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Gestational Diabetes - Now what?!

(22 Posts)
tiggy2610 Thu 06-Nov-14 20:04:43

Evening ladies, I'm hoping for a little advice!

I was scheduled in for a GTT during my booking in appointment as my BMI was calculated as 30.5. Fast forward 10 weeks and midwife realised there was a mistake in her calculations and my BMI was actually only 28.5 (still chubby...) and asked if I wanted her to cancel my GTT. I decided I might as well go ahead and have it as it's another thing crossed off the list. It turns out it was a good job as I was informed today that I had tested positive for gestational diabetes shock I know that my overweight BMI would have put me slightly more at risk and that I should have turned down those chocolate biscuits much sooner, but I naively expected this to be the one test I could pass easily.

The midwife didn't tell me anything over the phone just that I have an appointment next week and will be given blood sugar monitoring equipment for a week before they come up with a treatment plan. I've been slightly naughty this pregnancy with the odd take away and helping of ben and jerrys, but my main cravings have been apples, melon, broccoli and cabbage (honest!) so I've been stuffing my face with those.

So, what now? I'm sort of in a mild state of shock after reading that my baby will be large, I've an increased chance of developing diabetes permanently and that induction at 38 weeks is very likely.

What does this mean for me and baby? I know I need to be much more sensible with my diet and up my exercise if possible but are there any foods I should stock up on? Any foods I should avoid completely, apart from the obvious?

I know its pointless but I genuinely feel so guilty that my body is potentially causing harm to my little man. I need some experienced mums to give me some words of wisdom and share their experiences of GD.

cake <- the only cake I'll be having for a while

TinyTear Thu 06-Nov-14 20:11:12

Hi. I had gd in my previous pregnancy
Main thing is cut out fruit juice completely
Porridge in the morning is sugar, try cinnamon

And reduce carbs a lot... Halve the portions you are used to...

CheshireSplat Thu 06-Nov-14 20:15:25

I know a few people who had GD. They followed a low GI diet and actually things turned out really well for them. The two most recent babies born to mums with GD that I know were both normal weight and because the mums were really careful and ate so healthily through their pregnancy the mums shed their baby weight and more quickly after the pregnancy and are really fit now. So actually following the low GI eating plan was really good for them. Good luck!

CheshireSplat Thu 06-Nov-14 20:16:03

I know a few people who had GD. They followed a low GI diet and actually things turned out really well for them. The two most recent babies born to mums with GD that I know were both normal weight and because the mums were really careful and ate so healthily through their pregnancy the mums shed their baby weight and more quickly after the pregnancy and are really fit now. So actually following the low GI eating plan was really good for them. Good luck!

FrazzledFandango Thu 06-Nov-14 20:16:38

I had GD despite having bo risk factors at all.

Mine was able to be controlled by diet and I was very strict. You'll soon get the hang of what you cam and cant eat by watching what certain meals do to your blood sugar.

For me I had to ration fruit, no white bread (granary bread was okay as long as I had something high fat/protein to balance it out - peanut butter on toast was my stable snack), no pastry, no sugary stuff.

If your GD can't be dietary controlled then they'll give you metformin, if that doesn't work its insulin.

The consultant will probably have you do a food diary and get you to monitor you blood sugars for a few days so they can assess the best treatment.

I know its scary (I got all tearful when told), but I had a 7lb 4oz baby born after induction at 39 weeks. His sugars were perfect and so are mine now.

CheshireSplat Thu 06-Nov-14 20:17:10

Sorry for duplicate post...

FrazzledFandango Thu 06-Nov-14 20:18:03

Oh yes cereal and juice are terrible sugar wise. Ive not had porridge since pregnancy as I got so fed up of it!

UriGeller Thu 06-Nov-14 20:19:30

I've had it twice. It's a pain because, even though you can be doing all the right things, as your pregnancy advances, the placenta working efficiently interferes with the pancreas and its ability to produce insulin.

I would say don't worry, monitor monitor monitor and write it all down in that little book they give you, you'll see a pattern developing and begin to see where you can make changes. If you have lows or highs and you'll learn a lot about the action of carbs on the body. It really is an enlightening experience if you choose to see it that way. Keep your appointments!

Good luck!

UriGeller Thu 06-Nov-14 20:21:51

Oh, I had no other risk factors either. But I ended up on insulin because I couldn't tole rate the Metformin. Injecting is not as bad as it sounds!

TarkaTheOtter Thu 06-Nov-14 20:22:18

The best thing about GD is that once it is diagnosed you can actually do something about it. You will be monitored closely and depending on your sugar levels you will just have to eat a low sugar diet, or maybe take metformin tablets or maybe use insulin. They will give you a kit to test your blood sugar levels at home then decide on a course of action. Don't worry if you can't control with diet - it doesn't mean you have failed - just that your diabetes is more severe.

They will give you lots of scans to check baby's growth and if you follow the treatment there is no reason why baby should be big. I needed insulin with dc2 and he was only 7lb3. With dc1 my levels were controlled on metformin alone and she was 7lb.
If you need metformin or insulin they will offer to induce at 38weeks. This is because the placenta ages quicker with diabetes.

With regard your food, you'll need to watch carbs as the body turns them into sugar. Complex carbs like brown pasta, Wholemeal bread etc are better than refined carbs. Sweet potato better than potato. Watch the sugar content in cereals and yogs (particularly low fat). Eat protein with every meal. Exercise after eating (eg take a walk). Sugar free jellies are good if you want something sweet, most food labelled "for diabetics" is too high in sugar as your levels have to be tighter in pregnancy than normally.

Don't feel guilty. It's not caused by what you have eaten whilst pregnant. My bmi was 20 in my last pregnancy and I was diagnosed at 16 weeks.

TinyTear Thu 06-Nov-14 20:23:06

And my dd was born on 50th centile so not a giant... Big for her as she settled on the 9th centile by 10w

tiggy2610 Thu 06-Nov-14 20:29:06

Thank you so much for all the responses [thank you]

Feeling a little calmer. It doesn't help that I have to wait 5 days until my appointment with the diabetes midwife but I feel like I need to start changing immediately.

I think I definitely need to up my protein with meals. I have a bag of porridge oats at work that are sitting in the back of the cupboard and I've found more inviting things for breakfast but looks like I'll be digging them out tomorrow!

Thanks for the tip about 'diabetic' food Tarka, DH did ask about that earlier.

Uri I like your outlook on it smile I'll try and see it as an educational experience as well as a scary one!

FrazzledFandango Thu 06-Nov-14 20:32:00

Diabetic ice cream is awesome though when you're truly fucked off about being the only pregnant woman in the world not allowed to eat cake grin

Gruntbaby Thu 06-Nov-14 20:46:45

Don't feel bad. I was shocked to find I had GD - I am slim (early pregnancy BMI 18), do sport and eat healthily. Sometimes the pregnant body just goes a bit mad. I think my risk was mainly genetic as my dad has Type II diabetes.

What does it mean?
Initially they'll probably want to control your sugar levels through diet only. If this isn't working then they will look at a safe drug like Metformin, and if this doesn't work will look at injectable insulin.

Buy this book (also an app) - recommended by my gestational diabetes nurse. An eye opener for me was the portion control of carbs. I am used to eating massive bowls of wholewheat pasta. rice after sport and large bowls of muesli and hat to cut these down. Also interesting in that chocolate eclairs, if I remember correctly, are low carb! Obviously they are also high in fat and high fat diets can affect how your body measure insulin (IIRC), but I needed fattening up at that stage.

They'll give you an electronic blood sugar monitor with test strips and you will need to test before and 2 hrs after 2-3 meals a day. You keep a food diary and soon learn what will take you over the very strict limit (stricter than in normal diabetes I think due to the risk to the baby). I found a latte could take me to the limit, so latte and a sandwich was a no no due to the carbs. You will get sore fingers from the testing.

You will have regular - maybe fortnightly - check ups at the hospital as you will prob be classed as high risk, but don't panic too much due to that label. They'll also likely do some late growth scans and also check your amniotic fluid levels, as a further complication is polyhydramnios (excess fluid), which can be risky for the baby. Take your partner to scans as they can find complications and want to make decisions.

If your levels are well controlled and baby seems ok then they'll probably induce you at about 38/39 weeks. If you are on insulin I believe they induce at 37 and may give the baby steroids for its lungs.

After birth the risk is that the baby might have a sugar low which can be dangerous as its body is used to higher sugar levels. Therefore it will be frequently monitored for blood sugar and could spend time on Special Care Baby Unit. It might need a glucose drip and will need early breast/bottle feed.

IIRC GD can delay milk coming in so some MW advise priming your breasts and actually squeezing out some colostrum in the few days before birth and freezing it in little syringes they'll give you. It can be quite sore, but even a few drops are good (and are all you can expect at first). Take these to hospital with you, make sure they're frozen with your name etc on and get the staff to feed the baby with that as they're not always effective suckers at first and if their blood sugar levels are dropping the staff may want to supplement with glucose or a formula feed. Usually the baby is fine, often they don't need anything (the better controlled your sugars in the run up to the birth the more likely this is).

You will probably have weird blood sugar levels for about 48 hrs and then things should usually be normal. At your 6 week check you will need to do another GTT and may need to do a GTT every year for life now.

So basically - carbs and obvious sugars bad, exercise and protein good. So eggs, nuts, seeds, tofu, meat, fish, cheese all good. Pasta, rice, bread etc not so good :-( As a vegetarian with hyperemesis who could only eat lucozade due to the hyperemesis, I was stuffed but did manage to keep my sugars controlled (by diet alone). I lost even more weight though.

For me my baby was delivered by c-section at 38 weeks due to his large size (8.10 at 38 weeks), severe polyhydramnios and a number of other serious complications I had by then. He had respiratory problems after birth, which I think can be a consequence of polyhydramnios, which is a GD complication, and was in NICU on a ventilator for 2 days, but it now seems there may be other unrelated issues that could account for that. He did have a slight bloody sugar dip IIRC, and was fed formula as I wasn't producing anything and due to his lung damage the staff needed to stop him screaming quickly. We did manage to EBF for about 6 weeks.

At my 6 week check the GTT showed my pancreas isn't working properly and I am borderline diabetic.

I think that's all, hope that was helpful.

Gruntbaby Thu 06-Nov-14 20:48:58

Watch those porridge oats - IIRC for breakfast you can have about 40g of them only. They're carbs...

However for a sweet treat Seeds of Change and another company do lovely oatcakes which contain ginger/chocolate chips. They're about 8g of carb per biscuit so you can have them as a snack sometimes without causing problems.

Fruit - stick to berries mainly as they're almost 'free' in carb terms.

sparkle101 Thu 06-Nov-14 21:03:52

I had gd with my Ds who is now 15 months. And is between the 9th and whatever centile it is above.

I found out at 30 weeks, when you have your regular appointments with the consultant you will get your blood checked, they check blood for the recent changes and also to see patterns and older blood - they could see that I'd had it for a lot longer than they thought.

I was put on metformin straight away, and monitored with extra scans and tests etc.

I was induced at 38 but that was due to pre eclampsia, he was 7.8 when born. It was bizarre as I gave birth at 7am which was when I was meant to have my tablets. I asked for them and was told, "nope, that's it, all gone now" just like that, no tests, no nothing!

Have had a gtt since then and I'm fine so far. Fingers crossed.

Agree that rice was my nightmare ingredient. Very small portions needed.

Oh, and one more piece of advice: the diabetic chocolate- pay very very close attention to recommended amounts. I got the boots hazelnut one which was amazing but I had 8 times the recommended amount. Um.... Explosive is a good word. Sorry for tmi!!!

TarkaTheOtter Thu 06-Nov-14 21:12:34

I was insulin dependent GD and was induced at 38 weeks, no steroids needed.

You do need to make sure you are eating enough and not cutting carbs out completely as baby needs them to grow. You might lose weight (they don't seem to be phased by this, I was 1/2 stone lighter the day before I gave birth than at booking), but if you are finding you can't eat enough without sugars going high then they should prescribe metformin and/or insulin. I think some of the language used about this is a bit misleading as it suggests that if you are strict enough at the diet you won't need medication but really, the determining factor for whether or not you need medication is how severe the diabetes is, and therefore for those who need it, it is unavoidable.

Needing metformin or insulin also does not mean that the baby will be more likely to have complications. So long as you are keeping your sugars low (by whatever means - diet, insulin, metformin) you are not exposing your baby to excess sugar and should not gave heightened risk of complications.

TinyTear Thu 06-Nov-14 21:44:53

Ah yes and you need to go by trial and error to what suits you. We discovered that my body wasn't processing carbs at all in the morning so I was not allowed toast, porridge, or any of the sort for breakfast. Had to have fry ups, cheese, ham, yogurts... For snacks I lived on babybel... My dd loves cheese now

I was on metformin - caution may cause looser bowels and ahem productive parps... And overnight insulin just the last week before induction

My dd was fine if a little jaundiced but took to breastfeeding straight away and never had formula and was fine...

tiggy2610 Thu 06-Nov-14 22:03:37

thanks thank you all so much for the information. Its honestly invaluable and I feel a lot more prepared for what could come over the next few weeks.
A big shop for healthy food is in order tomorrow. I think my biggest challenge is figuring out what are good carbs vs. bad carbs and what my own body will do once I start monitoring.

winohhh Fri 07-Nov-14 08:07:02

Hi tiggy, I could have written your post! I'm in a very similar position. Got a call this week to say i'd been booked in to see the diabetes team after 'failing' the gtt. Appointment not till next week and no clue what I'm supposed to do till then, but feel I should do something. Thanks for everyone's helpful advice. I'm trying to cut down on the obvious things, but guess I need to wait till I get the thing to monitor my sugars to work out what I really need to change. It's so scary! They just leave you for a week with no info but dr google!

Let us know how it goes tiggy! Good luck!

cheshirem2b Fri 07-Nov-14 13:02:31

All I would say is don't worry! I was diagnosed with GD a few weeks ago - only borderline but still present. I've cut out fruit juice as that does seem to spike my readings and I've cut out the naughty snacks and chocolate. Other things I've found affect my readings are pasta and bread.

My readings are all now 5.X and I saw the diabetes team yesterday who are happy with my readings and just want me to keep doing what I am now.

The positive things to look on are that being monitored means extra scans and checks that baby is fine - that isn't a bad thing. It also means that you can try to manage your readings using diet and hopefully everything will be fine. My baby is currently measuring around 90th percentile for abdomen but well within the "normal" range so my consultant is seeing me again in 4 weeks and we'll decide whether to induce me at 38 weeks if baby has got bit, or leave me until 40 weeks if s/he is fine.

Take advice and be guided by the diabetes team but don't worry - it will all be fine!

zoobaby Fri 07-Nov-14 13:43:29

Oh yes, the extra care given to GD is brilliant. At my hospital the diabetes clinic has far better time management for MW and consultant appointments [awesome] and they give extra growth scans as the pregnancy progresses. I used insulin and metformin when pregnant with DS and I was seen in clinic every 2 weeks minimum. Lots of checking of urine for nasties and listening to baby's heartbeat regularly.

When I had DS, the midwife stayed in the room with me the whole time plus they kept the monitors on DS which was very reassuring. I was induced at 38 weeks, which wasn't massively pleasant but again just something to endure. When DS was born we had skin to skin for a while and then they placed him into a warming bed to regulate his temperature. He was in and out of that for the first day between feeds and cuddles and then they did a heel prick test to check his own blood glucose levels, which were fine. After that he was in the regular crib.

The day-to-day monitoring and poking and pricking was slightly annoying but manageable and you'll do anything to get a healthy baby.

You need to look for LOW GI foods. Your dietician will help you out here. Plus the way food reacts to each person is totally individual. Once I found out what was good for my blood glucose levels, I tended to stick to it (luckily it was pasta and rice).

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