There was a time not too long ago where the term ‘GDM’ or Gestational Diabetes Mellitus wasn’t in my dictionary. Little did I know it would be a condition I’d become uncomfortably familiar with over the years. This is my personal story and journey of how I survived three pregnancies living with GDM, wishing all the while that someone would have told me all about it.
For the mamas who are currently going through the same challenge, this one’s for you.
Understanding GDM
It was March 2017 when we saw the two beautiful blue lines. Immediately, our world opened up to new dreams and ideas for our future family. But life always has a way of throwing curveballs. The high of expecting our first miracle lasted about 7 months before I downed that cup of syrup, only to be told two hours later that I had a condition called GDM.
Simply put, GDM is a condition characterised by an elevated level of glucose in the blood during pregnancy due to insulin resistance, typically resolving after the birth. Identifiable causes may include obesity, gaining too much weight during pregnancy, or (as in my case) having a family history of diabetes.
At that point, I didn’t fully grasp the severity of my condition and thought cutting back on a few cookies and scoops of late-night ice cream would be enough. A visit to the nutritionist had me facing my new reality. This meant no sweet drinks, absolutely no desserts, very selective fruits (read: guava and half an apple a day) and a limited portion of carbohydrates. It was a rude, abrupt goodbye to midnight cravings and durian feasts.
As kind as the nutritionist was in trying to break the news to me, I sat back after all her explanations, speechless. It took a while for it all to sink in; even then I couldn’t, or rather didn’t want, to acknowledge it. In my heart, I knew if I wanted the little life inside of me to thrive, I had to follow – so I silently surrendered with a smile.
Navigating the changes
I remember having major sugar withdrawal syndrome the week that followed. I would cry over not being allowed to finish the rest of the chicken rice staring back at me. Another new event to my routine was having to prick my finger four times a day to record my glucose readings and note it down; a daily occurrence until delivery.
As time went on, I got better at accepting my new diet and the cravings grew less frequent. There were certainly moments of weakness, but my doctor – who was wonderfully empathetic and encouraging – reassured me that as long as the good readings outweighed the high readings, I was on the right track. In November 2017, we brought home our 3.6kg bundle of joy, delivered naturally at 40 weeks. And the best part? As soon as my baby left my womb, the GDM left my body too.
Flash forward to April 2019, and we were thrilled to find out we would be welcoming another new baby! This time, I half expected GDM again, so when this condition recurred, I wasn’t too surprised. What did surprise me, however, was how difficult it was to adjust to the “new diet”; even though I was mentally prepared for it; my physical body just wasn’t. As before, it took a while to re-inculcate a good eating regime. By Jan 2020 at 37 weeks and 4 days, we had our 4th family member with us at 3.4kg and once again, I was clear of GDM.
Third time’s (not) the charm
Three years and a pandemic later, we were thrilled to announce another baby on the way. But being older and above 35 years old did make a world of difference. My metabolic rate had definitely slowed down and shortly after being diagnosed with GDM again, I was advised to start oral medication daily to reduce the sugar spikes. Sadly, my body alone was no longer capable of keeping the spikes low, even with a strict diet. The caveat was that delivery had to be carried out by Week 38 of my pregnancy by way of induction or C-section (if spontaneous delivery didn’t occur).
So here I was: bracing myself for the next 16 weeks left of pregnancy on a strict diet, finger-pricking schedule and medication, hoping for the best outcome. My third pregnancy posed a significant challenge of endurance; the runway to delivery was a lot longer, I was more advanced in age and I had two other children to care for. The severity of the possible outcomes, should I not adhere to the diet, also stuck with me a little more this time.
The effects of GDM and the risks faced by both mother and baby shouldn’t be taken lightly. Most women with gestational diabetes are able to have a vaginal birth, but are more likely to have a C-section than women without diabetes due to the large size of their baby. High blood pressure, premature delivery and preeclampsia are more common in women with gestational diabetes. Too much glucose in the blood can cause a condition in which your baby grows too big, which may result in shoulder dystocia during birth. GDM can also cause health complications for the baby after birth, including breathing problems, low blood sugar, jaundice, and a higher likelihood of childhood obesity and type-2 diabetes.
How I managed my condition
Most of these possibilities, including the one I feared the most (where my baby might be stillborn) constantly floated in my mind, keeping me grounded to my eating habits. To spice up the pregnancy a bit, we discovered at Week 32 that the baby was rather small and in breech position! What a Catch-22 situation I was in; I had to eat to bulk up the baby and still maintain stable sugar levels, while praying (and doing everything) to try and get baby into the right position. We even tried increasing my oral medication dosage, and that caused my amniotic fluid to reduce – which wasn’t ideal either!
I felt disheartened, and even turning to food for comfort wasn’t an option. My mama heart and head felt like it was about to explode. Breathe in, breathe out. So I started with what I could control, which was to switch up my diet to a higher consumption of good fat like avocado and salmon. I bought a box of avocados wholesale and piously ate one or two daily. The good glucose readings spurred me on to keep going with the end goal in mind.
By Week 37, the doctor had confirmed that my baby had turned to the right position for delivery and had put on some weight! She still wasn’t even close to the birth weight of my other two children, but enough for a less complicated delivery. At Week 37 and 5 days, we welcomed our 2.7kg miracle naturally and without complications.
My message to fellow GDM mums
I want to encourage mothers who are going through this right now that there is always hope and a way to live happy and healthily during this time. Most of it involves a change in mindset and understanding the bigger goal, which is to birth a healthy baby.
As I write this now, my heart is swelling from how it all happened. A part of me can’t help but think of what could’ve been, and even back when I did have these thoughts, I was surrounded by supportive family, friends and my doctor. I knew I did my best in the situation and many things are out of our control when it comes to bringing life into this world. We can only trust that we’ve done our best and to not blame ourselves, whatever the outcome may be.
This whole ordeal has been a wake up call to me to maintain a healthier lifestyle, moving forward. The likelihood of GDM mothers developing diabetes later on in life is 50% higher than women who didn’t experience GDM. However, I’m taking things one day at a time, while looking towards a longer-term goal for my health.
For now, I’ll just enjoy some desserts as a small reward – and no, I won’t be eating any avocadoes for a while!
By Celine Chew
Celine is currently a full-time stay-at-home mother of three. In between juggling school runs, meal prep, boo-boo kissing, and storytelling, she enjoys a good cup of coffee with a book or a friend, trying out new foods, sports, traveling and writing.
