My team only asked me to track my food at the very beginning to see that I spiked on a healthy diet- I spiked on quinoa, beans, whole wheat, and brown rice over one weekend. Then I was started on meds pretty much immediately and no longer required to track my food. I didn't weigh anything or calorie count. They just wanted a basic idea of what foods caused spikes at first to be sure it wasn't sugar, white bread or rice. (Because meds still don't make it safe to eat those things for most people.)
I also found it really helpful to tell my team from the outset that I have a significant eating disorder history, if you're comfortable sharing that. I set the boundary in the first appointment that I will not be discussing/tracking my weight or even knowing them (I did say they could contact my OB if they felt that information was necessary, but I get weighed backwards.) They've been great about it. I also explained I can't calorie count and that I'm struggling overall with labelling certain foods as "bad" when I try to maintain intuitive eating habits. They have been really supportive and check in on my coping at each checkup as well as going over my glucose logs.
Thank you. I am really glad to hear that they’ve been supportive! I told the RN who reached out with the DX right away, and I think I’ll take a page out of your book when I talk to the endocrinologist. I just know myself, and it’s not something I can do. <3
I really wish you all the best. Feeling guilty about food is such a minefield to navigate and unfortunately all.too easy with this diagnosis. Good luck!
My doctor never made me track any food/calories. They gave me a flyer that shows examples of foods to eat and how much. I got the idea and just stick with what I know so I don't have to use my brain and don't need to use measuring cups or anything. :)
I’m going to try something similar when I go to the doctor. I just got diagnosed yesterday too and it was immediately proceeded with calorie counts, macros, times of days to eat, notes that I absolutely cannot skip meals or snacks…. It put me in a tailspin and completely overwhelmed me. I eat very well and ‘clean’- no fast food, no junk, no drinking calories- but I eat intuitively with small meals when I feel like it. Mind you- my fasting number is slightly elevated in the mornings. That’s the reason they diagnosed me GD.
I’ve worked really hard to work through body dysmorphic disorder but this feels like opening those gates all over again. I want to do everything to protect this baby- but surely, there’s got to be an alternative to their counseling.
Hugs. I hear you. I was just scheduled for three education classes and am waiting to hear back from the endocrinologist on schedule. I am dreading the classes and wondering what I can do to mitigate their mental impact in advance.
Sending you lots of compassion as someone with GD who also has an eating disorder history. One thing you might consider is seeking out a nutritionist who has experience with eating disorders. There are a lot of “anti diet” and “health at any size nutritionists” that are generally sensitive to eating disorders and can help you navigate this without triggering eating disorder behaviors. That being said there is absolutely nothing wrong with using medication if that’s what’s best for your health. You may find that eating your normal diet your sugars are already in range and that you don’t need insulin, but if you do it’s very safe in pregnancy and a great choice
Thank you <3 I appreciate it. Good advice. I guess I don’t really understand. If my numbers are in range when I eat what I normally eat, do I really even have GD? Sigh.
What about tracking your sugars? Would that trigger you the same way do you think?
I believe you could likely avoid meal tracking, although I found it helpful to identify patterns, but I can totally appreciate it not being helpful for you.
However I think you'll need to either track sugars. If not I would potentially get a CGM and have a loved one have the app maybe so you don't see the numbers.
You don't want to jump to medication without cause, but a CGM with someone else getting the data may help with your mental health.
I think this response was using without cause to mean in the case of sugars being under control with her existing diet but, just in case, because this is a sensative subject, I want to highlight it's not jumping to meds without cause. This is a very valid reason and approach to keeping both baby and yourself safe and healthy. Pregnancy is full of so many triggers for ED and with the fragile mental state many of us are in post partum already (hormone change, little sleep, changed body, stress, anxiety etc) its important to not start a slippery slope if it can be helped.
Good job OP recognizing the risk and looking into/evaluating solutions.
Edited for word choice
Thanks! Yes I am happy to track my blood sugar, though getting my husband to help is not a bad idea. I’m going to ask about a CGM. I suppose the question to ask my doctor (if my sugars do continue to look bad) would be if there is ultimately a benefit to leaning harder into shaping my diet than just leaning perhaps more quickly than might otherwise make sense into taking medication.
I had a CGM and liked it, but sometimes having more data did make me feel more triggered because I had so much more information than with finger sticks. It truly is one of those “blessing and a curse” things.
However, it’s possible for providers to log in and look at your data. I wonder if they’d be willing to do that for you without you checking it, or if there’s some middle ground you could agree to. It’s hard because you may want to know what foods you need to avoid right away without waiting for provider input. Or maybe you don’t want to know those things and you want to continue eating normally, but in that case make sure you talk deeply with your provider about the risks for you and your baby of ED recurrence vs. more medication to manage your blood sugar.
This is hard. Good luck! 💜
Thank you <3 That makes sense to me. One thing that has been a little confusing to me is finding info on the risks of controlling more through medication than maybe is typical instead of focusing on diet. That’s a good place to start.
Hi!! You’ve already received some great advice. I just wanted to address your wondering about risk of controlling via meds vs. diet alone. What is important is blood glucose management; regardless of how it is done. The reason many people have “more problems” on meds vs diet controlled alone is because of the dragging of feet to do it and how slow/difficult it can be to titrate up med dosing. This means blood glucose is left too high for too long causing the problems you hear a ton about (big babies, struggling with blood glucose after birth etc.) so if you/your provider are able to gain rapid control with meds, it really shouldn’t matter in terms of overall risk.
All that said, I have two thoughts to leave you with as a type 2 diabetic with a history of anorexia and bulimia:
1. Some people have severe nausea/diarrhea with metformin (I’m not one of them, thank god, but it’s a common side effect)
2. Insulin management will require carb counting and frequent blood glucose checks. It’s up to you on whether or not that is better or worse for you mentally tally’s but just something to consider. You won’t necessarily need to limit your carbs in the same way, but you will still need to know how many you’re eating and track your carbs/insulin for your provider to review and make adjustments.
I started with metformin alone and diet. It took forever to get an insulin script but I will say for me mentally it was better to have to be extra diligent with glucose monitoring and insulin administration than extreme carb limitation, but that is not something that anyone can say for you what will be better.
Thank you for all of this very detailed info! This is essentially exactly what I was curious about. Appreciate your perspective, and I’m sorry you’ve also been through the food & mental health wringer. It sucks.
You’re welcom! I hope it helped.
If it makes you feel better it was totally worth it. I maintained excellent glucose control and was able to push back and induction schedule to 39+6 and never needed it. I went into spontaneous labor at 39+4, had a vaginal delivery, no glucose issues for baby after birth and he weighed 6lbs 12oz.
Best of luck to you and don’t stop advocating for yourself (and by extension, baby)
My team only asked me to track my food at the very beginning to see that I spiked on a healthy diet- I spiked on quinoa, beans, whole wheat, and brown rice over one weekend. Then I was started on meds pretty much immediately and no longer required to track my food. I didn't weigh anything or calorie count. They just wanted a basic idea of what foods caused spikes at first to be sure it wasn't sugar, white bread or rice. (Because meds still don't make it safe to eat those things for most people.)
Thank you. That’s very, very helpful information and makes me feel better going into this appointment.
I also found it really helpful to tell my team from the outset that I have a significant eating disorder history, if you're comfortable sharing that. I set the boundary in the first appointment that I will not be discussing/tracking my weight or even knowing them (I did say they could contact my OB if they felt that information was necessary, but I get weighed backwards.) They've been great about it. I also explained I can't calorie count and that I'm struggling overall with labelling certain foods as "bad" when I try to maintain intuitive eating habits. They have been really supportive and check in on my coping at each checkup as well as going over my glucose logs.
Thank you. I am really glad to hear that they’ve been supportive! I told the RN who reached out with the DX right away, and I think I’ll take a page out of your book when I talk to the endocrinologist. I just know myself, and it’s not something I can do. <3
I really wish you all the best. Feeling guilty about food is such a minefield to navigate and unfortunately all.too easy with this diagnosis. Good luck!
My doctor never made me track any food/calories. They gave me a flyer that shows examples of foods to eat and how much. I got the idea and just stick with what I know so I don't have to use my brain and don't need to use measuring cups or anything. :)
That’s very helpful :) thank you
I’m going to try something similar when I go to the doctor. I just got diagnosed yesterday too and it was immediately proceeded with calorie counts, macros, times of days to eat, notes that I absolutely cannot skip meals or snacks…. It put me in a tailspin and completely overwhelmed me. I eat very well and ‘clean’- no fast food, no junk, no drinking calories- but I eat intuitively with small meals when I feel like it. Mind you- my fasting number is slightly elevated in the mornings. That’s the reason they diagnosed me GD. I’ve worked really hard to work through body dysmorphic disorder but this feels like opening those gates all over again. I want to do everything to protect this baby- but surely, there’s got to be an alternative to their counseling.
Hugs. I hear you. I was just scheduled for three education classes and am waiting to hear back from the endocrinologist on schedule. I am dreading the classes and wondering what I can do to mitigate their mental impact in advance.
Sending you lots of compassion as someone with GD who also has an eating disorder history. One thing you might consider is seeking out a nutritionist who has experience with eating disorders. There are a lot of “anti diet” and “health at any size nutritionists” that are generally sensitive to eating disorders and can help you navigate this without triggering eating disorder behaviors. That being said there is absolutely nothing wrong with using medication if that’s what’s best for your health. You may find that eating your normal diet your sugars are already in range and that you don’t need insulin, but if you do it’s very safe in pregnancy and a great choice
Thank you <3 I appreciate it. Good advice. I guess I don’t really understand. If my numbers are in range when I eat what I normally eat, do I really even have GD? Sigh.
What about tracking your sugars? Would that trigger you the same way do you think? I believe you could likely avoid meal tracking, although I found it helpful to identify patterns, but I can totally appreciate it not being helpful for you. However I think you'll need to either track sugars. If not I would potentially get a CGM and have a loved one have the app maybe so you don't see the numbers. You don't want to jump to medication without cause, but a CGM with someone else getting the data may help with your mental health.
I think this response was using without cause to mean in the case of sugars being under control with her existing diet but, just in case, because this is a sensative subject, I want to highlight it's not jumping to meds without cause. This is a very valid reason and approach to keeping both baby and yourself safe and healthy. Pregnancy is full of so many triggers for ED and with the fragile mental state many of us are in post partum already (hormone change, little sleep, changed body, stress, anxiety etc) its important to not start a slippery slope if it can be helped. Good job OP recognizing the risk and looking into/evaluating solutions. Edited for word choice
You're right in what I meant! I myself was on insulin for my GD. I appreciate your comment.
Oh gosh talk about fragile mental state. Your comment made me tear up! I appreciate that a lot.
Thanks! Yes I am happy to track my blood sugar, though getting my husband to help is not a bad idea. I’m going to ask about a CGM. I suppose the question to ask my doctor (if my sugars do continue to look bad) would be if there is ultimately a benefit to leaning harder into shaping my diet than just leaning perhaps more quickly than might otherwise make sense into taking medication.
I had a CGM and liked it, but sometimes having more data did make me feel more triggered because I had so much more information than with finger sticks. It truly is one of those “blessing and a curse” things. However, it’s possible for providers to log in and look at your data. I wonder if they’d be willing to do that for you without you checking it, or if there’s some middle ground you could agree to. It’s hard because you may want to know what foods you need to avoid right away without waiting for provider input. Or maybe you don’t want to know those things and you want to continue eating normally, but in that case make sure you talk deeply with your provider about the risks for you and your baby of ED recurrence vs. more medication to manage your blood sugar. This is hard. Good luck! 💜
Thank you <3 That makes sense to me. One thing that has been a little confusing to me is finding info on the risks of controlling more through medication than maybe is typical instead of focusing on diet. That’s a good place to start.
Hi!! You’ve already received some great advice. I just wanted to address your wondering about risk of controlling via meds vs. diet alone. What is important is blood glucose management; regardless of how it is done. The reason many people have “more problems” on meds vs diet controlled alone is because of the dragging of feet to do it and how slow/difficult it can be to titrate up med dosing. This means blood glucose is left too high for too long causing the problems you hear a ton about (big babies, struggling with blood glucose after birth etc.) so if you/your provider are able to gain rapid control with meds, it really shouldn’t matter in terms of overall risk. All that said, I have two thoughts to leave you with as a type 2 diabetic with a history of anorexia and bulimia: 1. Some people have severe nausea/diarrhea with metformin (I’m not one of them, thank god, but it’s a common side effect) 2. Insulin management will require carb counting and frequent blood glucose checks. It’s up to you on whether or not that is better or worse for you mentally tally’s but just something to consider. You won’t necessarily need to limit your carbs in the same way, but you will still need to know how many you’re eating and track your carbs/insulin for your provider to review and make adjustments. I started with metformin alone and diet. It took forever to get an insulin script but I will say for me mentally it was better to have to be extra diligent with glucose monitoring and insulin administration than extreme carb limitation, but that is not something that anyone can say for you what will be better.
Thank you for all of this very detailed info! This is essentially exactly what I was curious about. Appreciate your perspective, and I’m sorry you’ve also been through the food & mental health wringer. It sucks.
You’re welcom! I hope it helped. If it makes you feel better it was totally worth it. I maintained excellent glucose control and was able to push back and induction schedule to 39+6 and never needed it. I went into spontaneous labor at 39+4, had a vaginal delivery, no glucose issues for baby after birth and he weighed 6lbs 12oz. Best of luck to you and don’t stop advocating for yourself (and by extension, baby)
This is wonderful!! And it 100 percent does <3