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Support thread for those diagnosed with Gestational Diabetes

(371 Posts)
HighFibreDiet Sun 22-May-11 01:19:06

Hi, it seems there are a few of us around and I wondered if you wanted to start a support thread? There seemed to be a good thread going through 2010 but I can't find one running at the moment.

My due date is 17 July. I took the OGTT at 30 weeks (not realising that the best time for diagnosis is supposed to be 24-28 weeks). I was only diagnosed last week, given my blood glucose monitor on Thursday and have been trying to tweak my diet to bring down the readings since then. Seeing my midwife today and have to phone in my readings next week to see what they make of them!

My main problem seems to be the fasting blood sugars and the endocrinologist I saw on Thursday said if I couldn't keep them consistently down, I would go on insulin, with 'no negotiation'. sad

Would love to hear from other pg women with GD, or those who have been through it before. I'd also like to compare how the antenatal 'care' varies with country, as I am in Australia and it seems extremely strict over here (e.g. my fasting blood sugar levels have to be under 5.0 mmol/l).

Looking forward to getting some responses smile

expatnow Sun 22-May-11 04:12:05

Great idea. I haven't been officially diagnosed with GD, but am on the borderline and so trying to be careful with my diet and being monitored. I am in the Middle East and they also seem very strict here because it is such a problem with the local population. I had my GTT at 28 weeks (everyone has it here regardless of any other indications) and my level was 8. Last week's reading was fine (4.6 for fasting and 5.5 after 2 hours). The doctor at the clinic said this was fine, but then the OB/Gyn at the hospital said that it wasn't great, so a bit confused!

Maybe we could share ideas about foods, meals etc would be great. I'm just trying to eat a bit more often as I do tend to go ages without eating. Only eating multicereal bread and cutting down on carbs generally. No sugar in my tea anymore! and no juice. I was drinking a fair bit of watered down juice before as I was told I had a vitamin defficiency and also to drink juice with my meal and it is so, so hot here that I have to keep drinking all day.

3kidsnobump Sun 22-May-11 08:15:41

Hi Highfibre and Expat. I will definately join this thread!

Am 26 weeks with no.4, and was told just over a week ago I had GD (not had it with any previous pregnancies). Have been glucose testing for alost a week now.

Not doing too bad with keeping the levels down, except in the morning, when it is always over after breakfast. Highfibre your levels must be different in Aus than here in the UK - my fasting levels have never been under 5, but the level here is under 5.9!

Incidently, has anyone been given Metformin to take? I was told on Fri I needed to take it, but when I collected it and took it home, says on the leaflet 'do not take if pregnant?!'. As it was Friday night by that time, diabetic nurse then not available until Monday, so haven't taken any yet, thought I would wait until Monday when I can talk to them about it. Just wondered if anyone else had taken it?

ZimboMum Sun 22-May-11 08:28:35

Im not currently pg but had gd with DS. I took metformin from 30 weeks and believe it is an alternative to insulin.

belfast80 Sun 22-May-11 10:47:31

Hello! I have it too. I am 30 and am currently 35+5 with first DC and was diagnosed at 31 weeks and so far have been able to control it with careful diet. My DP is type 1 diabetic so it's probably been easier for me than most cos I've been cooking for him for 11 years so I have a fair idea of good/bad carbs/portions etc.
I've lost nearly a stone since monitoring my diet. Drs are not worried because baby is growing OK (and secretly I am slightly pleased as I will probably be lighted when I give birth than I was when I got knocked up which will spur me on to lose the rest of the weight I need to!).
Not sure about metaformin, I have to send my blood results weeky to a diabetic nurse and she is trying to put me on insulin, despite the fact my levels are mostly normal and the consultant is happy with my results.

Firawla Sun 22-May-11 10:58:03

I have it aswel, my gtt came back borderline but like you i have had really high fasting levels so i think i do have it? I have my first appointment with the diabetes clinic tomorrow, and a growth scan, so will see what they say. My levels have been coming out all really high for the fasting, and after food ones generally okay but a few high ones. So I wonder if they will put me on insulin aswel then confused
the diet thing is weird, i am trying to improve and control it a bit but it seems to make no difference?! for eg if i have had something that i think oh hmm it should be high after this, it most of the time has come up okay but just the fasting ones come out soo high although i have eaten nothing?!

good idea to have a support thread so we can all chat, because it can be a bit confusing.

i am due in august i think im something like 28 weeks? (i lose track blush ), its my 3rd baby but first time ive had diabetes, my 2nd baby was quite big though so after i had him community midwife asked are u sure u didnt have it? soo maybe had it mildly undiagnosed or something.. or he might have been just naturally big. oh and i am in uk

oinkyoink Sun 22-May-11 12:55:13

Is the diet you're allowed very dull when you have gd? I have my test in the morning and am hoping it's not positive. This is due to big baby but dh is tall so let's see! I have to say though I'm constantly dehydrated no matter how much I drink so that's not a great sign... Just wondering what foods I'll be allowed if test is +ve??? Thanks

Firawla Sun 22-May-11 13:05:18

oinky i found they wont give out a specific diet? i asked mine like can i have a list of foods all to avoid, foods that are definitely okay etc and they said no as different foods effect people differently so just gave some general hints? not sure if its the same for everyone or whether some hosp will give something more structured

squirrel007 Sun 22-May-11 14:04:30

Hi everyone! I just got diagnosed too - had high blood sugar at 28 week bloods, so took the GTT at 31 weeks (bank holidays in between hence the delay). Now I'm 32w4d and have been monitoring my sugar levels for a few days. Fasting levels are fine (I've been told below 5.5) but I have to keep levels below 7.8 after meals, and I've gone over a couple of times. But, I think I'm slowly working out what foods are good and bad.

Luckily I do eat quite a lot of 'ok' foods anyway, I just need to tweak the portions and cut down on the carbs at main meals. I'm veggie, so quite a few of my meals are carb-heavy! I am noticing though that I'm having to snack a lot more throughout the day, and without regular snacks I just get grumpy and irritable (poor DH!). And it seems like I can eat much larger portions of carbs in the evening than I can earlier in the day.

I've been eating more cheese than I normally would, and I've discovered that eggs are great for breakfast. I used to eat a lot of yoghurt but that's quite high in sugar sad the little mini petit filous tubs are a good alternative for a quick fix! And I've just bought some hummous and have a big tub of chopped veggies in the fridge for snacking on. Am looking around for other snack ideas though smile

belfast80 Sun 22-May-11 22:05:19

I've found that by eating loads of salads with a small granary roll, meals with wholewheat pasta or sweet potatoes (lower carb than normal potatoes) I can keep my levels on track. Breakfast is one piece of granary toast every morning with either ham & cheese or a couple of eggs. I've found that I actually miss fruit and fruit juice more than cakes etc. but the odd three strawberries or half a banana or so keeps me getting the good stuff from fruit without raising the levels. Mullerlight yoghurts are the only yogurts my hospital recommends and I throw a spoonful of crushed flax seeds in..to make sure the oul constipation doesnt get too bad.

midori1999 Sun 22-May-11 22:27:25

I was diagnosed at 24 weeks and am not 33+5, so used to things now really. I am insulin controlled as it was impossible with diet alone and I actually got a huge lecture from the dietician about not eating enough carbs. blush There's no way I could control without insulin now as even though I stick to the diet I am supposed to, my insulin requirements have gone up and up. I also didn't gain any weight at all until last week and even then only a couple of pounds, about 3/4 of which was baby!

I wasn't given a diet sheet as such, but told to carb count and stick to wholegrains/wholemeal versions where possible. The dietician said to have 180g of carbs a day, 40g breakfast, 50g lunch, 50g dinner and then 10 each for 3 snacks and the other 10 for milk in tea and coffee. She also said I could be a little flexible if I needed to.

An average days food for me consists of:

Breakfast: 2 slices of seeded toast with two boiled eggs or small bowl of museli.

Lunch: wholemeal pitta bread with greek salad or toasted with cheese and ham/cheese and salami and some celery, cucumber, radished, avocado etc, plus a weight watchers youghurt or piece of fruit or packet of crisps.

Dinner: Salad with a few new potatoes in their skins with some meat or fish. Or home made chilli with brown rice or wholemeal pasta with chicken, pepper and pesto. Then maybe a yoghurt or sugar free jelly. Occasionally a scoop of Ben and Jerrys. (which doesn't seem to affect my readings!)

Snacks: weight watchers yoghurts (about half the carb value of mullerlights) fruit (was told up to three pieces a day) nuts, chocolate peanuts, veg and hummous, glass of milk. whatever makes up 10g of carbs.

Hope this helps someone.

3kidsnobump Mon 23-May-11 10:12:37

Morning everyone. Looks like there are quite a few of us here! AT least I have someone else to chat to about this. Didn't realise what a pain this would be!

Well I have phoned the hospital this morning to ask them about these tablets - waiting for someone to call me back! What I find completely ridiculous is that they are quite happy to dish out tablets, but my appointment with the dietitian isn't until the 9th June. Would have thought I should be seeing them first to check what I am eating is ok, before taking medication!

Is anyone else really starving the whole time? I am so hungry - but if I eat anything very much it seems to send me over the limit (my ones after breakfast are always over anyway!)

Midori did they say anything about not putting weight on? I weighed myself yesterday (don't normally bother when pregnant, as I just assume I'm going to get heavy anyway!) and I am actually 10lb lighter than before I got pregnant. On the plus side, at least I won't have as much weight to lose once I've had the baby. Guess for every negative there has to be a positive wink

midori1999 Mon 23-May-11 10:53:40

They weren't very happy about it at first, but then were when they were confident I was eating enough carbs.

Metformin isn't trialled as safe for pregnant women (like all medications really) because it's unethical to test on pregnant women. However, it is widely thought to be safe because it has been used on pregnant women with no adverse or ill effects for so long. My unit prescribe it, but didn't in my case as they said it takes too long to see the effects and I would probably end up on insulin anyway.

I mainly have problems with my fasting readings and my after breakfast ones too. I struggle to increase my insulin fast enough to keep my readings down and my fasting are always in the high 5's if not over 6 and my after breakfast readings have almost always been over 8.

I too get hungry. I try and fill up on protein foods if I am hungry as they dont' affect your sugars too much. So, for breakfast today I had a 4 egg omlette with cheese along with my measly portion of museli. Then with lunch I'll add in some cheese/cooked meat if I am hungry. You do get used to the smaller portion sizes after a while though and I actually had to take some food off my dinner plate last week as it looked too much! grin

3kidsnobump Mon 23-May-11 12:38:25

Well hospital phoned back and said yes - definately no reason not to take, so guess I will have to take their word for it!

Midori my fasting readings are usually high 5's and have never had a breakfast one lower than 8 - has been over 11 some mornings hmm. So guess I will see if the tablets make it lower then.

Think I am just having a bad day. Am so flipping hungry, and I know I am being really grumpy with the kids but is very frustrating when I am trying to be really careful but still struggling to keep the readings down. Worst thing is with normal dieting you can at least give yourself a break and just eat a load of rubbish to make u feel better, obviously not allowed in this case! Roll on August...

oinkyoink Mon 23-May-11 13:25:00

I hammy gd test this morning (two blood test and lucozade in between). I've to wait a week for the results- is that normal? Seems like ages if there is an issue. Hmm... How long did you have to wait?

oinkyoink Mon 23-May-11 13:25:26

*hammy = had my smile

HighFibreDiet Mon 23-May-11 14:10:36

Wow great to see so many people on here smile although not so great that we're all going through this I suppose.

I have found that my post-breakfast readings are very high unless I really minimise the carbs - I can probably get away with half a slice of toast but only just. I have been having omelettes with mushrooms and onions or whatever leftover veg is in the fridge, plus cheese too. Like squirrel007 I find I'm eating a lot more cheese than usual. And like midori I am getting used to the small portion sizes. In fact I tried making myself porridge with the recommended amount of oats and it was far too much for me to finish.

The dietitian did say to try to eat low-fat versions of milk, cheese, yoghurt etc. but I am sceptical about this and think it's not really specific to GD, just that they prefer to recommend low fat foods to everyone. They also specified which sweeteners we should or shouldn't use and when I queried whether the forbidden ones were anything to do with insulin production they said, no it was just that the 'bad' ones had been linked to cancer if consumed in huge amounts. hmm. Not that I eat artificially sweetened food anyway.

Anyway my 'typical' meals so far are:

Breakfast: veg omelette with cheese and maybe half a slice of wholemeal sourdough bread;

Snacks:nuts and seeds, a pear or apple, or something like raw veg with cheese or hummus, or wholemeal sourdough bread with peanut butter. A small piece of dark chocolate (>70% cocoa) is also fine. I always have a snack straight after my post-prandial blood sugar reading grin.

Lunch: Loads of salad with different veg and seeds, plus some protein (usually fish or chicken) and a few carbs (bread or chickpeas, but not too much)

Dinner: Meat or fish with veg and sweet potatoes.

I know about the risk of ketosis if you don't eat enough carbs but I don't think I'm getting to that point yet. I don't feel hungry, anyway.

I am quite pissed off about how strict my levels are: they are not only lower than the NICE recommendations but also the regulations for the Australian state we are in (NSW). So next time I go in if they dare say I'm not doing very well I will ask on what basis they suggested their levels in any case. It's almost like they want me to go on insulin rather than giving the diet and exercise a chance (similar to putting you on metformin straight away, Midori).

Apparently the huge rise in testing for and diagnosing GDM is due to someone finding a link between stillbirth and undiagnosed diabetes. But a review paper I found from last year said that the only statistically improved outcomes between managing GDM and not were the rate of shoulder dystocia and macrosomia (big babies). Other outcomes like hypoglycaemia in the newborn, perinatal death or birth trauma weren't shown to be affected (at least not to any statistically significant level).

My midwife also said that exercising after 8pm, preferably as close to bedtime as possible, and making sure you exercise the large thigh muscle, is a good way to lower the fasting rate. She has a research paper all about this and I don' t have the reference but she said she'd try to get me a copy. Apparently it also explains why fasting levels can get so high overnight, which would be a good thing to get my head around.

I did 30 mins on our exercise bike tonight and some other exercises which my physio has given me to do. I saw a physio a while back as I also have SPD. I'm going to see her again this Thursday and see if she has some more strengthening exercises to recommend. At this rate I'm going to be pretty fit by the time I go into labour!!! The midwife also said that, if nothing else, at least having this diagnosis will mean the baby doesn't end up as large as it might have done. My babies have steadily got larger and ds3 was 4.03 kg and not a terribly easy labour (although still vaginal and at home).

Anyway a bad night's sleep can also affect fasting blood glucose levels so I'd better get off to bed now smile

Looking forward to hearing more news from everyone next time I log in.

midori1999 Mon 23-May-11 15:03:54

3kidsnobump I was the same. I tried everything to lower my fasting, a walk before bed, protein snack before bed, no snack before bed, nothing made a difference. I still get readings of over 10mmol occasionally now even on the large amounts of insulin (started on 3 units with breakfast, now on 17) so goodness knows what they would be without it. My clinic only worry about lots of readings over, not the occasional one. Maybe the Metformin will help. Otherwise I am guessing you could request insulin instead of the metformin if you were worried about taking the metformin in pregnancy? It was always my preferred option. It makes life so much easier as instead of worry so much about what I eat, I eat the amount of carbs they suggested and then adjust my insulin accordingly. It also means if I do want the very odd 'treat' (meal out with desert for example) I can adjust my insulin to keep my sugars in order. (the clinic said to do this, I'm not simply being irresposnsible! grin )

oinkyoink I had my GTT at 8am and then saw my consultant that afternoon and they already had my results in. I hadn't expected them so fast. The DAU that did the GTT did say to ring after 6pm that night for the results if I hadn't heard anything though, although also said they may not be back.

highfibre did the dietician give you a guide to how many carbs to eat? I was previously having a similar diet to you and they really tore strips off me about it, saying it wasb't enough carbs at all and I must increase them. I am lucky though in that my dietician is also pretty realistic and said the main thing was controlling the carbs in order to control my sugars and not to worry too much about anything else for now.

My babies have also been big. DDS2 was the biggest at 4.540KG when he was born at 38 weeks and I didn't have GD then. (they tested me) This baby was estimated at 2.5KG (5lb 10) at 33 weeks, so is on track to be around 4KG/9lb, but her measurements are all ahead, not just her AC, so I personally think her size is just down to the fact I have big babies and not the GD. I do think they panic about shoulder dystocia etc. I delivered all of mine vaginally with no problems, not even any tears or stitches. I love big babies and am looking forward to another one! grin

Firawla Mon 23-May-11 15:16:20

interesting to see people's mealplans and what your eating etc, i will have to copy some ideas
i had my apt with diabetes clinic today and prescribed metformin, the dietician said because its mainly the fasting readings that are high and not the after food ones, then its not as much diet related? i have to admit my diet is not that great and i do eat a fair amount of carbs so wil prob try to start reducing them anyway, as she said i will probably have to reduce them more as pregnancy goes on because the readings are likely to start going higher as time goes on..
had a scan and baby was an okay size altho on the bigger side of average, but midori like you my last one was naturally big anyway (4.3 kilo)
high fibre thats good to know about exercise bike in evenings i will have to try that, i was doing that daily before pregnancy but have not done it at all since, as i was using pregnancy as an excuse for laziness really... dietician just told me it can be reduced by increasing walking but i already do walk a lot daily, so maybe nightly exercise bike riding would have more of an impact

squirrel007 Mon 23-May-11 18:59:14

3kidsnobump I'm hungry too! Feel like sometimes I'm only just eating enough to stave off the hunger, and if I don't eat regularly then I get really grumpy and irritable. Plus the hunger comes on suddenly, without warning!

highfibre I've been trying to fit in some exercise but I'm not sure that walking is enough. I might have to follow your lead and dust off the exercise bike!

midori a 4 egg omelette sounds great! I've found that eggs for breakfast are the best (fill me up as well as give low readings) but does anyone know if eating 2 or more eggs every day is ok?

oinkyoink I had my test on the Thursday, and got a letter the following Monday telling me to go in on Tuesday. I think if there's anything wrong they should get back to you quickly.

I'm frustrated today because I had exactly the same breakfast and lunch as one day last week - then my readings were fine, but today for some reason the post-lunch one was high?!

3kidsnobump Mon 23-May-11 19:55:50

Evening all,

Well just took the Metformin tablets with my tea, and my hour after figs were lower than normal, so that is definately a good sign. Test will be in the morning, as it is always worse then, so will see what they are then. Just hoping I don't get any of the horrible sounding side effects which taking the tablets can give you...

Squirrel I have also found that - even though I have eaten the same thing as on other days, my levels are higher sometimes than others! Doesn't seem to be an exact science to this!

Oinky I had my test on a Tues, and they rang me on the Friday, but I didn't see the nurse to get the blood testing kit until the Monday, so was almost a week before anything was done about it anyway! Am guessing if it was really bad they would tell u sooner?

Highfibre that is interesting about the stats. THis is the first time I had the GTT, but all my other babies have been fairly big - DS1 was 9lb and not even 38 wks when born, so I do wonder if I had it before, but just wasn't picked up? Also have never had any problems with delivery, except for DD, when I was induced for pre-eclamsia, but I thought that must be down to induction and her being my first baby, as she was actually the smallest out of all the babies!

What has everyone else been told regarding induction? Haven't seen the consultant yet, but diabetic nurse told me the other day that they won't let you go over 38 weeks.

Firawla Mon 23-May-11 20:01:40

3kids what are the side effects?! i didnt even read the leaflet or anything, i just took my first one tonight with dinner too

i was told that would probably have to be induced bang on 40 weeks, at most they might let you have a couple of days extra? i hope mine will not have to be 38 weeks i need the extra time, we are still trying to find somewhere to live! :S perhaps it depends how the babies size is going based on growth scans??

3kidsnobump Tue 24-May-11 07:49:42

Firawla they told me can cause tummy problems - cramps, sickness, diarrhoea type things. Sounds lovely! Well not had anything so far, maybe I shouldn't speak too soon!

May the induction thing depends on the hospital policy as well. They do sometimes do different things in different areas. Am just hoping if I do have to be induced that it won't be anywhere near as bad as the experience I had with DD. Only plus point is that at least I will know when to get the other kids looked after if it's planned. No worrying about being left with 3 kids on my own at the last minute - unless it comes before 38 weeks of course!

squirrel007 Tue 24-May-11 19:31:51

3kidsnobump, I have just come back from the clinic where I saw the obstetrician - she told me that most people with GD get induced early so it was likely to happen. And it's normally earlier if insulin controlled (38-39 weeks) than if diet controlled. But, they don't make any decisions until 36 weeks. The nurse and midwife told me that it depends on a lot of factors and insulin doesn't necessarily mean early induction. But I think they thought I was scared of induction and were trying to reassure me!

The good news is that my diet is fine, bad news is that even with a good diet my readings are still high so there's a good chance I'll have to go on insulin. For some reason they didn't think metformin would work. I have another week to try and get the readings down!

My typical (veggie) diet now is something like
Breakfast: 2 scrambled egg, 1 slice wholemeal toast, fromage frais
Lunch: Innocent veg pot; chickpea curry and rice; halloumi salad; hummous veg and pitta
Dinner: Bean chilli and rice; lentil and tomato sauce with pasta; wholemeal wraps with beans, veg and cheese; veggie sausages potato and veg
Snacks: Apple; nuts; crisps; oatcakes and cheese or nut butter; fromage frais

HighFibreDiet Wed 25-May-11 05:10:13

Mmm squirrel your diet sounds lovely. Can you tell I used to be a vegetarian too? Just remember things like lentils and chickpeas will have a certain amount of carbs in them too - you can check the label to see how much you are having.

Firawla and 3kids I think the induction depends a huge amount on the hospital. The NICE guidelines say that induction can be offered at 38 weeks but doesn't say you have to accept it. I think it depends on how well you've managed to control the blood glucose levels, and how big the baby seems to be growing. But remember that the late scans can be 500g out either way which is a huge amount! Anyway I was reassured by a story from the dietitian about a woman who was huge when she first came in for GD (fundal height measuring 40 cm at 29 weeks) but had her baby at 40 weeks after all.

midori yes they did give us guidelines on amounts of carbs, so after the first appointment I went home and happily ate 1 1/2 cups of cooked pasta with my lunch, then had an 8.4 mmol/l reading afterwards sad and 9.0 after dinner (breaded fish with potatoes and veg). So I'd rather cut down on the carbs, and make sure the ones I eat are really low GI, than be getting such high readings. After that first day the postprandial readings have been far better.

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