Sugar Crash: Riding the Roller Coaster of Gestational Diabetes

A common pregnancy journey for approximately 10% of pregnant women in the United States, is the kind with a sugar crash, or a gestational diabetes (GD) diagnosis. The entire process from diagnosis to birth is mired with being phangry—pregnant, hungry and as a result angry—due to care coordination challenges,and a lack of technological and medical innovation.

The journey begins with the dreaded glucose test. At the 27 week mark, your provider should ask you to drink 24 oz+ worth of gatorade concentrated into a 10 oz bottle within a ten minute period. For me, it brough flashbacks of college and shotgunning a beer except someone else is timing as you must drink every last drop.

After you have consumed the beverage, DON’T MOVE, because they want to see what your body can do without any help. I found out after both tests that I had GD, a diagnosis where your pregnancy hormones are blocking insulin from traveling from your pancreas to your bloodstream.

Enter in care coordination challenge number one— instead of one care provider, I now have three. My OB/GYN practice referred me to the Maternal Fetal Medicine (MFM) department at my delivery hospital system for 1-2x ultrasounds a week as well as a Nutritional Program affiliated with the MFM department called, “Sweet Success.” Yes, this is true—a program designed to teach you to eat less sweets, is called Sweet Success.

The irony did not fail me, don’t let it fail you.

Enter the lack of medical device innovation, where I traveled back in time to use an Accu-Chek monitor to prick my finger 4x a day. When I asked my doctor for an upgrade to a continuous glucose monitor, a monitor made for Type II or Type I diabetics to conveniently monitor glucose levels and is easily inserted into your arm, my experienced doctor of 30+ years, told me she didn’t know why—read there is not a good reason— CGMs are not FDA approved for pregnant women. Ok, so back to pricking my finger at restaurants in front of my friends and wiping the blood on the napkins, I guess!

After a few weeks, I was prescribed daily insulin injections to control my morning glucose levels using a “only in pregnancy” used slow acting, hard to obtain insulin into the subcutaneous tissue. In other words,inject the insulin into your pregnant belly. But don’t worry, the needle isn’t long enough to get close, so you’re good and it only works half the time!

Enough people have this condition, there should be better technology, medicine, and information to manage it. After two GD pregnancies, being my own advocate, knowing what foods (and amounts) to eat, and using the Sweet Success program when I couldn’t control my glucose levels with diet alone ultimately helped me get to the finish line. As a working mom, I took conference calls during ultrasounds, found a mobile app for virtually everything, and said no when I needed to (without putting my babies at risk). Stay tuned for my next post where I explore what companies have and are doing about making a better care journey for pregnant women with this condition.

Idf. org, Accessed on January 10th, 2023

Medline Plus, Accessed on January 10th, 2023