Gestational diabetes anyone?

[YouAndMeAreGoingToFallOut]

I'm 28 weeks pregnant and yesterday I had a GTT because of higher BMI and family history of diabetes. My midwife called this morning to say that unfortunately my fasting blood sugar level was just over the limit (my 2 hour level was fine). I've been given an appointment to see a diabetes nurse on Tuesday, and a consultant a week on Tuesday.

I'm absolutely gutted - I've been worried about this since before I even got pregnant and now it has happened. I feel so sad and guilty.

I've been looking at Gestational Diabetes UK and they have tons of diet advice: I feel that I should be able to cope with the diet. I'm mainly upset about what this will probably mean for the birth, and the risks to the baby.

Anyone else going through this?

[babynumber3eek]

Yes, you are far from alone!

I would suggest reading as much diet info as possible and ignoring diet info given by the NHS (avoid cereal for example - the NHS thinks it's fine!). It's easier said than done, but try not to worry. If you can keep everything controlled then the risks to baby are minimal, undiagnosed GD is far more dangerous. And if at some point you can't control with diet then don't feel like you've done anything wrong or failed in some way. Hormones are 'wonderful ' things and some of us just need more help (I'm on insulin ).

[YouAndMeAreGoingToFallOut]

Thanks babynumber3eek. From what I've managed to read it does sound like the NHS diet advice is a bit bonkers - it looks like they will probably recommend the same low fat diet they suggest for everything and everyone.

I think I'm mainly feeling sad that this puts an end to my hopes of a lovely water birth at the MLU. I've got horrible visions of giving birth on my back strapped to a monitor with forceps and an epidural. And that feels like it's probably the best case scenario. I know it doesn't really matter in the grand scheme of things, but it isn't what I was hoping for I suppose.

[wonkylegs]

Cereal is fine for me and rarely affects my sugars, potatoes send them crazy. You may find what works for one person doesn't work for another.
I'm on insulin because my GD is steroid induced so is harder to control with diet alone but they have kept close eye on baby and as its fine (steadily growing on 50th%ile) they have stuck with my original birth plans.
My hospital have been fab at explaining everything and answering questions. Its taken a bit of getting used to but honestly it's not too bad - although I'm craving pizza and jam doughnuts and will be having them as soon as I can once this baby is out

[YouAndMeAreGoingToFallOut]

I suppose there is a trial and error process. I feel a bit in limbo just now because my appointment isn't until Tuesday so I can't monitor sugars until then. I suppose I've just got to be sensible and not stuff my face with chocolate and cakes and hopefully it won't make too much of a difference until I can work out properly what affects what.

[babynumber3eek]

If you stick to high protein and low (but not no) carb then you'll be doing a great job. It is definitely trial and error and the frustrating part is that at times things you could tolerate you can't later BUT if you are monitoring and adjusting then you are doing everything you can.

There is no reason whatsoever to suggest your birth will involve interventions like you mentioned. Different trusts have different policies regarding going overdue etc but it's quite possible to not have to be induced etc and even if you are it isn't a given that it'll be an awful process at all!! Plus, even with the lowest risk pregnancy in the world there is absolutely no guarantee that you won't end up needing to divert off of your ideal birth plan!

[anontoday23]

I had GD with two pregnancies and didn't manage to control it with diet either time and ended up on insulin.

There are a couple of misconceptions about GD that annoy me. One is that it is somehow your 'fault'. Yes you are at increased risk if overweight but you can also get it if stick thin. With my first baby I was a size ten and running half marathons when I got pregnant. I am not a medical expert but it's all to do with your hormonal response and some people are just unlucky. So pls try and not feel guilty or sad it's just life - and also if you can't control it with diet it's again not always your fault - I tried and tried to control it with diet but I couldn't eat anything without it causing my sugars to go nuts so had to be put on insulin. The silly midwife who said to me I just needed to drink less Juice (when I didn't touch juice ) made me livid- I did feel there was a lot of mis information about it and some people thought I had brought it on myself which was annoying.

Putting baby to bed will come back...

[YouAndMeAreGoingToFallOut]

I feel more positive today. I've started following the advice about diet from Gestational Diabetes UK (high protein, lower carbs, small frequent meals). Obviously it's total guesswork with no blood sugar monitor yet, but it's a start. This isn't the worse thing that could have happened, and I'll be able to cope.

To be honest I think I took it so badly yesterday partly because it feels like the next in a long line of crappy things that have happened this year. I had a lot of worries about cervical shortening earlier in the pregnancy, with a lot of extra monitoring. Luckily I didn't need a cervical stitch in the end but have been on progesterone pessaries since 17 weeks.

My dad had a stroke when I was 16 weeks pregnant (at exactly the same time as the cervix trouble kicked off) and then unfortunately he passed away when I was almost 21 weeks. So it's been a rough few months for the whole family really, and this just felt like a bit too much to cope with. But it isn't that awful, and it will be OK!

[MrsGlam]

Really sorry to hear about all the issues you have benefits having and very sorry to hear about your dad.
I was diagnosed with GD at 34+1 weeks after a clear 16 week and 28 week GTT.
I can control my day time sugars with food alone but my overnight sugars first thing in the morning were always higher than they would like but not drastically so..I am now on 2 x 500mg meteformin at evening meal and 8 units of Insulin before bedtime which is controlling it nicely now.
I was like you and having GD was just the icing on the top of the cake..(Two late miscarriages previously so I was doing weekly swabs and urine tests progesterone suppositories from 14 weeks..I have had 9 scans and SPD)
I am actually turning it in to a positive and being induced on Monday which I will be 38+3 weeks so I only have 3 daysish until I get to meet our baby!
I have prepared myself for induction as much as possible but it's not easy when it's not what you wanted.
Wishing you all the luck with your GD I hope you can control it with diet but don't be disheartened if you have to go on Metformin and or Insulin it's really not as bad as you think it will be.

[YouAndMeAreGoingToFallOut]

Given that it wa my fasting level that was over the limit I wonder if I might end up following a similar pattern MrsGlam. I suppose there's no real way of knowing how it might go. Good luck for Monday!

I feel very much in limbo at the moment as I don't see the diabetic nurse until Tuesday, so until then I've got no way of knowing what might be happening with my blood sugars. I'm making adjustments to my diet, but am quite scared of how it might go when I actually start testing: I have a fear that it will be hellish and I will end up hardly able to eat anything!

I'm also worried that they might be mean. So far all the midwives and obstetricians I have dealt with have been very nice, but I'm dreading being made to feel like this is all my own fault for being overweight, and also having to be regaled with a big long list of horrible risks and potential complications. I have done my own reading and am aware of what they are, and of how important it is to take this very seriously. I don't want a scary doctor laying it on with a trowel about risks of stillbirth!

[babynumber3eek]

In my experience they won't be like that at all. In the nicest possible way, you are worrying about something that is very unlikely to be the case and stress levels can play havoc with blood sugars, so please try to stop putting extra pressure on yourself.

My team made it very clear that plenty of 'gym bunnies' end up with GD - it's a hormonal response that can affect anyone. I was expecting all manner of starchy 'advice' but got none. I even got told to eat cake by my dietician if I was having a bad day (husband seriously ill in hospital) but adjust my insulin appropriately! Please try to relax as much as you can...

[YouAndMeAreGoingToFallOut]

Thanks - I know you are right. I'm an incredibly anxious person at the best of times tbh, and I was in a massive state about the GTT, which probably didn't help the levels in the end!

[APotterWithAHappyAtmosphere]

I had GD and was never made to feel bad about my weight. The session I went to after it was diagnosed was full of women of all sizes.

I reiterate what a pp said - if it can't be controlled by diet it's not your fault. There is a misconception that it always can and should. In fact when I took my diet sheet in to the dietician she said I wasn't eating enough carbs and needed to add a slice of wm toast in and a bit of brown rice or pasta as I had cut down completely.

I had only been just over the threshold with my fasting GTT but it was that morning sugar level that couldn't be controlled so I did have metformin and eventually insulin. Because of that, I was told I must try to have the baby 2 weeks early, this was stressed to me repeatedly. When I went in for induction, suddenly the whole attitude was, "oh well it might take a week or so", and then after 4 days of pessaries and contractions but no baby, "you can always go home and come back next week". I was so confused and stressed I ended up having a CS, which I didn't want. I am sorry that's not more cheery but I just want you to be prepared for the pregnancy focus to be different to the birth one as it was a shock to me and I wasn't myself at all for the week I was in hospital and wasn't prepared for the decisions I would have to make.

DS is now a gorgeous 3-yr-old and of course all that matters is he was born safe and well.

[Kpo58]

The scariest part of GD is waiting for that first meeting before you get the blood sugar monitor (I burst into tears at that meeting before the specialist midwife even said anything!).

I've been having to monitor my bloods since about 15 weeks and until recently it was just diet controlled. I also have to have a check up with the specialist midwife fortnightly and had the extra scans (growth has been normal). The important thing to remember, its only those who don't monitor their blood sugar levels that are likely to get complications, not those who do.

You will still most likely to have a normal birth (unless you have any other complications), its just they are unlikely to let you go over your due date.

[HTKB]

Hiya, I had GD this pregnancy. Baby now four weeks old.

I was only slightly over on my post lucozade glucose.... Ended up on a shit ton of insulin and metformin. Just couldn't do it with diet at all. Was induced at 39+1 and had a 2 hour labour in the MLU..... Admittedly I wasn't supposed to be there but things moved quickly! At my trust if I'd kept it diet controlled they treat you as low risk. I was never made to feel bad about my weight, my BMI was 30.

Please don't get into the mindset that you will have to restrict and restrict and you must control with diet. You just might not be able to, and you need to eat! I followed what they told me to eat to the absolute letter (small portions of starchy carbs, lots of protein, low sugar) and it didn't work, but their response was that I needed treatment, not that I needed to further restrict. It's a malfunction of your placenta and may not be in your control.


On the plus side, the day after I gave birth I was 5 kilos lighter than the day I got pregnant! And I'm continuing on the low sugar, high protein thing and feel really good. X

[SaltySeaBird]

I had GD with my first pregnancy. At the time of falling pregnant my BMI was in the normal range and I was running quite long distances several times a week - I could run 10km without breaking a sweat, I was very fit.

I have a family history of diabetes and couldn't control it with diet so went onto insulin, but I did follow a fairly strict low GI diet to help minimise the insulin I required. Read up on diets and try to be as healthy as you can, but don't beat yourself up over the odd treat - I used to ration out some Malteasers to suck on after meals as something sweet!

DD's birth was a normal vaginal delivery, no instruments and just gas and air. It was long and I wasn't allowed to go to a MLU or have a water birth due to being on the insulin sliding scale (glucose and insulin drip).

For me the diabetes didn't go post-birth and I have remained on insulin ever since, including through a second pregnancy which again required a lot of management. That one ended up with a crash c-section and was a horrible experience, but we were both fine so even a bad birth had a good end result and I'm sitting breastfeeding my newborn now.

In my experience I'd reassure you it will all be fine, you'll get tons of extra care and scans and it is actually quite easy to manage and deal with.

[SaltySeaBird]

I have a fear that it will be hellish and I will end up hardly able to eat anything!

Just to reassure you on this; you have to be able to eat a normal, albeit healthy, diet. If your blood sugars are high while eating normally you will be given insulin to help balance it out - they won't make you starve or just eat salad the rest of your pregnancy!

[AliceInHinterland]

Hi - it's my second pregnancy with GD and I feel much more relaxed about it this time. Last time I was so ashamed and cried about it loads, this time I'm more familiar with what I can eat - and have only cried when on a family holiday where everyone was eating croissants! I definitely believe stress is a factor, which in your case seems totally out of your control - I'm so sorry about your dad. I find that 1/4 plate protein 1/4 plate green veg (or salad) and 1/4 plate low GI carbs (beans, root veg) works for me - apart from breakfast where I can't have any carbs at all! If you want to remain diet controlled I would keep a record of what you think triggered any high readings - so if potatoes are obviously the culprit, tell the nurse you will swap them for cauliflower in future. Keeping active (just brisk walks) is important. And read the NICE guidelines, and know your rights about birth - they need your permission remember! If you push them when they start going on about still birth etc then you will find that it's actually a very poorly understood area and that as pp said the additional risks for well-controlled GD seem minimal. Good luck and once you've started testing just ask for any food tips.

[YouAndMeAreGoingToFallOut]

Thanks everyone! I will let you all know how the appointment goes on Tuesday. I think this has made me realise that actually I was feeling pretty low anyway but was trying to just ignore it: delayed grief I suppose.

[ItsLikeRainOnYourWeddingDay]

Go to a fantastic Facebook page called gestational diabetes uk mums. There is also a closed group absolutely masses of info and support.

GD is a frightening diagnosis but you will be well cared for. I was diagnosed at 28 weeks last pg and o stayed diet controlled until my baby was born. Hopefully a few diet changes will be enough for you as well.

You have to take it seriously though. Be careful with diet and consistent with blood sugars and if all normal and baby is measuring ok on growth scans there is no reason you can't have a midwife led birth. The only thing that will be different Is that baby will have 2-3 hourly blood glucose levels or make sure he/she is OK after birth. If you do end up in medication you will likely have a consultant led birth.

[Cakeymum]

Hey
GD with first pregnancy, and they have got me to monitor my sugars from 14 weeks with second. they just assume you will get it, no GTT this time. Diet controlled first time and so far so good with second (25 weeks tomorrow) although morning fasting is creeping up

You will find it trial and error to begin with, what is fine one day will push you over a few days later. I am Ok with 2 slices of brown bread with peanut butter, but without the peanut b is close to being over for example.
Some fruit is ok, some isn't, some cereal is OK early on, some isn't, combine carbs with protein, - they usually allow you some margin for error in the first weeks as you get to know what your body reacts to

and wash your hands before testing your sugars would be my hint!! stuff on your fingers can give you a higher reading

DO NOT feel guilty. Out of 8 NCT mums, 5 of us were GD and we ranged from slim to chubby - there was nothing any of us could do.

Oh - and the plus side is you don't put on as much weight! at 25 weeks I have put on 3lbs, and with DS1 I was 7lbs lighter after giving birth than before i even got pregnant :)
And you get extra scans

Good luck Tuesday and don't panic!!!

[YouAndMeAreGoingToFallOut]

Had appointment this morning, in a group with 2 other women. Turns out my fasting level was actually quite a bit above the cut off - 6.3 when cut off was 5.1. My second reading was only 6.0! So well within the limits.

I've been sent off with a monitor and instructions to test before breakfast, lunch and dinner, and 2 hours after dinner.

We were also all given a packet of metformin (vote of confidence there!). The nurse will phone on Friday and if she isn't happy with the levels then it's straight on to meds. Not sure how I feel about that - might be prepared to argue the toss depending on what the readings seem to be saying. I suspect though that I might never get that fasting level under control without medication.

[lilygirl81]

I'm glad I found this thread, I have my GTT in 2 weeks after there being a lot of fluid showing on my latest scan. I'm fairly sure it will come back positive, I've had a horrendous time with this pregnancy so seems about right, plus I have been so thirsty and having funny turns if I have too much sugar, though this might be coincidence.

[AliceInHinterland]

You can normally buy the starter kit for blood testing quite cheaply or even free online (to hook you into buying the expensive sticks!) I did this to give me a head start on understanding my own blood sugar responses.

[CheeseandGherkins]

You should be testing an hour after meals, not 2, it's what (afaik) nice recommends and when I've been told to do. I have GD and am on insulin, have been since 12ish weeks and I'm now almost 20 weeks.

I've had it in my past two pregnancies from around the same gestation and also been on insulin both times. Sadly, I went undiagnosed with GD (so my consultant thinks), the pregnancy previous to those and I had a stillbirth at 37 weeks.

I am careful monitored now and am very careful with what I eat. I'm a size 8 and pretty much always have been, no reason for the GD that they can see and always comment on how unusual it is...not very helpful!

Insulin isn't all that bad tbh, you do get used to the injections and the testing becomes second nature. I do still get frustrated at times and upset about it all but I try and remember that it's for the best and that it won't be forever (hopefully).

I was induced with my dd3 at 33+ weeks due to the GD being unstable even though I was doing everything I could and that only took half a pessary. Long story but she ended up being born 45 mins after I arrived back at hospital after the inducement didn't work and they let me home for the night as scbu was full. She ended up in nicu on cpap for a while and around 2 weeks in total before coming home. The birth was easy, no tears and no assistance. She weighed 6 pounds as well!

Dd4 similar happened but a bit later, she had to be born due to the GD and this time I couldn't face the induction again (nothing went wrong with my previous one but I was having flashbacks to my inducement with dd2, who was my stillborn baby and I just couldn't cope with it. She had already gone so I was induced knowing that and it was just all too much) and so my consultant agreed to do a section. All went well and I was home with her after about 28 hours, her blood sugars were perfect after she was born, weighing 8 pounds at 37 weeks, and I recovered well.

This time I'm hoping for a vbac but it all depends on what happens with my sugar levels and growth scans later on. I don't put on much weight during pregnancies either, I have to eat more than I was before to get the carbs in as they want me to eat a set amount at meals and snacks.

Happy to help if I can and sorry for the epic post.

[MrsGlam]

Hi ladies
Just came on to say I had my induction started on Monday afternoon and my little boy was born at 23:57 Tuesday evening by forceps delivery in theater due to getting good a little stuck! He is doing so well and I managed to control my levels all the way during labour without any help..I was on Metformin and Insulin which have now stopped Yay!
Hope you are all doing as well as you can and hope my bit gives some hope that you don't always end up needing help in Labour!