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Gestational diabetes - do you know the mmls I should be aiming for?

(18 Posts)
Andanotherthing123 Sat 23-Nov-13 17:51:10

Thank you, sounds as though it's ok so I'll stop worrying. Just been to collect my son from a child's birthday and turned down a tempting slice of cake...roll on post birth eating!!xx

SidandAndyssextoy Sat 23-Nov-13 16:53:37

My first child had an AC measurement on the 95th centile at a scan I had at 40+10 and I had a trouble free vaginal birth. She wasn't as big as the scan suggested, which is common. Also the dangers in GD are mostly around delivery and the period immediately after delivery. Diabetes can cause miscarriage, which hasn't happened, and I assume your scans haven't raised any other worries. So please try not to worry. As long as you're controlling your blood sugar and being monitored, you should avoid complications.

lotsofcheese Sat 23-Nov-13 11:46:45

I wouldn't worry about that measurement from a 20 week scan. You'll probably be offered fortnightly scans from now on & it's more useful to look at sequential measurements/patterns rather than a one-off. So please don't stress!

Just to add that I didn't have GD & my baby's AC measurement was always higher than her head, that's just the way she is, even now at 7 months old.

TarkaTheOtter Sat 23-Nov-13 11:41:50

In theory it can mean an increased risk of the baby getting stuck during delivery. But most of the growth happens in the third trimester so plenty of time for things to even out. I think the centile curves are quite close together at 20weeks so the difference between the 25th and 90th isn't that big.

Have they offered you another growth scan to check how things are going?

Andanotherthing123 Sat 23-Nov-13 11:28:49

Sorry, is me again, just having a bit of a worry. I read a thread about large abdominal circumference and GD and suddenly remembered how surprised i'd been at my 20 week scan that my baby's head circumference and femur length was on the 25th percentile, while the abdominal circumference was nearer the 90th. I've just checked my notes and this is the case, so now I'm worried I've had GD for a while and it might be harming my baby. I'm 29 weeks now. Could anyone tell me that what a large AC measurement means for baby? I don't want to google as I don't think I can take the stress!

terilou87 Sat 23-Nov-13 11:28:14

My hospital are quite strict, 3.5 - 5 fasting result and no more than 7, 1 hour after eating and I am on insulin.

SidandAndyssextoy Sat 23-Nov-13 09:43:24

I was told that the lower levels for GD would normally be considered too low. I never got anywhere near a 3 anything in the morning. Occasionally, later in pregnancy when the whole thing improved, I would see 3.9 in the afternoon after exercise!

Along with being stricter, my hospital was also ready to support me in my own birth choices. At 37 weeks with good blood glucose control, and a baby and waters both showing normal size on a scan, I was pretty much discharged from the diabetes clinic and signed off for a home birth. DS arrived at home on 40+3 weighing 7lbs 15oz and showing no signs of hypoglaecemia.

TarkaTheOtter Sat 23-Nov-13 09:25:44

My hospital would agree with you about 3.5 being too low on insulin. I have noticeable symptoms if I go below 4 (mainly irritability). But I'd really struggle with <5 for fasting. In fact I've been told to eat before driving if my levels are <5 (and eat then wait 45mins if <4).

lotsofcheese Sat 23-Nov-13 08:25:30

I work in a hospital diabetes care team. Our targets are: < 5mmol fasting, < 8 mmol within 1 hour after eating, < 7mmol within 2 hours.

We'd consider 3.5 mmol too low if the diabetes is treated with insulin (not metformin or diet only).

Please keep recording your blood glucose levels. Even if you don't know how to interpret them your care team definitely will, and will base any treatment decisions on that.

Our centre delivers at 38 weeks if c-section is required or if on insulin. Sometimes if the baby is measuring large it would be at this stage too. Otherwise it's by term date, never over.

Hope that helps - and good luck.

Andanotherthing123 Sat 23-Nov-13 07:47:28

Crikey, I can't believe there's such different advice about mmls - it's also completely different for my type 1 son, who aims for 4 to 8 and anything below 4 is a hypo and needs treating. He also sees levels of 14+ mmls on a weekly basis, so 8 seems great in comparison, although I can see it isn't for GD.

Thanks for the advice about the finger pricking - will defo try the warm water and curlywurlyllass I'll buy a pair pair of man pants for us both - is good excuse to get DH to look after the kids while I go off shopping today!

I'm trying to fathom my way through the diet thing and have reconciled myself to no more sherbet dips till baby arrives sob.

I'm booked in for an ELCS at 39 weeks because I've had two previous sections - does anyone know if they would look to do it at 38 weeks or if the 39 I'd still ok?

BTW, it's very nice to meet you all, and thanks for helping me out with info!

TarkaTheOtter Sat 23-Nov-13 06:51:16

If you run your hands under warm water first you can get away with a smaller setting on the, ahem, "pricking bit". Also, you have more blood the further on you get in pregnancy so again you might be able to get it on the smaller setting by the end and it hurts a lot less.
Oh, and drinking lots of water helps too.

TarkaTheOtter Sat 23-Nov-13 06:48:07

I found testing dh's blood sugar really put it in perspective for me. An hour after eating Christmas dinner (including pudding/chocolates etc), dh had a reading of 6.2. It really helped me realise how high 7 is for a non diabetic.

TarkaTheOtter Sat 23-Nov-13 06:45:20

Here is a link to the NICE guidelines. Fasting should be between 3.5-5.9 and 1hr after eating should be below 7.8.
Interesting that some hospitals are setting stricter guidelines.

curlywurlyllass Sat 23-Nov-13 00:20:47

I have been told they want my levels between 4-7
They didn't specify before or after meals but were very concerned about levels over 7. I had been given no diet advice and breifly talked thru doing the tests before meals one day then 2hrs after meals the next. At my next appointment (5days later and a few levels over 7) i was put on metformin and given diet advice.

Hope you can get your man up pants on-and advise me on where to get some as im struggling big time with finger pricks! Needlephobic big time lol

SidandAndyssextoy Fri 22-Nov-13 23:58:48

I know some hospitals let you be 7.8 two hours after eating, so you can see that my bunch were tough!

Are you pricking the side of your finger? Far fewer nerve endings there.

Andanotherthing123 Fri 22-Nov-13 23:48:01

Ah thanks, that's really helpful! My fasting was 5.2 and 8 an hour after eating yesterday. Have failed to test today as I wasn't sure what those meant so it seemed pointless, but will get back on it tomorrow (although I have found myself dissapointingly wimpy with the finger pricker, which makes me feel ashamed as my 6 year old has to tough it out with diabetes and never complains...I have vowed to man up!).

SidandAndyssextoy Fri 22-Nov-13 23:38:40

For me, fasting levels were 3.5-5.5, and under 7.0 an hour after eating. I know levels vary between hospitals, and some do two hour testing and others an hour, and some pre-meal levels, but my hospital is one of the strictest so I don't think you can go wrong following those numbers till your appointment. Good luck.

Andanotherthing123 Fri 22-Nov-13 23:33:12

I found out this week I have GD and have got an appointment wed next week when I'll get all the info about what to do. But I've been looking for the mml level in the morning and an hour (or should it be 2 hours?) after eating that I should aim for.

I've got the testing kit as DS1 has diabetes but GD is so different in what to aim for and I haven't found the answer online like I hoped I would.

Could any of you lovely ladies enlighten me please?

Many thanks in advance.

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