Navigating a healthy pregnancy with gestational diabetes

Halie Reyes discovered she was pregnant in March of 2019. While she and her husband were excited, they couldn’t help but be a little anxious, too. A couple of months earlier, Halie and her husband experienced the pain of miscarriage. This, coupled with the fact that Halie had type 2 diabetes, made them particularly nervous.

Halie immediately set up an appointment to meet with diabetes educators at the Center for Maternal and Fetal Care at The Children’s Hospital of San Antonio. Prior to getting pregnant, Halie had Type 2 diabetes and knew this would put her at high risk for developing gestational diabetes during her pregnancy. The educators would help Halie regularly track her numbers and made sure she stayed on top of her monitoring each time she had a doctor’s appointment.

“I felt so blessed to be able to work alongside the doctors and educators at the Center for Maternal and Fetal Care. They did a really good job of helping me manage everything and stay on top of my logs. The team went the extra mile for me to ensure a safe and healthy pregnancy,” said Halie. “One of the first things they did was enroll my husband and me in a series of cooking classes so that we could develop healthier eating habits.”

The program, called Culinary Health Education for Families* (CHEF), was provided in the Teaching Kitchen at The Children’s Hospital of San Antonio.  The program was aimed at teaching men, women and children how to grocery shop, prepare nutritious meals and establish healthier eating habits. Halie found the classes extremely helpful. A chef and dietitian showed Halie and her husband how to prepare various recipes and give them tips on using healthy substitutions.

“The food was amazing and we learned so much in each class. One of our favorites was the healthy version of a fish taco. It has now become a staple in our household,” said Halie.

In addition to helping her establish a healthier eating path, her care team also helped her properly manage her blood sugar and keep track of her glucose numbers. Initially, she was put on insulin and had to do finger pricks every day, but eventually, she was able to use a sensor, called the FreeStyle Libre to track her blood sugar. Halie found the device helpful and easy to use.

“Instead of pricking my fingers eight times a day, I was able to use the sensor that went on the back of my arm,” explains Halie.  “It can sync up with either your phone or a tracking device and will give you your glucose levels. This device was a game changer for me.” 

Doctors saw Halie every two weeks throughout her pregnancy to monitor the diabetes and as they got closer to her due date, her appointments were weekly. They were most concerned with Halie developing preeclampsia, a complication during pregnancy when blood pressure is too high, impacting the vital organs, most commonly the liver and kidneys. In addition to preeclampsia, they were also worried Halie would gain too much weight and that the baby would get too big during the pregnancy.

Doctors told Halie that she would not carry the baby to full-term due to the gestational diabetes because it could pose a greater risk to her and the baby. The plan was to induce her at 39 weeks. On Nov. 25, 2019, Halie had an excruciating headache and couldn’t sleep. At midnight, she went in for the induction, and Dr. Marisol Garcia-Hodge performed an emergency C-section because Halie’s blood pressure was too high and was not coming down.

Dr. Marisol Garcia-Hodge is an OB-GYN at CHRISTUS Central Women’s Health Care. She delivered Halie’s baby by emergency C-section at 39 weeks.

Despite being diagnosed with gestational diabetes, Halie and her husband welcomed a healthy baby girl into the world in November 2019.

After controlling Halie’s blood pressure and managing her pain, they safely delivered her baby, a daughter she named Sarah.

“Due to the gestational diabetes during pregnancy, the doctors had to monitor Sarah’s blood sugar levels,” said Halie. “She had to spend a few days in the neonatal intensive care unit to make sure her body could learn to regulate itself.”

Today, Sarah is a healthy 22-month-old toddler.

Two years later, Halie said she would do it all over again, even though the experience was scary at times.

Halie praises the team at The Children’s Hospital that helped her give birth to a healthy baby girl in 2019.

For other mothers who have diabetes or develop gestational diabetes during pregnancy, Halie tells them it will get better and that they need to do what is necessary to care for themselves and their baby. She said a big part of this is finding the right care team to help you manage every aspect of your diabetes, including how to develop healthier eating habits.

“I will wholeheartedly recommend the care team at Children’s to anyone who will listen,” said Halie. “If any mom is looking for an obstetrician, I always tell them I know the best team!”

To read a Q&A about gestational diabetes, read our latest blog: You’ve Been Diagnosed with Gestational Diabetes: Now What?

*The CHEF program at The Children’s Hospital of San Antonio was placed on hiatus due to the pandemic.

November 14 is World Diabetes Day

Ruchi Kaushik, MD, MPH, FAAP
Assistant Professor, Pediatrics
Medical Director, ComP-CaN (Comprehensive Peds for Complex Needs)
Medical Director, The Children’s Hospital of San Antonio Blog
Baylor College of Medicine
Children’s Hospital of San Antonio

Diabetes mellitus is a chronic disease caused by a lack of insulin.  Insulin is a hormone produced by the pancreas, is essential to life, and lowers blood sugar levels by allowing it to be taken up by our cells so we can use it for energy.  One analogy describes insulin as the “key” to opening the door to cells for sugar to come in.  An absence or deficiency of insulin leads to high blood sugar levels; conversely, an excess of insulin results in hypoglycemia, or low blood sugar levels.  Importantly, in diabetes, even though blood sugar levels are high, the sugar cannot enter cells and cannot be used for energy because the “key,” insulin, is missing.  This is dangerous because sugar is the most important source of energy for our body.  There are two types of diabetes–type 1 and type 2.

Taking a closer look at type 1 and type 2 diabetes

By Dr. Ruchi Kaushik
General Pediatrics
The Children’s Hospital of San Antonio

Diabetes mellitus is a chronic disease caused by a lack of insulin. Insulin is a hormone produced by the pancreas, is essential to life, and helps in the metabolism of glucose, a simple sugar derived from the carbohydrates (“carbs”) in our diet. It lowers blood glucose (glucose = sugar) levels by helping glucose enter our muscle cells so we can then use it for energy. One analogy describes insulin as the “key” to opening the door to muscle cells for glucose to come in. An absence or deficiency of insulin leads to high blood sugar levels; conversely, an excess of insulin results in hypoglycemia, or low blood sugar levels. Importantly, in diabetes, even though blood sugar levels are high, the glucose cannot enter muscle cells and cannot be used for energy because the “key,” insulin, is missing. This is dangerous because glucose is the only energy source for red blood cells and the brain.

Diabetes mellitus is of two types, type 1 and type 2. In type 1 diabetes, the cells of the pancreas are either absent or destroyed. These individuals have a lifetime dependence on injectable insulin. Type 2 diabetes is more complicated. The body’s cells have become resistant to insulin.  Essentially, the cells have changed their “locks.” Traditionally, type 2 diabetes has been a disease of adults; however, with increased rates of childhood obesity, as many as one-third of all new cases of diabetes in adolescents is of type 2.