Gestational Diabetis

[apelsinnka]

Hi, I know there were discussions before but it would be nice to connect to the ones who are struggling with it right now.
My story: I have big son, who was born when I was very young without any problems
My DD is 2y5m now and with her I was diagnosed with GD at 33 weeks. The values at the beginning very wild but I learned to control them and didn't take medicine despite the doctors telling me to take them in the first week in clinic. The values were then quite good actually and they planned my induction for 39+ but DD came earlier by herself
Now I am 31 weeks and was monitoring sugars now and then since the beginning. GTT came normal at 26 weeks, but I still went to clinic since the values were a bit high. They immidiately wanted me to take metformin. But the values ARE better then last time and I am trying to control the diet. And the private obstetrician said the baby is normal size.
I am now having the scan on Monday and clinic appointment after that, where I am sure they will push me to start medication again.
The main concern is that my morning values are 5.4-6.5.
Post food they are not bad at all.
Long story...
Anyone in a similar situation
What are your hospital protocols for GD???
Any thoughts

[terilou87]

Hi iv had a call the other day from mw after being borderline for my gtt results I don't know a hardly anything about gd so I have been worrying about it a bit, on the call the mw said the morning result was anything below 5.5 is ok and mine was 5.5 exactly and after the 2 hours anything under 8.5 was ok mine was 7.4. I'm unsure why they want to see me if I was under but I'll find out on Wednesday, x

[littleomar]

My hospital's limits are 6 fasting and 7.8 an hour after eating.

FWIW I kept overshooting first thing in the morning but I was doing it after a (milky) coffee. Started doing it on empty stomach instead and levels down in the 5s now.

Apart from that I've gone over a few times but never beyond 8 (GTT was 10.3) and they were happy to let me carry on without pushing metformin.

[apelsinnka]

littleomar which hospital are you with?

[apelsinnka]

terilou87 they want to see you I guess to start measuring sugar at home. A GTT is not very precise. My GTT was within normal range, but my mornings don't seam to be normal. So they say here. At another hospital it would be different
They also should do a test for average sugar for the last three months which also gives some idea

[MrTumblesKnickers]

I'm in a really similar situation - am 33 weeks, and my morning levels are high (6) but the rest are low. I am on Metformin but it hasn't done anything to the levels.

I know my doctor is going to push me to take insulin, which I don't want to do. I just wonder if 6 is really so high that my baby's in danger? The baby's weight and all the rest of it is normal.

[browneyesblue]

When I was pregnant with DS2 (now 3 months old), I developed GD. My morning/fasting figures were between 5.8 and 6.8ish and the cutoff was 5.5. My numbers after food were normally ok.

I was put on metformin at night (lowest dose), as they said that the problem was hormonal. As it was a fasting issue, it wasn't anything I could control by diet. By the end of my pregnancy, I was taking metformin morning and night as the fasting numbers kept rising as the pregnancy progressed.

I was due to be induced at 38+2 (big baby), but DS2 arrived very quickly the morning that I was supposed to go in - labour was 1 hour 20 mins from beginning to end.

Interestingly, my numbers all dropped to a low normal the day before labour started, even though I was struggling to keep them low by that point.

DS2's blood sugar levels still dropped dramatically after birth though, but the only sympton was sleepiness. It was quickly reversed though, and after keeping him in for monitoring, he was fine to go home.

[MrTumblesKnickers]

browneyesblue Thanks for that. Did your HCP want you to go onto insulin or any other medication because of your fasting numbers?

Very glad to hear your DS2 was all right in the end.

[browneyesblue]

Oh, and although DS2 is/was big, between 91st and 95th centile, he isn't just chubby - he is the same centile for everything (weight, length etc). There's a good chance his size has nothing to do with GD, and everything to do with my 6ft 2in DH!

[browneyesblue]

The consultant was happy for me to stay on metformin, but may have pushed for insulin had I had longer to go - the numbers were at their worst in the final week. She said I had to be really strict with my diet though, as it would all help.

By the end of the pregnancy (38 weeks), I was on the maximum dose of metformin, and was really trying to use my diet to help keep my numbers down. I ate so many eggs that I haven't had one since giving birth! I had other issues in the pregnancy, so exercise (however light) wasn't really an option, but if I could have I would have done some walking or swimming as that could have helped a lot.

[comewinewithmoi]

Can I ask why you don't want to take medication? I had gd with dc4. Quickly given insulin. Diabetes very controlled.

[MrTumblesKnickers]

Thanks browneyes. I think I need to up my exercise levels, to be honest. Maybe that will help.

I too am REALLY sick of eggs!

[terilou87]

Thanks apelsinnka that does make a bit more sense, when I spoke to mw of was very brief and she didn't really have time to explain, I suppose when you think about it 1 test doesn't give much info when it's something that goes up or down through the day, x

[littleomar]

East Surrey

[apelsinnka]

MrTumblesKnickers I actually prefer to do insulin. It is what the body produces and used for much longer. I am much less keen to take metformin which does a lot of changes to the whole metabolism.
Today my sugars are even worse so I probably will not get around that.

[apelsinnka]

MrTumblesKnickers
"I just wonder if 6 is really so high that my baby's in danger?" that's exactly what I wonder.

browneyesblue what type of ranges do you think are really risky?

[apelsinnka]

comewinewithmoi
did your doctors offer you metformin as well?
did you have high morning values or post meal?

[terilou87]

Hi all, well seems there are a few on here who know about gd I have a few questions I'm hoping you all might be able to help me with, so I had my growth scan/ dietician and consultant appointmemt today, iv got to do the finger prick thing 4 times a day 1 first thing in morning then 1 hour after each meal, what are the results supposed to be under? An when I had growth scan consultant said babies belly is measuring big compared to head circumference and he thinks this is because of gd and told me to start metformin, iv no experience of this and I'm always reluctant to take things I know nothing about. Does anyone know anything about it?

[comewinewithmoi]

No, no mention of that. High morning numbers and some post meals usually if I ate lots of carbs.

[apelsinnka]

terilou87 be really careful with your diets. based on the results of this week the doctors will decide whether or not you should have medicine. Mornings are usually much harder to manage, so only small piece of dark bread or one plain yogurt without fruits works for me for example. lunch and dinner are easier and one can have some fruits in between and full fat fruity yogurt (fatty ones usually have much less sugar)
My hospital's guide line for diet only are

[apelsinnka]

comewinewithmoi sorry but how high are your "High morning numbers"?

Just to get an idea, because different hospitals do have very different processes.

[browneyesblue]

I'm not sure what ranges are risky. In fact, there was one point where I felt worried because I kept getting the odd high number (8/9ish), and I was told it wasn't an issue. The following week my numbers were all below 5.5/7.5, but only just, and they were more concerned by that.

I think they looked at the whole picture, rather than just the numbers. For example, in my case there was a family history of GD, the scans which (very accurately) predicted DS would be around 9lbs 3oz if born at 38 weeks, persistant ketones and protein in my urine (both were high).


terilou87 I had no problems or side effects with metformin, although I was reluctant to take it just because I didn't like the idea of any medication. The consultant was reassuring though. I also remembered that when I was trying to get pregnant, the consultant I was seeing mentioned maybe using metformin to help me conceive. A quick Google showed me that it is commonly used as a fertility treatment, which made me feel better.

I found online forums really useful when it came to meal ideas, and in a pinch, eggs and a slice of wholegrain toast (maybe bacon or something too) gave me good morning numbers. I snacked a lot on cheese too.

[blueseashore]

Hi all. I'm struggling to keep my readings (fasting and post meals) down with diet alone but am now 37 weeks so don't know if they'll bother giving me insulin for the next few weeks as apparently it can take a week or two to perfect the dose. Have appt on Tues when I'll be given metformin if I still can't get my numbers in order.

I know it's a physical disorder but it feels like I am failing a test constantly by not being able to control it with diet! Was v careful yesterday and still had high post prandial readings as well as 3+ ketone readings in my wee which means I am cutting too many carbs. Argh!

Hope everyone else is getting on ok. I don't know anyone else in RL with GD so it's comforting to know am not the only one!

[terilou87]

Well my readings yesterday were all good and this mornings fasting wad was normal too, I'm having really bad diarrhea from the metformin but hoping that will ware off when my body gets used to it, what is everyone else eating? I could do with some ideas, I get very bored eating the same things.
My day is breakfast 1 slice of wholemeal toast with sunflower spread and 2 poached eggs with a cup of tea, or a bowl of porridge
Dinner is either chicken breast with broccoli and small baked potato or steak with sweet potato and broccoli
Snack grapefruit or a rivita and low fat cheese
Tea, soup and slice of bread, or chicken fajitas using wholemeal wrap. I need more ideas!!!

[apelsinnka]

blueseashore you are not alone. I had 6.9 this morning and 9 after breakfast. I wasn't very strict yesterday since I was very hungry.
"it feels like I am failing a test constantly by not being able to control it with diet" - It really does feel like that

[apelsinnka]

terilou87 I have lots of eggs, but I am beginning to hate them.
milk products: plain yogurt, cottage cheese, quark, ricotta
nuts for snack. a small apple works too. last time I was eating bananas, but this time the sugar goes up too much even after a small one.
pasta or steam boiled potatoes work for dinner.
houmus is great. cheese. avocados
when I am really craving sweets I eat a bit of full fat custard or some organic chocolate ice cream, but it should have less then 15% carbs in ingredients and only a small ball.