Inflammation is Taking Over

I had an interesting lunch-time appointment with a nutritionist today. Beyond the obvious cruelty in meeting with a nutritionist when you're hungry, I was concerned to find out that along with having to deal with RA and autoimmune thyroid disease while pregnant, I now have gestational diabetes, too. I never had that with any of my three other pregnancies, but both my parents have diabetes, and next week I turn 41 – my risk of developing diabetes is going up, so I'm not totally surprised. What did surprise me was how quickly I went from normal checks for sugar to failing the one-hour and then three-hour glucose tests.

The root of it all? Inflammation. Over the past few weeks, my sed rate and CRP level have gone up. Now that I'm off sulfasalazine for the RA, the inflammation is increasing. I've been reading for quite some time about the connections between inflammation and diabetes, and I'm currently working on an article about it. How ironic.

So how to go about resolving the problems? Fix the timing of when I eat, and of course, eat less, move more and try to relax. Overall, I already eat the way the nutritionist recommends. I don't drink fruit juice or sodas very often – certainly not every day, sometimes not even weekly. And my family doesn't have a dessert-every-night-after-dinner habit, so no problem there. My favorite snack? Apple slices and peanut butter – one she recommended. My usual lunch? Dinner leftovers (so meat and veggies) or soup and a sandwich – both on the list. But this one surprised me: My usual breakfast of high-fiber cereal, fruit and organic skim milk is better eaten in the middle of the day. Who knew?

Apparently the hormones generated by the placenta during pregnancy cause insulin to spike both in the morning and at night (and I do admit to the ocassional bowl of cereal before bed). So, for breakfast she recommended scrambled egg and whole wheat toast. I can do that, although one of our upcoming nutrition articles points out that eggs might not be the best choice for people with diabetes. (Find out why in the Sept-Oct issue). I'll try alternating eggs with organic, whole-grain, steel-cut oatmeal and see which affects my glucose level more. I'll now be testing my blood glucose four times a day and reporting my results weekly to the perinatologist.

Beyond that, I'll continue walking – maybe go for two walks a day. The pools are open here now, so I'm back to walking in the water and doing laps, which I love. My oldest son goes with me to the gym ocassionally, and we do the cardio and weight machines together (usually while laughing, which is good for reducing inflammation, too). School's out next week and baseball season winds down in early June, so we can do that more often. I'm still taking a few flights of stairs at work and elsewhere this far along in the pregnancy (beginning of third trimester) so staying active won't be a problem. Finding time to relax, though? Hmm. Does collapsing into bed at night after a jam-packed busy day count?

I've got to do it all, though. For myself, for the little girl I'm carrying and for all of you – to prove that it is possible to take control of the inflammation that can affect every system in our bodies.

I'll be continuing to work on the inflammation and diabetes article for the next few weeks. Post a comment here if you also deal with both conditions and let me know what works for you. If you'd like me to consider including a comment from you in the upcoming article, e-mail me directly at dsiegfried@arthritis.org.

Take care!