Practice what I preach, not what I do.

Disclaimer:  This post is not intended to be a substitute for medical advice. 

In my line of work, I end up seeing a lot of patients with diabetes and weight issues. I often wonder if the patients are actually listening and following through with my recommendations.  Most of the time, I think people’s eyes just glaze over and they nod politely as I talk about carbohydrates and fiber content, but there is one group of patients that I’ve found incredibly interesting:  gestational diabetes patients (high blood sugar first diagnosed during pregnancy).

It has really been amazing to see the number of women that have come to see me with abnormal blood sugars during pregnancy, so afraid that I’m going to sentence them to a lifetime of insulin injections.  Instead I have had the opportunity to sit down with them and talk in detail about their lifestyles and for the most part, I’ve been very pleasantly surprised by how many of these women have been able to change the way they eat so that they are within the targets that are recommended for them.  I’ve learned a couple of important lessons in my interactions with my gestational diabetes patients.

1. Limiting carbohydrates is hard!  Out of curiosity, I tried to keep track of the carbohydrate content of foods that I eat, just so that I have an idea of exactly what it means to limit oneself to 30-45 grams of carbohydrate per meal. For example

Breakfast: Small bagel (29g) + grande Startbucks Misto (10g)

Lunch : 12oz Chicken noodle soup (20g) + small side multigrain baguette (14g) + blueberry greek yogurt (20g)

Dinner : California roll 6 pieces (55g) + 1/2 cup of edamame (10g)

I haven’t even included the snacks I have throughout the day or the desserts that I have on a regular basis!  or the days when I pig out on pizza or french fries.  Yikes.  By the way, when I was pregnant with my son, I did go through a hypochondriac phase when I limited my carb intake to 30g each meal for 2 days.  It was awfully miserable for a big carb-addict like myself.

2. Postpartum weight loss is tough.  I counsel my gestational diabetes patients to lose 7% of their prepregnancy in the next year to decrease their future risk of type 2 diabetes.  I used to just spout off these numbers without much thinking, but now that I’ve done the pregnancy thing twice, I laugh at my own naivete.  What busy sleep-deprived mother can balance work, chasing after a toddler, breast-feed an infant, and drag themselves to the gym on a regular basis and focus on losing that 7%?

Taking care of these patients has been a humbling experience.  I’m learning what it means to be realistic and what it means to be encouraging. I hope that as I continue to grow as a physician, that I continue to develop wisdom and sensitivity to the needs of my patients.


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