Gestational Diabetes: What to Expect. 5th edition. American Diabetes Association, 2005
I've been reading a bunch of stuff out there about Gestational Diabetes, and I have to say that most of the slim books that *are* available for consumers are pretty much the same as the pamphlets one gets from the Diabetes Educators. This one, at least, has a little bit about what to expect in labor and delivery, though I wouldn't spend the $10 to get it from ADA. Unfortunately, one of the things it says is "Be sure to discuss both vaginal birth and cesarian delivery with your obstetrician months before your baby is born, so you will know what to expect." My experience is that might work with a midwife, or in Wyoming, but my experience getting straightforward information from a variety of care providers early on (other than, 'at X weeks we'll decide when you're going to have the baby' was... ahem... fruitless; my partners suspect this is a way to avoid being seen as promising anything).
(One of the problems with gestational diabetes is that all the normal pregnancy books pretty much do an ABEND when it comes to GD, saying "this applies as long as you don't have conditions like X, Y, and Gestational Diabetes" and then leaving you hanging, while the books and pamphlets about GD tell you that if your sugars are well-controlled, you can probably have a mostly normal birth, talk to your obstetrician. Again leaving you hanging. Which puts a GD mom in the uncomfortable position of having little to no information about what to expect.)
One worrying thing about this publication is that it claims that one hour
after eating, a Blood Glucose test should show less than 120
, which is not currently the standard from the medical information I've received and the medical articles I've read; this could be a typo, or an overly-stringent recommendation. It also claims that women on insulin should test 7 times a day, which is a recommendation that I've seen only in Lois Jovanovic's work (Jovanovic contributed to this work; I have dark suspicions about her understanding of what is reasonable in time and supply cost for testing-- 50 test strips run about $25-$50 if not covered by insurance).
On the other hand, the book was the only source, other than Kmom's consumer site, to clearly state that the postpartum 'testing for diabetes' one is supposed to have is another one of those miserable Glucose Tolerance Tests, rather than the fasting blood glucose, Hemoglobin A1C, or other simple test and only mildly annoying test you might have received as a previously fat woman being checked for diabetes. (Fat women, I've found, are disproportionally suspected of and tested for diabetes automatically, while my male friends who have weight issues and turned out to have diabetes often had to present to the their doctor complaining that they suspect diabetes before being tested.)
Compared with Lois Jovanovic's older book: Managing Your Gestational Diabetes: A Guide for You and Your Baby's Good Health
, by Lois Jovanovic-Peterson, M.D., this is the preferred resource. (Yes, I know I'm prejudiced. Every time I experienced some really intrusive testing or stringent protocol in my GD pregnancy, further investigation showed that it was a protocol suggested by Jovanovic.) But again, I would say it's not worth BUYING it yourself; ask your public library if they have it, or can interlibrary loan it for you. Certainly, don't bother contacting the American Diabetes Association asking for more or other information about GD; they simply don't have it or don't want to distribute it. This the best you'll get out of them, and it IS good background reading, especially if you don't have access to or the patience for reading medical journals.
However, along with this book, I would suggest spending some time looking at Kmom's Gestational Diabetes pages: http://www.plus-size-pregnancy.org/gd/gd_index.html
Looking at consumer-created sites on medicine, especially those that have a definite bias (Kmom is 'size-positive' which gives many people the creeps) is a chancy thing. However, size-positive or not, size-activist or not, if you're a person looking for information about the experience of having Gestational Diabetes, this is the best resource out there to read. Kmom has read the research papers, and she's very careful to explain what they say, and where and why she differs from them; she's also got lots of stories from other mothers who've had GD.
Though many medical professionals don't seem to feel there's any long-term stress associated with a Gestational Diabetes diagnosis and treatment, I have to say that I certainly was stressed by it. While I got some help and emotional support from sympathetic nurse-practitioners and diabetes instructors, I would recommend looking at Kmom's pages just to know you are not alone, and that things you're experiencing-- for instance, widely varying protocols for handling labor and delivery, the feelings of blame (overweight/obese women have a higher proportion of GD diagnoses, though there are certainly a significant proportion of GD diagnoses in slender women), and just general stress-- are not unique to you. Pairing that with this book may make you feel that you're taking a balanced view.
On the other hand, if you read the food suggestions in books like What to Expect when You're Expecting
and/or What to eat when you're expecting
and would like some more food guidance, this is probably also a comforting place to start. I can't tell you much about the information here, except that it's based on the food exchange program (I'm no diet fan or dietician). Obviously paying close attention to a diabetes nutritionist with experience with GD is key.
In the current OB climate, it seems there's less support for doing your own research and reading around before following your doctor/hospital's dictates on what must be done. If that's what you feel comfortable with, that's fine. I believe that American Diabetes Association's Gestational Diabetes: What to Expect
actually will help you follow your doctor's guidelines. (Note: of special interest is the section on post-partum birth control; this book is the one resource that at least explains clearly *why* they want to talk to you about BC, because some methods of BC are considered less useful in patients who have a tendency toward diabetes mellitus II, which includes all women who have had gestational diabetes.)
If you're a maverick that is skeptical or even cynical about what OBs might say, you may want to get this book to get an idea of the general concensus; it's probably the best consumer resource on the topic, even though it's only 100 pages.
If you're just nervous and like to read up on what's going on in order to feel comfortable, this is DEFINITELY the book to go with; it's calm, relatively supportive, and reassuring, as well as having good information. You may actually want to spend the $10 to have a copy.