Food for Thought

I had my much-anticipated appointment with the dietitian today and it was definitely worthwhile.

As I have mentioned in previous posts, my diet has basically fallen apart over the course of this pregnancy. Between treating the ever-present lows, soothing my nauseated stomach, and catering to my temperamental digestive system, I have thrown all of my diabetes-friendly diet techniques out the window in favor of foods that are comforting, easy to digest, and quick to raise a 24 mg/dL blood glucose. Out the window went my fiber-rich whole grains, fruits, and vegetables. In their place, I am living on juice boxes, white pasta, white bread, and gummy candies (my newest craving.)

But I am into the fifth month now, and that placenta must finally be doing it’s thing because the spikes after my meals are higher and more stubborn. And the lows, while still severe, are fewer and farther between.

The dietitian asked me to keep a food log for three days and to bring it along to the appointment. I was embarrassed with what I had to show her. Besides my carb-laden meals, I also documented an alarming number of trips to the vending machine for things like donuts and Rice Krispies treats. Yikes.

Luckily, she was one of the “good dietitians” — you know, the ones who realize that we live in the real world with real world temptation and real world schedules. She did not try to beat me up over my bad choices, and instead offered a few suggestions for how I could do better.

She put together a pregnancy meal plan based on the old-fashioned exchange system  and it is very reasonable. But the suggestions for better choices were probably the best take away. For example, I am struggling with a ravenous appetite in the mornings. It starts when I wake up and doesn’t die until after lunch. Mid-morning is when I spend most of my time at the vending machine … hello donuts.

Instead of donuts, she suggested a sandwich. Or, if I just can’t give up the donuts, half of a sandwich and half of the package of donuts. That is a pretty basic idea, and  I probably could have come up with it myself, but it sure helps to have the reassurance from an “expert.” Plus, it really helps that she did not try to tell me that I absolutely could not have the donuts. Because the craving center in my brain has been on fire lately and there is no telling what I will feel like I “need” to devour next.

We also talked about my ketone issues. Like the High Risk OB, she thinks I can get away with moving the 2AM snack to before bed, but she disagrees with him about the protein. She thinks I need the protein to keep my energy level up overnight to prevent going into “starvation mode.” I tend to think she is right, and proteins are starting to sound better now, so I think I will take her advice. She suggested string cheese and a box of juice for my pre-bed snack because it is quick and easy and has the requisite number of protein and carb exchanges. I think I will give it  a try.

Sidenote: My Endo thinks that moving the 2AM snack to before bed is a recipe for disaster. I have not been able to test this change yet, because my BGs are bottoming out every night at 3AM, so I’ve had to eat then anyway. Hopefully I can get him to change my basal rate and then I can give this snack time change a try. Just goes to show you that even the experts disagree on these things!

Another idea she had was with my boluses. In the past, I have used the dual wave bolus to offset my slow digestion, but recently, I haven’t needed it. She suggested that I experiment with the square wave instead of the dual wave when I eat a higher-fat meal. She said to start with a duration of an hour or so and see how it goes. I have noticed in the last couple of weeks that my digestion is really slowing down again … another of the side effects documented in the book … so I think this could be really helpful, too.

All in all, I am really glad that I finally found a dietitian. She made some good suggestions that I think I can use to improve my diet and she gave me the tools I need to make better decisions. Perhaps most importantly, though, she has given me the information I need to at least partially relieve my diet-based anxiety. Whew!

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