Gestational… Hypoglycemia?

The women in my family are all diabetic, except for me. My mother, my sister, my aunt, my grandmother: all type two diabetics. I watched my favorite great-aunts deteriorate and die from the complications. I know what diabetes is, I know what it looks like, and I am very, very paranoid about it. I would like to avoid getting it. I have a glucometer, and I monitor my blood sugar. Anything that sends my numbers over 150 gets axed from my diet. I never eat a whole banana, but so far I can handle just half of one. I’m careful about things like rice, and sugar is The Enemy.

Or at least, that was the picture until I got pregnant. Very shortly after I confirmed I was pregnant, a weird thing happened to my blood sugars: my fasting numbers dropped from a consistent 83-84 down to 70-74. I assumed this had something to do with the horrific nausea disrupting my eating patterns. I lived for a month on cottage cheese and plain yogurt, unable to keep anything else down. But then, we left the country. Up in the mountains I got even more sick, and my fasting numbers got even more weird, dipping into the upper 60s. I was really, really hoping it was something to do with the altitude, and things would normalize once we were out of the mountains. This was not the case.

In the meantime, the nausea abated some, but we lacked the facilities to cook properly, so we ate at least one meal a day in restaurants, and made up the rest with avocados and yogurt. When we returned to normal altitude, the problem actually seemed to get worse. At the hostal, we didn’t even have the dishes to manage avocado and yogurt, so all meals were in restaurants. My morning blood sugar readings were regularly in the 60s– the lowest I recorded was 61, just at the edge of real, scary hypoglycemia. I started keeping little juice boxes in our room, so I could get back up to normal first thing in the morning– we usually wake up at 6am, but none of the restaurants open for breakfast until 9am. That’s a long time to wait with low blood sugar. I was waking up groggy, confused, and lethargic. And ravenously hungry. 84 is my normal zone, where I feel good. At 65 I am a barely-functioning zombie.

Once we got our apartment, we stopped eating in restaurants. the content of our diet didn’t change all that much: meat, vegetables, rice, etc. But over the course of a week, my blood sugars went back to their pre-mountains level: still low, but back in the 70-74 range so I don’t feel dead when I wake up, but I can still feel out of sorts and a little slow-thinking until after breakfast.

Then one Sunday some friends from church took us out for lunch. The next morning my glucometer read 68. I think it’s something about the restaurants that is really doing me in. An expat friend informs us that “everything here has MSG in it”, so that’s a natural first suspect. I certainly don’t cook with the stuff at home. Whatever it is, there seems to be a pretty strong correlation between me eating in restaurants, and my blood sugar doing a nosedive over the next 24 hours.

But that still doesn’t solve the riddle of why it dropped to begin with, and why it is still consistently lower than my normal pre-pregnancy readings. That part mystifies me. There is a ton of literature on gestational diabetes, and how it’s normal for your body to get a bit insulin-resistant during pregnancy to make sure the baby is getting enough nourishment blah blah blah. But I can’t find any information on why my blood sugars might drop while I’m pregnant. There’s a tiny hint that this might not be unusual, in that the recommendations for morning sickness sometimes include a little blurb about eating as soon as you wake, because low blood sugar may be what’s making you nauseous. But that’s it. Nobody elaborates. Has this actually been studied? Are we talking about ordinary first-thing-in-the-morning fasting blood sugar as though it’s “low” or are we talking about lower-than-normal blood sugar? The literature is extremely unhelpful here.

I know I’m not the only person to have experienced this: I’m not half-Martian, and no single human physiology is THAT unique. But I’m guessing there aren’t that many weirdos out there paranoid enough to be monitoring their blood sugars without being diabetic (yet). Maybe there are a ton of women attributing that new I-feel-like-hell-in-the-morning feeling to the pregnancy alone, and never investigating it further. But I can’t help worrying that the low glucose levels may be having a negative effect on the baby. I wish I could find a good answer for it.