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SALT LAKE CITY — During a pandemic, any type of pregnancy risk or complication can cause additional stress. One Utah woman who had gestational diabetes says with the right approach, both mom and baby can stay safe.
Karli Valdivia gave birth to her second daughter Esty Valdivia on Sept. 25, 2020. Her older daughter, Ramona, who is 3 years old, was happy to greet her little newborn sister.
"It was really cute when we brought Esty home for the first time," said Karli. "Ramona was so excited to meet her that she was just crying."
Karli was diagnosed with gestational diabetes during both her pregnancies. Unlike Type 1 or 2 diabetes, gestational diabetes only occurs during pregnancy when pregnancy hormones affect how the body processes glucose or sugar.
"When you're pregnant, your body changes the distribution of oxygen and nutrients and one of those is glucose," Intermountain Healthcare's Emily Hart Hayes, a certified nurse midwife and women's health nurse practitioner, explained. "In gestational diabetes, it's almost like an overshoot. It's a mechanism that was meant to be useful and has gone overboard."
The Centers for Disease Control and Prevention reports it happens in between 2-10% of pregnancies.
The first time she was diagnosed, Valdivia admits she was nervous. She didn't know anyone else who had also gestational diabetes until she opened up about her experience online. "I found a few friends that ended up having gestational diabetes, but nobody really talks about it," she said.
At the end of her second trimester, Valdivia went through regular screening in which she drank 50 grams of glucose and had her blood sugars measured an hour afterward to see how her body processed the sugar. She didn't pass the test.
"It was kind of just like, 'Well, crap, now I'm pregnant and I have to deal with this too and I have to adjust to my diet. It feels like one extra thing," she expressed.
But Intermountain Healthcare offered a diabetes class through the education center where she learned all about the disease and how to manage it, including how to prick her finger, test her blood, and develop diabetes-friendly meals.
While the diagnosis can be concerning, Hart Hayes says with the right measures it can be controlled.
Hart Hayes said diabetes during pregnancy can increase the likelihood of having a larger birth weight than normal which can lead to delivery complications, in addition to other issues. "People who have gestational diabetes have a higher chance of developing gestational hypertension or high blood pressure disorders in pregnancy and that also includes a condition called preeclampsia, which can be really quite life-threatening for mom and baby," she said.
She said other complications include birth defects, stillbirths, respiratory distress and low blood sugar.
"It's not something to be taken lightly and it's important that we identify people because we actually can manage it pretty well with often just diet and exercise changes and sometimes people need medication."
Hart Hayes says maintaining a healthy weight, eating a balanced diet low in sugar, and getting regular exercise all help the body keep blood sugar under control. She says exercise is especially important because it helps the body be more receptive to insulin.
Karli made simple substitutions to her diet and included lots of healthy fats and proteins. "It was mostly changing how my meals looked. They ended up looking much more rounded," she said. "If I were to have rice with my meal, I would have half of the rice be cauliflower rice, so that was cutting down those carbs a little bit, and not having to sacrifice my whole meal — I wasn't feeling like I'm on this super-restrictive diet."
Hart Hayes urges women with gestational diabetes to avoid super surgery foods and foods that are high in carbohydrates. "I think a really quick and easy rule is don't eat white things — like white rice, white bread, chips, fries or hamburger buns. Even though they're not sugary, they are refined carbohydrates that hit the bloodstream and spike it up," she said.
Valdivia also tried her best to stay active.
"So like taking an extra walk, or making sure I take a walk every evening, or putting in the time to do 20 minutes of yoga at night," she explained.
Hart Hayes says it doesn't have to be very intense exercise. "Even just daily moderate exercise like a 30-minute walk each evening and one in the morning, or even just once a day, can really help manage glucose levels and keep them in the normal range so we can avoid those complications that sometimes happen," she said.
Valdivia was also diligent in monitoring her blood glucose levels and taking her medication. "You take your blood sugar four times a day. There's the fasting blood sugar in the morning, and then an hour after each meal… I just had to set myself a timer so that I would remember to take my blood sugar after I've had my meal," she explained.
Although most people with gestational diabetes don't display any symptoms, Hart Hayes said there are certain risk factors which may increase someone's likelihood of developing the disease such as being overweight, having a family history of Type 2 diabetes, having given birth to a baby who weighed more than nine pounds, and having had gestational diabetes in a previous pregnancy. She encourages women to get their health under control before conceiving if possible.
While Hart Hayes urges mothers to do everything they can with their diet and exercise routine to stay healthy, she says there are some cases in which a woman's genes make her more prone to developing gestational diabetes. In those cases, she urges women to be kind to themselves. "Put away the guilt. There is no place here for guilt, right? There's no home for that. It doesn't serve us. It doesn't help us," she said.
Valdivia echoes her message. "Your body is doing a huge thing by growing a human and it's a lot of extra strength!" she said. "I had to stop myself from worrying too much because it's very much out of your control."
With the help of additional monitoring and screening from her doctor, Valdivia was so grateful to give birth to two healthy and happy babies. "You just love your new babies so, so much. And you know, you'll do anything to care for them and to help them in any way," she said. "It's always worth it in the end."
Hart Hayes said women do not need to be fasting before they are tested for gestational diabetes around 24-28 weeks gestation. She recommends women don't eat sugary foods before the test, though, as it might falsely elevate the result. Instead, she suggests eating a breakfast of eggs and whole-wheat toast without honey or jam.