, 3% perhaps maybe required insulin. So the number who requires insulin is relatively small.

ANNIE LAIRD: Oh okay. Now Aran what did you do as far as you talk about testing you’re blood sugar that it wasn’t need to be done in the clinic or anything and you just do that right at home?

ARAN TAVAKOLI: Yeah you do it at home they set you up with little kits and the meter they’ll tell you how to do your finger stick. You do it in the morning. You do it I think it was like 30 minutes after you ate your meal…

ANNIE LAIRD: Yeah. Do you always use the same spot on your finger?

ARAN TAVAKOLI: No…

ANNIE LAIRD: Ouch.

ARAN TAVAKOLI: I rotate through with different fingers then back and forth in different little areas and…

ANNIE LAIRD: Yeah. Yeah.

ARAN TAVAKOLI: So I mean you get used to it. It gets pretty easy and you get used to writing down everything that you eat.

SUNNY GAULT: And they’ve apps too for that.

ARAN TAVAKOLI: Yes.

SUNNY GAULT: I actually used an app because that was much more convenient for me to write down my levels and then it even created like little graphs and comparison stuffs so when I went to my OB you know and share that information because obviously ...
ANNIE LAIRD: You know my dad has diabetes…

SUNNY GAULT: Yeah.

ANNIE LAIRD: Obviously it’s not gestational in nature. But yeah he you know and God bless my mom you know I think that’s that really has worked as far as having your partner on board.

ARAN TAVAKOLI: Yeah.

ANNIE LAIRD: With controlling the diet you know it really has to be that if somebody has diabetes, you can’t just have okay well here’s the person on the no fun diabetes diet.

SUNNY GAULT: Right. Right.

ANNIE LAIRD: And then everyone else gets to eat ice cream. You know I mean that doesn’t work really well but he uses an app as well so…

SUNNY GAULT: I think it was really eye opening to me like I said I really didn’t have it for that long, I wasn’t officially classified with it for more than 5 weeks 6 weeks maybe. But I still have to go through everything and I don’t know when I’m pregnant I would like to eat what I want to eat and the first time when they tell me not only can you not do that, but you can’t even eat what you know you were normally eating you know before you got pregnant or so hungry. So just stuff like not having regular peanut butter and having to substitute something with less sugar like I don’t even know there was a lot of sugar in peanut butter you know and really paying attention to what you’re eating I think was the most difficult thing because like I said I just wanted to eat everything. And then the finger pricking isn’t something that I would like to do for an entire pregnancy.

ANNIE LAIRD: No…

SUNNY GAULT: It isn’t the most fun thing to do but I think if we keep in mind that you know granted there are people that afterwards that this could turn into something else but if you keep you know in mind that for most people this is just gestational, it’s just when you’re pregnant and it’s kind of like breastfeeding. It’s like okay can I get through the next month, yes, okay can I get through the next months

ANNIE LAIRD: I’m like the next day of breastfeeding. Yeah so you know but just day by day.

SUNNY GAULT: That yeah, I think that’s how you have to look at because I don’t think it’s a fun thing. I don’t think anyone would say oh yeah that was great it’s just gestational diabetes…

ANNIE LAIRD: I’m stoked, I got diagnosed.

SUNNY GAULT: I’m the lucky one.

ANNIE LAIRD: Yeah.

SUNNY GAULT: But it’s for your child.

ANNIE LAIRD: Yeah.

SUNNY GAULT: So it was for a good reason obviously.

ANNIE LAIRD: For your baby. So and doctor like you were saying you know it’s a good time to say hey this is a good time to watch what you’re eating you know establish an exercise routine. Speaking of exercise routine, what is something that you would recommend to a mom that has a diagnoses of gestational diabetes? Obviously they’re not going to go and run a marathon but what kind of exercises would you recommend for them to help control that blood sugar?

DR. FRANK GOICEOCHEA: Well I recommend exercises for all pregnant women to start with especially we encourage especially a woman who are diabetic I mean gestational diabetes. Even doing inside like 30 minutes aerobic exercises, walking, swimming, bicycling is very very important. Not just because, that’s because the exercise itself increases your insulin level so it gets you your insulin it drops your glucose. There is less need for medication. But also if you do a lot of exercise there is some [inaudible] that makes you feel good. And I usually encouraged them to do that because the more exercise you do you are going to be better fit when the baby comes. And so those, and emotionally I think the woman who is more physically active I think that they all started out much better.

ANNIE LAIRD: Alright Aran what type of exercise did you do with the when you’re pregnant with your little guy?

ARAN TAVAKOLI: I think I read... it was something like I walked every day and the baby like almost fell out. And so I was like okay I’m going for it. So I walked a lot which is really nice and just being outside is awesome. A lot of yoga, a lot of yoga that was great. Those are my two big ones and then swimming because it was over the summer.

ANNIE LAIRD: Well since the thing that you’re mentioning and doctor you mention this as well. They all seemed to be very low impact type of thing so you are already carrying so much more weight.

DR. FRANK GOICEOCHEA: Yes, especially for aerobics. Swimming is great you have great buoyancy, so you’re swimming a lot better.

ANNIE LAIRD: Oh, as far as diet changes you know I hear my mom talking a lot about carbohydrates. What’s the deal with carbohydrates? Is the idea to bring your carbohydrates down or is it that carbohydrates have more sugars in them or I mean do you have to like plan your meals around a lower carbohydrates type of level or what do women have to do when they have that?

DR. FRANK GOICEOCHEA: I think it has to do more with the type of carbohydrates. There are things like a refine sugar that are carbohydrates, sweets, candies, cookies, syrups, all those things that have a carbohydrates are pretty much sugar. [inaudible 00:26:40] like pasta, dry beans, they have carbohydrates that are not very high in the sugar content but they’re very nutrition that’s a big difference.

ANNIE LAIRD: Oh okay.

DR. FRANK GOICEOCHEA: So you really want…

ANNIE LAIRD: So you really want the complex carbohydrates.

DR. FRANK GOICEOCHEA: Right.

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: You don’t want that simple refined and even we don’t want moms who had this problem or even without diabetes we drink a lot of juices. Juices have a some of pure sugar or in any canned fruits they have syrupy or even sometimes woman come to me in the office and I said gee what happened with your weight. I am eating a lot of fruits. What are you eating? Oranges and I said they’ve got, they have a lot of sugar…

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: So you don’t think about, you just think about healthy like fruits is healthy but being healthy doesn’t mean that you’d eat a lot like the oranges that have a lot of sugar. So you have to be modify that…

ANNIE LAIRD: That makes a lot of sense now, I mean because my midwife in my last pregnancy, we knew the baby was a little bit bigger but you know I chose to go in for the diabetes. Just I wasn’t diabetic, I just make large children but she was saying the same thing with my dietary, like don’t eat so much fruit you know. Take it easy on the fruit Anne you know. So focusing a lot more on leafy green vegetables and lean protein and you know. Maybe not so much dairy, but I’m from the dairy states. I like my cheese. So yeah…

Thanks Dr. Goiceochea for joining us today. For more information about our expert and our panellists, visit the episode page on our website. This conversation continues for members of our Preggie Pals club. After the show, Dr. Goiceochea is going to share with us how diagnosis of gestational diabetes may affect the birth of your baby and what your OB’s biggest concern with the diagnosis of gestational diabetes is. To join our club, visit our website www.preggiepals.com.

[Theme Music]

SUNNY GAULT: Hey everyone it’s Sunny, I have not shared my birth story of my twins yet so I thought I would do so in a segment we like to call 5 minute birth stories. So before I get started, if you guys have a birth story that you’re just dying to share with our audience we would love to hear it. Call our voicemail at 619-866-4775. It’s just a voicemail, no one is going to pick up the phone so don’t be freaked out by that. Just leave your story in 5 minutes or less and we’ll play back on our show.

So for my story with the twin it was pretty crazy because I had in my head all along that I was going to make it to full term for twins for my type of twin and that usually only goes to that 38 weeks. They don’t let you go much pass that because my twins are sharing the same placenta and it can become kind of dangerous after that point. But I really wanted to make it you know right to the 38 week mark and I thought if I just put in my head it’s going to happen, it’s going to happen and everything was going really well with the pregnancy. I didn’t have gestational diabetes and I was just kind of swimming along and then on the morning of November 11th, I’m taking a shower in the morning and I get out of the shower, this is kind of gross, and like oh boy because you know either I’m peeing myself which it didn’t feel like I had to pee.

And I certainly didn’t think it was the water from the shower or my water just broke. And I had two waters keep in mind because of the twins they were sharing with the same placenta but in two separate sacs. So yeah my body just kind of leaking those fluid, I’m going what’s going on because you know with my two boys they had to break my water. Well my second boy was a C-section so it’s a whole other thing. But with my first they have to break my water so my water was never broken naturally you know it’s not like you’ve seen in the movies were you know just kind of comes gushing out. And so I’m sitting there going should I tell my husband because it was veteran’s day which was good because my husband had the day off.

So he’s downstairs cooking breakfast for our kids and you know I don’t know what to say to him so I walked down and just have this look on my face and he’s like what? And I’m like I think one of my waters just broke. And he just give me that look because we not planned what we are going to do you know and again in my head I was going to make it to 38 weeks. So my parents were coming in to town and you know in a couple of weeks but nothing was, nothing was ready to go at that time. And so I ended up calling labour entourage and kind of explained to them my symptoms and what was going on and they said well if you think your water broke, we absolutely have to see you.

So on my way to the hospital, I started to feel contraction and I thought oh this is it. I knew it was and so we are able to drop off my older children, my two older sons at our friend’s house and then we went straight to the hospital. And sure enough you know they checked me you know I’m like 2 or 3 cm dilated and mind you this was a planned caesarean so I was at least thinking you know I wasn’t going to go into labour with this and I’m like man I’m going to have a C-section and in labour, man this totally sucks. Because with my second son I just had a C-section that was it I didn’t went into labour.

And so I’m a big woos when it comes to pain but probably for the next two hours they were admitting me and doing vitals and getting the, you know the OR prep and all this kind of stuff and I’m in a lot of pain. And they didn’t give me anything because you know I was going to go and get my spinal when once I was in there and so fast forward and my husband joined me in the OR. Everything went well with the spinal and the girls were actually born the same minute. Can you believe that like they don’t even have their own minute that they were born? But the girls came out great and baby A was 5 pounds 5 ounces and baby B was 5 pounds 8 ounces. And so other thing I had hoped is that they would get to 6 pounds but they were still very healthy, they never had to go to the NIQU, they were breathing great and we were able to go home you know in about 4 days. So that’s my 5 minutes birth story.

[Theme Music]

ANNIE LAIRD: That wraps up our show for today. We appreciate you listening to Preggie Pals. Don’t forget to check out our sister shows Parent Savers for parents with newborns, infants and toddlers, Twin Talks for parents of multiples and The Boob Group for moms who breastfeed their babies.

ANNIE LAIRD: That wraps up our show for today. We appreciate you listening to Preggie Pals.
Don’t forget to check out our sister shows:
• Parent Savers for parents with newborns, infants and toddlers
• Twin Talks for parents of multiples.
• The Boob Group for moms who breastfeed their babies

Next week we’re going to be continuing our series on foetal development moving in to the second trimester. What exactly is going on with your baby during months 4 through 6 of your pregnancy.
This is Preggie Pals, your pregnancy, your way.

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

SUNNY GAULT: New Mommy Media is expanding our line up of shows for new and expecting parents. If you have an idea for a new series or if you’re a business or organization interested in joining our network of shows through a co-branded podcast, visit www.NewMommyMedia.com .

[00:34:32]
[End of Audio]

View Episode

Episode Transcript

Preggie Pals
Gestational Diabetes: Managing Your Blood Sugar
Episode 100, April 7th, 2014

[00:00:00]

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

DR. FRANK GOICEOCHEA: Can be a scary time when you get the phone call from your doctor that your test came back indicating that you have gestational diabetes. However, there are many things you can do to control your diabetes and still have a healthy, happy pregnancy. I’m Dr. Frank Goiceochea and today we’re talking about how to manage your blood sugars when you have been diagnosed with gestational diabetes.

[Theme Music/Intro]

ANNIE LAIRD: Welcome to Preggie Pals broadcasting from the birth education center of San Diego. Preggie Pals is your weekly online on the go support group for expecting parents and those hoping to become pregnant. I’m your host Annie Laird and its episode 100 today. As my oldest daughter would say pop the roof. I don’t know what that means.

SUNNY GAULT: It’s like raise the roof a little bit.

ANNIE LAIRD: Raise the roof yeah I guess pop the roof. Yeah pop the roof, episode 100. So if you haven’t joined our Preggie Pals club then you’re missing out on exclusive bonus interviews after each show, transcripts and also special giveaways and discounts. See our website www.preggiepals.com for more information. Another way for you to stay connected is by downloading our free Preggie Pals app. That’s available both in the Android and the ITunes marketplace. And you can also subscribe to our monthly newsletter. Now our producer, Samantha, is going to tell us more about the virtual panelist program.

SAMANTHA EKLUND: Thanks Annie. If you do not live in San Diego but you like to be a panelist on our show, you can still participate through our virtual panelist program. Simply like us on Facebook and follow us on Twitter using #preggiepalsvp. We’ll post questions throughout the week prior to our taping and we’d love for you to comment so we can incorporate your thoughts into our episode. You can also submit your questions directly to our experts. Learn more about our virtual panelist program through the community section on our website.

ANNIE LAIRD: Thanks Samantha. Well, let’s go around the table here and introduce ourselves and the panelists that we have in the studio today. I’m Annie. I’m 35. Government contractor during the day, panelist...

SUNNY GAULT: Rockstar host and producer on weekend.

ANNIE LAIRD: Exactly. Yeah by weekend that’s what I do. And early in the morning I was on the fox show for the mocktails and that was a lot of fun.

SUNNY GAULT: Yeah.

ANNIE LAIRD: So I have 3 kids. 3 little girls. Crazy busy all of the time but we have a great time. So…

SUNNY GAULT: You want me?

ANNIE LAIRD: Yeah.

SUNNY GAULT: Alright I’m Sunny, I am actually the owner of New Mommy Media which produces this show as well as Parent Savers, The Boob Group and Twin Talks. I am a mommy of 4 kids and my oldest is about 3 and a half years old. My middle guy is about to enter his terrible two’s, he’s floating around the terribleness right now. And then I have identical twin girls who are about 5 months old.

ANNIE LAIRD: I’d say this is the first time they’re not in the studio since they were born.

SUNNY GAULT: I know. Crazy, crazy.

ANNIE LAIRD: I know it’s so quiet in here.

SUNNY GAULT: Yeah I know. I’m actually much less stressed when they’re not around. I do miss them by the way. Yeah.

ANNIE LAIRD: Yeah you know when they were first born it’s I think it’s a lot easier because they’re so sleepy.

SUNNY GAULT: Yeah.

ANNIE LAIRD: But they were starting to definitely get into they’re oh we’re awake and…

SUNNY GAULT: And where is momma?

ANNIE LAIRD: Yeah. There’s milk around here somewhere, too many lactating females around here anyways. So Aran go ahead and introduce yourself.

ARAN TAVAKOLI: Hi I’m Aran. I am 36, I have to think about that I just had a birthday.

ANNIE LAIRD: Happy Birthday!

ARAN TAVAKOLI: Thank you so much. I am a nurse and I had my little man September 2nd on Labour Day. I think he was playing a joke on me. I have to make my mom labour on Labour Day. He is our first and as far as the type of birth we had, awesome midwife birth hospital setting. It was fabulous.

ANNIE LAIRD: Great.

ARAN TAVAKOLI: Yeah.

[Theme Music]

ANNIE LAIRD: Alright well today on Preggie Pals we are going to be looking on over an app. This is free as most of them are that we do our app reviews are in the iTunes market place and it’s called Baby Countdown. And that’s pretty much I’m looking at it right now on my phone that’s pretty much what it is. So you can go on here you can do a count up or countdown. So I guess you can do a count up if you want to set the date to whatever your baby’s first birthday is or if you want to do a countdown to the day to the delivery day of your baby. You can do that as well so it’s very cute. There a little baby cake and then some baby shoes on top and says until my bundle of joy comes. I put in here a client of mine I’m a labour doula I guess I forgot to mention that in the a... So this gives me 24 days 1 hour 31 minutes and 20 seconds until my client goes into labour.

SUNNY GAULT: That’s actually that might be helpful for you actually.

ANNIE LAIRD: Yeah, maybe, yeah. So, I mean, I guess that’s you know I guess that’s helpful of going okay when’s my next client due? But I guess the down side of it is you know unless you’re getting induced to having you know a C-Section…

SUNNY GAULT: Right.

ANNIE LAIRD: On a certain day…

SUNNY GAULT: Right.

ANNIE LAIRD: Who knows what I mean [inaudible]

SUNNY GAULT: Yeah.

ANNIE LAIRD: Why you didn’t know you’re twins where coming. You thought you were going like I’m a going to 37 weeks.

SUNNY GAULT: That app wouldn’t have really helped me too much. Although you know I will say the more kids that you have the more the dates all become confusing and you know how many weeks pregnant am I and all this kind of stuff.

ANNIE LAIRD: Yeah.

SUNNY GAULT: This is a really simple-simple app. I mean I actually didn’t set it up but I’m assuming what it just ask you for your due date in the beginning and that was it and up came a clock.

ANNIE LAIRD: Yeah you can put it in here. Let me go to the settings here. So I can put it a date and time so I put in I mean I put in a certain time but who knows. I mean you know like I said…

SUNNY GAULT: Yeah.

ANNIE LAIRD: Who knows when the baby is coming?

SUNNY GAULT: Oh yeah.

ANNIE LAIRD: Now you can do that for you know when my child next birthday is coming.

SUNNY GAULT: Right.

ANNIE LAIRD: Which with more children you kind of lose track. I mean I lose track of my toddler the other day. So she walks out of the store and the security guard. How embarrassing is this. So I’m shopping, I tell the oldest watch her. And she’s watching Frozen in which of course turns her into like a zombie I guess kind of. And a security guard comes in with my toddler and is like who’s baby is this? That’s my baby, she was like she was playing in the alley.

SUNNY GAULT: Oh my gosh!

ANNIE LAIRD: Yeah. So that went off topic there. That’s nothing to do with the app but the point is you lose track of stuff including your children.

SUNNY GAULT: Yeah.

ANNIE LAIRD: When you have multiple children.

SUNNY GAULT: So it’s nice because it’s just a single screen pops up countdown count up whatever you want. So I guess if you know if you forget that kind of…

ARAN TAVAKOLI: And it’s free?

SUNNY GAULT: It is free.

ANNIE LAIRD: It’s free.

SUNNY GAULT: Can you change the background at all. It looked like it had a little baby cake or something.

ANNIE LAIRD: Yeah let me see although here phrases, until my bundle of joy comes, until my baby is born and until my sweetie pie arrives.

SUNNY GAULT: So those are all phrases that can be on the screen right?

ANNIE LAIRD: Yeah. And then you can update to premium but then type your own phrases, multiple countdowns.

SUNNY GAULT: But it really is just about the countdown.

ANNIE LAIRD: Yeah.

SUNNY GAULT: I know a lot of these apps have like kit counters and contraction timers kind of all of that.

ANNIE LAIRD: Yeah.

SUNNY GAULT: Yeah. So it really is about the countdown.

ANNIE LAIRD: Yeah.

SUNNY GAULT: For this

ANNIE LAIRD: Yeah. Aran what you think about? You just saw it is.

ARAN TAVAKOLI: Yeah. I think it’s really simple and the only thing is if it’s showing the piece of cake and our discussion today is on gestational diabetes. Might not be the best…

SUNNY GAULT: Might not be the best if you’re if you have gestational diabetes. Just a second did you change the background at all?

ANNIE LAIRD: Well I’m trying and I don’t know. Oh here we go, photos.. baby feet.

SUNNY GAULT: Okay, so you can do multiple things.

ANNIE LAIRD: That’s so cute.

SUNNY GAULT: So some minor modifications, just kind of tailor it to your style.

ANNIE LAIRD: Yeah.

SUNNY GAULT: But it’s all about the countdown. I mean you know if that’s how you want from it and you just know you just go to this one place on your phone and you can find it instantaneously, I don’t have a problem with that. And it’s free. And I don’t’ think you can really go wrong.

ANNIE LAIRD: Yeah.

SUNNY GAULT: It’s free so I would recommend and I give it a thumbs up.

ANNIE LAIRD: Sure I would give it a thumbs up too. What about you Aran?

ARAN TAVAKOLI: Yeah. Easy.

ANNIE LAIRD: Alright, 3 thumbs up.

[Theme Music]

ANNIE LAIRD: Today we are talking about gestational diabetes and some practical things you can do to keep your blood sugar at the right level. Joining us today is our expert is Dr. Goiceochea.

DR. FRANK GOICEOCHEA: That was excellent.

ANNIE LAIRD: Okay, alright great. In addition to caring for his patients at Sharp Grossmont Hospital, he’s previously served as the hospital’s OBGYN department chairman. Dr. Goiceochea, welcome to the show. Thanks for joining us.

DR. FRANK GOICEOCHEA: Thank you for inviting me.

ANNIE LAIRD: Now to start off with what is gestational diabetes and what makes it different from traditional diabetes?

DR. FRANK GOICEOCHEA: Well a woman who’s pregnant, who has never had diabetes and who has very high levels of sugar or glucose during the pregnancy, that would be considered somebody diagnosed with gestational diabetes.

ANNIE LAIRD: Okay. So you could be totally not have diabetes before the pregnancy and then be diagnosed with diabetes. I take it that once the pregnancy ends that it goes away generally?

DR. FRANK GOICEOCHEA: You’re correct. If you don’t have diabetes before pregnancy and you have it during the pregnancy itself that’s gestational diabetes.

ANNIE LAIRD: Okay.

DR. FRANK GOICEOCHEA: When the pregnancy ends, unfortunately there’s a 20% risk of women with gestational diabetes may end up having diabetes later on.

ANNIE LAIRD: Oh wow.

SUNNY GAULT: So it’s later on in life?

DR. FRANK GOICEOCHEA: Yeah.

SUNNY GAULT: Or is it so… But it could go away right after you have the baby right?

DR. FRANK GOICEOCHEA: Correct.

SUNNY GAULT: Yeah.

DR. FRANK GOICEOCHEA: Right.

SUNNY GAULT: But you could…

DR. FRANK GOICEOCHEA: But there are high risks for 20% having it so it’s important that they follow on afterwards with the evaluations to make sure they would not continue going out.

ANNIE LAIRD: Oh wow.

DR. FRANK GOICEOCHEA: And be treated properly then.

ANNIE LAIRD: Yeah. So what causes the increased blood sugar in the first place?

DR. FRANK GOICEOCHEA: We don’t know exactly, we do get some clues. We think that the placenta produce a lot of hormones and products that made the baby grow. The same compounds can actually affect or cause insulin resistance on the mother. Meaning that these products cause the insulin in the mother not to be as effective and for the mother to have the same metabolism like sugar in their body she needs [inaudible 00:10:16] 3 more times as much insulin as she were already require. So because you cannot produce so much that’s why your levels go up high.

ANNIE LAIRD: Oh okay. Now what are the kinds of symptoms that you would have of gestational diabetes if it got out of control?

DR. FRANK GOICEOCHEA: Actually at the beginning you don’t have any. And that’s why we diagnose or run a screen on everybody in the pregnancy.

ANNIE LAIRD: Okay.

DR. FRANK GOICEOCHEA: There is no symptoms in people have those who have [inaudible 00:10:48] diabetes in regard to insulin we know that they have a they become very thirsty, they are the go to the bathroom very frequently because of the high sugars in the urine. But they usually do not see that early in the pregnancy.

ANNIE LAIRD: Yeah. As was it say wow going to the bathroom pretty frequently I mean that’s…

SUNNY GAULT: That’s every pregnant women.

DR. FRANK GOICEOCHEA: Every pregnant who had diabetes [inaudible] that’s not a …

ANNIE LAIRD: Yeah. Aran you said that you got tested for. I know that during my pregnancies I was got tested for like 28 weeks you know where you drink the kind of orange crushed soda and some woman love it and some woman think it’s really disgusting. And then you get your blood drawn. But you said you had testing done earlier for it so what you have done?

ARAN TAVAKOLI: Yeah I was tested and they did the haemoglobin A1C which essentially measures kind of how your blood sugar levels have been over a period of about 3 months. Am I correct?

DR. FRANK GOICEOCHEA: You’re correct yeah.

ARAN TAVAKOLI: And so that was slightly elevated. It put me in this category called pre-diabetic?

ANNIE LAIRD: Now how pregnant were you when you had that done?

ARAN TAVAKOLI: This was my first trimester screening…

ANNIE LAIRD: Oh wow.

ARAN TAVAKOLI: And lab work.

ANNIE LAIRD: Okay.

ARAN TAVAKOLI: Yeah. So really early…

ANNIE LAIRD: The one where they have like 20 vials of blood all lie down

ARAN TAVAKOLI: Yes.

ANNIE LAIRD: And like are you afraid of needles? Well I am now.

ARAN TAVAKOLI: Exactly. So…

ANNIE LAIRD: Yeah.

ARAN TAVAKOLI: Just during that one was when my level came back slightly elevated and they said you have gestational diabetes.

ANNIE LAIRD: Oh wow. So and then you basically had to just do what you have to take insulin or something like that?

ARAN TAVAKOLI: No. So from that they then sent you to the educational class then I’m sure there are probably other moms that have gone to this exact same thing were you go and meet with the diabetes educator. They tell you about diet and diet modification. And they talk about how you do the blood sugar testing after each meal and the time frames and then reporting back to the clinic as far as how you are doing on your blood sugar. So I went through all of that education and started testing my blood sugars and found out that after each meal when I tested, they were absolutely fine. They’re within the normal limit every time that I tested. So from that, this is from my experience, from that I went back and was like all my blood sugars are within the normal limit. Do I need to continue doing this and they’re like no, we’ll retest you again when you come in for your glucose tolerance test, the orange soda. So…

ANNIE LAIRD: Yeah. Yeah.

ANNIE LAIRD: Yeah doctor, what kind of how does gestational diabetes, how would that affect a woman’s baby if she was diagnosed with that?

DR. FRANK GOICEOCHEA: Well if you are diagnosed with it on time and you treat it properly you can most likely end up with a normal baby. That’s the good part about it, if you’re diagnosed it early and that’s why we encourage all the women to be screened for that.

ANNIE LAIRD: By normal baby do you mean like their blood sugar is within normal limit…

DR. FRANK GOICEOCHEA: Correct.

ANNIE LAIRD: or size?

DR. FRANK GOICEOCHEA: Size, not having any problems later on when they are born because when the baby is born with a with the when a mother who’s diabetes pretty controlled to be very big can be have problems with their own sugar, their own calcium, so they had a lot of problems. But the good news about it is that if you’re diagnosed on time and be treated properly, most women will have a relatively normal pregnancy and normal delivery…

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: And a nice baby.

ANNIE LAIRD: Yeah. And I know that was something when I had my first baby, my mother was like well they must have misdiagnose you know misdiagnosed you. You had gestational diabetes. My first baby was 10 pounds 4 ounces but then again my husband is a big guy and I’m not exactly petite either. You know I’m rather tall. So I kind of wonder if that had probably more to do with than my mother just…

SUNNY GAULT: Well I know your babies have been bigger babies too so then…

ANNIE LAIRD: They have I just don’t have 6 pound, yeah I just don’t have 6 pound peanuts so yeah. Yeah. Oh well. So and Sunny you said you were diagnosed, which of your pregnancies did you have a…

SUNNY GAULT: Number 2…

ANNIE LAIRD: Okay.

SUNNY GAULT: My first you know I passed with flying colours on everything never thought you know I was ever going to have an issue with it. But my baby was over 9 pounds when he was born and so for baby number 2 right at my first appointment, my first prenatal appointment, they told me I needed to get some blood work to see just because the first baby was bigger and that came back fine. And then when I went for whatever the 28, 24 weeks then I had one of my levels were was a little high so then I had to come back for 3 hour. And that was questionable like it didn’t confirm me as gestational diabetes but they basically said we need to modify your diet and we’re going to test you again in you know 4 or 5 weeks.

So when I came back and had to do that 3 hour test again then another level was high and they have forewarned me listen most people were you know two were their levels were high the next time we test it’s 3 and you’re probably going to be classified with having gestational diabetes during this pregnancy. So eventually I was and I did have to go to all of the classes and do all that kind of stuff but really I wasn’t classified as having gestational diabetes until I was 34 weeks pregnant and I delivered at 38 so I really didn’t have that much experience you know time to really I mean I did have to change my diet and I had to test my sugars, I didn’t have to you know have anything you know beyond that. But what that was really crazy is that my next pregnancy was twins and I thought for sure there is no way I’m not going to have gestational diabetes.

ANNIE LAIRD: Yeah. Remember you’re talking about that in the studio like oh well I’m coming up for the test.

SUNNY GAULT: Oh Yeah. Yeah.

ANNIE LAIRD: Yeah.

SUNNY GAULT: Yeah because I think that the time we…

ANNIE LAIRD: Once you got over the total shock of having twins.

SUNNY GAULT: Totally. Yeah. Yeah. After whatever that is in your first trimester you know when you’re doing your screening stuff…

ANNIE LAIRD: Right.

SUNNY GAULT: That came back a little bit high and I thought oh no you know you felt like I got away with it.

ANNIE LAIRD: I remember that.

SUNNY GAULT: Pretty much for you know baby number 2 but I though oh no this whole pregnancy is going to be gestational diabetes and I caught early so I’m going to be miserable this whole pregnancy.

ANNIE LAIRD: Yeah.

SUNNY GAULT: But then yeah. So I you know I did the necessary testing and had to do a 3 hour again and then but it came back fine so you know like sometimes they kind of like scare you in to thinking that if you have it once you’re going to have it to all of your kids and that wasn’t the case with me.

ANNIE LAIRD: Yeah. Well doctor in your experience, does if a woman has a pregnancy and it is gestational diabetes for any subsequent pregnancies is their risk higher that they’re going to have it the next time?

DR. FRANK GOICEOCHEA: It is higher but doesn’t necessarily means as you’re saying that you’re going to have it. I think the fact that you already have had it before what that does is triggers for you to be tested in the first visit. So instead of having the one test or around 22 weeks we’ll make you go through that and everybody dislikes that especially in the first trimester you have all the nausea to [inaudible].

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: But it is because of that. But it doesn’t necessarily mean that you’re going to have it but you are on high risk of having it.

ANNIE LAIRD: Oh okay. When we come back we’ll talk about how to control your gestational diabetes.

[Theme Music]

ANNIE LAIRD: Welcome back, today we’re talking about controlling your blood sugar when you’ve been diagnosed with gestational diabetes. Doctor now we were talking a little bit in the break here about has there been like a change of what the tolerances as far as what level as far as blood sugar that triggers a diagnoses of gestational diabetes? It sure seems like, you’re mentioning this Sunny, that over the years from like my first pregnancy to now I hear that diagnose. It’s kind of like with breastfeeding kind of like with tongue tied…

SUNNY GAULT: Yeah.

ANNIE LAIRD: I hear tongue tied all the time…

SUNNY GAULT: Right.

ANNIE LAIRD: With breastfeeding and it kind of like with pregnancy I hear…

SUNNY GAULT: Gestational diabetes.

ANNIE LAIRD: Gestational diabetes a lot more than I did a decade ago with my first born. Has there been a change in that doctor?

DR. FRANK GOICEOCHEA: Yeah there seemed to be a changed as for years ago the breakpoint for that so to speak was like a 135 sub sugar if we do the one Glucola test it was coming down to 130. So it’s mostly coming down [inaudible] behind that is that it was felt that by using the higher levels that you’re missing some patients who might have diabetes, gestational diabetes that is. It’s not a 100% embraced by everybody because some people think that if you make it so long that you’re going to be over diagnosing and which is not as good. But in most cases now, in most laboratories is 130 depending on the lab to135 seems to be the right base line study I mean base line level for treating you for Glucola test.

ARAN TAVAKOLI: I think too as far as being overly diagnosed. I feel like I kind of fell into that category and I think what comes with that and that we haven’t really addressed is the psychological impact of it, of the fear related to having you know having gestational diabetes or like I said I feel like it was very in pressed on me that if you’re diabetes isn’t under control you can have foetal demise. If you’re not doing your kit counts you’re going to have foetal demise.

SUNNY GAULT: Oh wow.

ARAN TAVAKOLI: Like I feel like that came up quite a bit…

SUNNY GAULT: It’s scary…

ARAN TAVAKOLI: In my education…

SUNNY GAULT: Yeah.

ARAN TAVAKOLI: And that was a bit scary so I’m wandering too like does that happen to other women and how are they dealing with that? You know in their monitoring their sugars and they’re all fine.

DR. FRANK GOICEOCHEA: It can be scary but I think it’s up to us to present those in a non-threatening way.

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: That can be also embraced by the moms because it’s already as stressful as it is.

ARAN TAVAKOLI: I agree.

ANNIE LAIRD: Well how is it treated? Is insulin a normal thing that is moms are putting on insulin or is it all having to do with control of diet and exercise?

DR. FRANK GOICEOCHEA: I think the most of the gestational diabetes say the first time or even the second time are that can be treated by diet and exercise.

ANNIE LAIRD: Okay.

DR. FRANK GOICEOCHEA: If you I don’t know, maybe I would say that at about 40% or 50 maybe put on an oral medication like Glyburide which is common used. And in small percentage 2, 3% perhaps maybe required insulin. So the number who requires insulin is relatively small.

ANNIE LAIRD: Oh okay. Now Aran what did you do as far as you talk about testing you’re blood sugar that it wasn’t need to be done in the clinic or anything and you just do that right at home?

ARAN TAVAKOLI: Yeah you do it at home they set you up with little kits and the meter they’ll tell you how to do your finger stick. You do it in the morning. You do it I think it was like 30 minutes after you ate your meal…

ANNIE LAIRD: Yeah. Do you always use the same spot on your finger?

ARAN TAVAKOLI: No…

ANNIE LAIRD: Ouch.

ARAN TAVAKOLI: I rotate through with different fingers then back and forth in different little areas and…

ANNIE LAIRD: Yeah. Yeah.

ARAN TAVAKOLI: So I mean you get used to it. It gets pretty easy and you get used to writing down everything that you eat.

SUNNY GAULT: And they’ve apps too for that.

ARAN TAVAKOLI: Yes.

SUNNY GAULT: I actually used an app because that was much more convenient for me to write down my levels and then it even created like little graphs and comparison stuffs so when I went to my OB you know and share that information because obviously ...
ANNIE LAIRD: You know my dad has diabetes…

SUNNY GAULT: Yeah.

ANNIE LAIRD: Obviously it’s not gestational in nature. But yeah he you know and God bless my mom you know I think that’s that really has worked as far as having your partner on board.

ARAN TAVAKOLI: Yeah.

ANNIE LAIRD: With controlling the diet you know it really has to be that if somebody has diabetes, you can’t just have okay well here’s the person on the no fun diabetes diet.

SUNNY GAULT: Right. Right.

ANNIE LAIRD: And then everyone else gets to eat ice cream. You know I mean that doesn’t work really well but he uses an app as well so…

SUNNY GAULT: I think it was really eye opening to me like I said I really didn’t have it for that long, I wasn’t officially classified with it for more than 5 weeks 6 weeks maybe. But I still have to go through everything and I don’t know when I’m pregnant I would like to eat what I want to eat and the first time when they tell me not only can you not do that, but you can’t even eat what you know you were normally eating you know before you got pregnant or so hungry. So just stuff like not having regular peanut butter and having to substitute something with less sugar like I don’t even know there was a lot of sugar in peanut butter you know and really paying attention to what you’re eating I think was the most difficult thing because like I said I just wanted to eat everything. And then the finger pricking isn’t something that I would like to do for an entire pregnancy.

ANNIE LAIRD: No…

SUNNY GAULT: It isn’t the most fun thing to do but I think if we keep in mind that you know granted there are people that afterwards that this could turn into something else but if you keep you know in mind that for most people this is just gestational, it’s just when you’re pregnant and it’s kind of like breastfeeding. It’s like okay can I get through the next month, yes, okay can I get through the next months

ANNIE LAIRD: I’m like the next day of breastfeeding. Yeah so you know but just day by day.

SUNNY GAULT: That yeah, I think that’s how you have to look at because I don’t think it’s a fun thing. I don’t think anyone would say oh yeah that was great it’s just gestational diabetes…

ANNIE LAIRD: I’m stoked, I got diagnosed.

SUNNY GAULT: I’m the lucky one.

ANNIE LAIRD: Yeah.

SUNNY GAULT: But it’s for your child.

ANNIE LAIRD: Yeah.

SUNNY GAULT: So it was for a good reason obviously.

ANNIE LAIRD: For your baby. So and doctor like you were saying you know it’s a good time to say hey this is a good time to watch what you’re eating you know establish an exercise routine. Speaking of exercise routine, what is something that you would recommend to a mom that has a diagnoses of gestational diabetes? Obviously they’re not going to go and run a marathon but what kind of exercises would you recommend for them to help control that blood sugar?

DR. FRANK GOICEOCHEA: Well I recommend exercises for all pregnant women to start with especially we encourage especially a woman who are diabetic I mean gestational diabetes. Even doing inside like 30 minutes aerobic exercises, walking, swimming, bicycling is very very important. Not just because, that’s because the exercise itself increases your insulin level so it gets you your insulin it drops your glucose. There is less need for medication. But also if you do a lot of exercise there is some [inaudible] that makes you feel good. And I usually encouraged them to do that because the more exercise you do you are going to be better fit when the baby comes. And so those, and emotionally I think the woman who is more physically active I think that they all started out much better.

ANNIE LAIRD: Alright Aran what type of exercise did you do with the when you’re pregnant with your little guy?

ARAN TAVAKOLI: I think I read... it was something like I walked every day and the baby like almost fell out. And so I was like okay I’m going for it. So I walked a lot which is really nice and just being outside is awesome. A lot of yoga, a lot of yoga that was great. Those are my two big ones and then swimming because it was over the summer.

ANNIE LAIRD: Well since the thing that you’re mentioning and doctor you mention this as well. They all seemed to be very low impact type of thing so you are already carrying so much more weight.

DR. FRANK GOICEOCHEA: Yes, especially for aerobics. Swimming is great you have great buoyancy, so you’re swimming a lot better.

ANNIE LAIRD: Oh, as far as diet changes you know I hear my mom talking a lot about carbohydrates. What’s the deal with carbohydrates? Is the idea to bring your carbohydrates down or is it that carbohydrates have more sugars in them or I mean do you have to like plan your meals around a lower carbohydrates type of level or what do women have to do when they have that?

DR. FRANK GOICEOCHEA: I think it has to do more with the type of carbohydrates. There are things like a refine sugar that are carbohydrates, sweets, candies, cookies, syrups, all those things that have a carbohydrates are pretty much sugar. [inaudible 00:26:40] like pasta, dry beans, they have carbohydrates that are not very high in the sugar content but they’re very nutrition that’s a big difference.

ANNIE LAIRD: Oh okay.

DR. FRANK GOICEOCHEA: So you really want…

ANNIE LAIRD: So you really want the complex carbohydrates.

DR. FRANK GOICEOCHEA: Right.

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: You don’t want that simple refined and even we don’t want moms who had this problem or even without diabetes we drink a lot of juices. Juices have a some of pure sugar or in any canned fruits they have syrupy or even sometimes woman come to me in the office and I said gee what happened with your weight. I am eating a lot of fruits. What are you eating? Oranges and I said they’ve got, they have a lot of sugar…

ANNIE LAIRD: Yeah.

DR. FRANK GOICEOCHEA: So you don’t think about, you just think about healthy like fruits is healthy but being healthy doesn’t mean that you’d eat a lot like the oranges that have a lot of sugar. So you have to be modify that…

ANNIE LAIRD: That makes a lot of sense now, I mean because my midwife in my last pregnancy, we knew the baby was a little bit bigger but you know I chose to go in for the diabetes. Just I wasn’t diabetic, I just make large children but she was saying the same thing with my dietary, like don’t eat so much fruit you know. Take it easy on the fruit Anne you know. So focusing a lot more on leafy green vegetables and lean protein and you know. Maybe not so much dairy, but I’m from the dairy states. I like my cheese. So yeah…

Thanks Dr. Goiceochea for joining us today. For more information about our expert and our panellists, visit the episode page on our website. This conversation continues for members of our Preggie Pals club. After the show, Dr. Goiceochea is going to share with us how diagnosis of gestational diabetes may affect the birth of your baby and what your OB’s biggest concern with the diagnosis of gestational diabetes is. To join our club, visit our website www.preggiepals.com.

[Theme Music]

SUNNY GAULT: Hey everyone it’s Sunny, I have not shared my birth story of my twins yet so I thought I would do so in a segment we like to call 5 minute birth stories. So before I get started, if you guys have a birth story that you’re just dying to share with our audience we would love to hear it. Call our voicemail at 619-866-4775. It’s just a voicemail, no one is going to pick up the phone so don’t be freaked out by that. Just leave your story in 5 minutes or less and we’ll play back on our show.

So for my story with the twin it was pretty crazy because I had in my head all along that I was going to make it to full term for twins for my type of twin and that usually only goes to that 38 weeks. They don’t let you go much pass that because my twins are sharing the same placenta and it can become kind of dangerous after that point. But I really wanted to make it you know right to the 38 week mark and I thought if I just put in my head it’s going to happen, it’s going to happen and everything was going really well with the pregnancy. I didn’t have gestational diabetes and I was just kind of swimming along and then on the morning of November 11th, I’m taking a shower in the morning and I get out of the shower, this is kind of gross, and like oh boy because you know either I’m peeing myself which it didn’t feel like I had to pee.

And I certainly didn’t think it was the water from the shower or my water just broke. And I had two waters keep in mind because of the twins they were sharing with the same placenta but in two separate sacs. So yeah my body just kind of leaking those fluid, I’m going what’s going on because you know with my two boys they had to break my water. Well my second boy was a C-section so it’s a whole other thing. But with my first they have to break my water so my water was never broken naturally you know it’s not like you’ve seen in the movies were you know just kind of comes gushing out. And so I’m sitting there going should I tell my husband because it was veteran’s day which was good because my husband had the day off.

So he’s downstairs cooking breakfast for our kids and you know I don’t know what to say to him so I walked down and just have this look on my face and he’s like what? And I’m like I think one of my waters just broke. And he just give me that look because we not planned what we are going to do you know and again in my head I was going to make it to 38 weeks. So my parents were coming in to town and you know in a couple of weeks but nothing was, nothing was ready to go at that time. And so I ended up calling labour entourage and kind of explained to them my symptoms and what was going on and they said well if you think your water broke, we absolutely have to see you.

So on my way to the hospital, I started to feel contraction and I thought oh this is it. I knew it was and so we are able to drop off my older children, my two older sons at our friend’s house and then we went straight to the hospital. And sure enough you know they checked me you know I’m like 2 or 3 cm dilated and mind you this was a planned caesarean so I was at least thinking you know I wasn’t going to go into labour with this and I’m like man I’m going to have a C-section and in labour, man this totally sucks. Because with my second son I just had a C-section that was it I didn’t went into labour.

And so I’m a big woos when it comes to pain but probably for the next two hours they were admitting me and doing vitals and getting the, you know the OR prep and all this kind of stuff and I’m in a lot of pain. And they didn’t give me anything because you know I was going to go and get my spinal when once I was in there and so fast forward and my husband joined me in the OR. Everything went well with the spinal and the girls were actually born the same minute. Can you believe that like they don’t even have their own minute that they were born? But the girls came out great and baby A was 5 pounds 5 ounces and baby B was 5 pounds 8 ounces. And so other thing I had hoped is that they would get to 6 pounds but they were still very healthy, they never had to go to the NIQU, they were breathing great and we were able to go home you know in about 4 days. So that’s my 5 minutes birth story.

[Theme Music]

ANNIE LAIRD: That wraps up our show for today. We appreciate you listening to Preggie Pals. Don’t forget to check out our sister shows Parent Savers for parents with newborns, infants and toddlers, Twin Talks for parents of multiples and The Boob Group for moms who breastfeed their babies.

ANNIE LAIRD: That wraps up our show for today. We appreciate you listening to Preggie Pals.
Don’t forget to check out our sister shows:
• Parent Savers for parents with newborns, infants and toddlers
• Twin Talks for parents of multiples.
• The Boob Group for moms who breastfeed their babies

Next week we’re going to be continuing our series on foetal development moving in to the second trimester. What exactly is going on with your baby during months 4 through 6 of your pregnancy.
This is Preggie Pals, your pregnancy, your way.

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

SUNNY GAULT: New Mommy Media is expanding our line up of shows for new and expecting parents. If you have an idea for a new series or if you’re a business or organization interested in joining our network of shows through a co-branded podcast, visit www.NewMommyMedia.com .

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