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low carb and pregnancy

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the_anticarb

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Before i got pregnant a couple of years ago, I low carbed and it was great for my glycaemic control. on getting pregnant I was advised not to do this, so I didn't. I kept my glycaemic control due to very tight monitoring, testing and injecting hourly towards the end but oh boy oh boy I was going hypo several times a day (once on the motorway - very scary) and I put on four stone.
Thinking of getting pregnant again (if they'll let me - but that's another story) and I don't want to be stuck in that carb/insulin spiral again.
Can anyone think of a good reason why I should not low carb in pregnancy? Seeing as the usual dietary advice to diabetics by the Nhs is a bit bonkers it would make sense to distrust the advice in pregnancy.

My logic is - a low carb diet is a natural (caveman) diet and caveladies had cavebabies for millenia before the good ole western diet came along. They had low carb diets - so why shouldn't I?
Last time I was told by a DSN that ketosis can harm a baby, but I think she was confusing it with ketoacidosis?
 
It's a difficult one isn't it? Obviously your primary aim is not to risk the health of the baby.

But I'd like to see specific reasoning on why one shouldn't do that.

Carbohydrates are not 'essential' in dietary terms; the body can make glucose from protein, so you technically don't need to eat any carbohydrates. You need some extra calories per day whilst pregnant and all the essential nutrients; i.e. those that cannot be made by your body, but why couldn't you get that from a mainly protein/fat based diet?

Carbohydrate, protein and fat are just sources of energy and the only one that is non essential is our friend the carbohydrate.

So many medical professionals don't understand the difference between ketosis and ketoacidosis it seems barely worth talking to your nurse about this; but just remember many people go into ketosis in the early hours of the morning in any event. Therefore many pregnant women do that too, so on the face of it how can that be a problem?

I'd ask as many people as you can why you shouldn't and if they answer you with statements like you 'need' carbohydrate for energy and should have 130 grams a day at least or whatever the figure is you know that they can be filed in the folder of people who don't know about gluconeogenesis and/or what they are talking about. Similarly if they talk about ketosis ask them what the difference between ketosis and ketoacidosis is and see whether they can be disregarded as well...

If you just reduce your carb intake to a level at which you feel comfortable whilst having some perhaps you would cover all areas of concern; I would have thought uncontrolled blood sugars would be much more of a worry than low-carbing.

Of course, I may be wrong; I'm no expert but my instinct is the same as yours - if so much of what the NHS say is wrong why should we just accept the same views here?

We need Phoenix to show up with a conclusive study!

Best

Dillinger
 
Hi - I'm an insulin dependent MODY. I'm currently doing atkins-style low carbing for weight loss, but in a pregnancy I would prob go up to 80-100g a day. I don't really count carb grams though, I just cut out all starchy / known carbs ( following Atkins phases one and two) but if pregnant I'd introduce some back in.

I just really don't want to be on the insulin/carb rollercoaster again, although I managed it pretty well last time it was difficult as I sort of got a paranoia of my blood sugar going above 8 in case it harmed the baby, every time it did I felt like I was poisoning the baby, so I'd get the novorapid out, over inject, go hypo, eat, bounce up again.

Then towards the end I lost my hypo awareness and was testing before I drove, but one day got into the car with a reading of 5.something, thought I'd be fine for the 20 min journey, got on the M-way, started to feel a bit funny 10 mins later, still no hypo shakiness just felt a bit sick and weird but thought I couldn't be hypo as just tested, came off m-way and tested, IT WAS IN THE 2's! This was at 8.5 months pregnant - I shudder to think......

Not to mention the 4 stone weight gain that I'm still losing!

Part of the problem was the unrealistic targets in pregnancy - I was told not to go above 7 one hour after meals, I was like sure doc I can keep it below 7 by injecting lots of novo...but I'll be on the floor with a reading of 3 an hour after that.

So an easier way to meet the one hour post prandial target of 7 is to have a low carb meal, right?
 
In your case I'd say there is no issue with lowering starchy carbohydrates during pregnancy and lactation so long as you don't attempt to lose weight during pregnancy. Simply make sure you are eating a varied diet containing nutrient dense high protein/fat foods with plenty of veg.

Because people have their babies best interests at heart they actually become less sure of what they are sure of! You are sure that carbohydrates are not essentialy but you don't want your 'fanatical beliefs' to harm your baby. Your cavelady cavebaby analogy is perfectly legitimate so long as you feel 'good' on a lowered carb diet.

Does that help at all?
 
I would think it depends on how low you call low.
Remember that DKA can occur at much lower glucose levels during pregnancy, it can also develop very quickly.
You can chase up the studies yourself from this
http://www.endotext.org/diabetes/diabet ... rame20.htm

Memory took me to this quote from Cahill who is/was probably the worlds expert on ketones/ketosis/starvation but mot necessarily on obstetrics
The larger the brain/body ratio, the more rapidly the ketosis develops, as in the newborn. The same holds true for the pregnant woman,since the conceptus, calorically speaking, is just another glucose-consuming tissue like brain. In the same vein, lactation necessitates increased gluconeogenesis, and nursing mothers who are fasting experience increased ketosis. However, prolonged
severe ketosis in a starving female may terminate pregnancy, which tragically can occur in prolonged population starving or more rapidly in diabetic ketoacidosis
Click to expand...
http://www.med.upenn.edu/timm/documents ... azar-1.pdf
 
I don't go into DKA Phoenix (believe me it would have happened by now if it were possible, due to abuse of my diabetes when younger) as my body must produce a little background insulin, just not very much! Does that make any difference?
 
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