Large baby and symptoms of very late gestational diabetes...wanted to share experience to help others

[Tyniclogs]

I wanted to share my experience on this subject in order to help anyone experiencing the same symptoms I had/have. I've just found out the answers to my questions at 36 weeks pregnant with my second and last child so it may help someone else in future.

My first pregnancy went well up until the final trimester when I started to feel 'ill' couldn't put my finger on what it was but had urine infections and a general feeling of things not being right. I was constantly exhausted and found it really difficult to move in the final weeks. My midwife and Consultant were not concerned and as my GTT tests had both come back ok and my last scan was fine there was nothing more said. I did however always have consistantly high sugar levels in my urine.

I ended up being induced at 42 weeks and delivered an 11lb 10oz (5.5kg) baby) unfortunately it wasn't straight forward ending in an emergency C-section. As I had a urine infection at the time of the birth I passed the infection to my baby and we both ended up in hospital for 7 days after the birth.

After the event I was given no answers as to why the baby had been so big and was left quite frustrated.

When I got pregnant again in October last year although I was classed as 'high risk' because of my last babies size I wasn't booked in to see a consultant until 34 weeks. As I was concerned about the birth and carrying another big baby I pushed for an earlier appointment. I've had both GTT tests and again they have come back ok...on the high side but under the guidelines. I have still had high levels of sugar in my urine. The pregnancy has followed the same pattern except this time I have been scanned later. The Consultant hasn't really been much help other than ordering extra scans.

Basically what has happened is that I have developed Gestational Diabetes after the last GTT test at 28 weeks and this time I have had indicators such as a furry tongue (white fur and a little sore), I've also had the same urine feelings (not exactly infections but uncomfortable) all caused by excess sugar. I have been feeling rubbish and experiencing lower groin pains, especially when trying to poo The extra scans have shown the baby is on the same path as the last (98th percentile) but as I am having an elective C section at 38 weeks I hope he will be smaller.

I am lucky that my midwife ordered an extra GTT test the other week which showed up the Diabetes and I am now under the Diabetic team and am having to test and follow a strict diet for the next 12 days. I just wanted to let people know that I have been feeling so much better for the past few days since following a strict no sugar diet, I have some energy and don't feel 'ill' anymore. I wish I had been a little more forceful in trying to find out the reasons for my discomfort but was told at my last Consultant meeting that my symptoms were just those of being pregnant. Having spoken to the Diabetic team everything now seems extremely clear that I have suffered from some form of sugar overload and whilst not diagnosed as Diabetic earlier I would have been helped by following a stricter diet from the start.

As a result of the Diabetes the baby will need extra mionitoring after the birth and I will need to have another GTT test at 6 weeks post birth to check my blood sugar has returned to normal. I'm just glad to have finally found some answers.

Sorry if this is long but I just wanted to make others aware if they are experiencing anything similar.

[olivo]

thanks for sharing this, Tyniclogs. I am going for a GTT next week, as the baby is measuring big and my glucose levels were not right. I will keep an eye out for other symptoms as well, just in case.

good luck with your last few days of pg.

[EyeballshasManBoobs]

Interesting. On reading your title I thought this was going to mirror my experience with dd. I had a GTT at 28 weeks, booked in because my father is type 2 diabetic but doubtless also because of my high BMI. GTT came back clear, well within the norms. At check ups at 36 and 38 weeks I had ++ glucose in urine and, at 38 weeks baby measured 40cms. Based on these two factors I was sent for another scan and to the diabetic clinic. Baby's abdomen measured a bit big but nothing to worry about apparently.

Was given a BG monitor and told that if levels went over 7 I was to come back in. No other guidance re diet etc was given. I got a 7.8 on Christmas Evening (was given the monitor on Christmas Eve). Based on that alone I was called back to a meeting with diabetic nurse and two consultants who told me in view of my BMI and the scan they would not let me go past 40 weeks as baby would be big.

I was induced and at 40w exactly dd was born after a 4hr 'natural' labour weighing 8.10oz.

DD was monitored for low BS for the first couple of days and given formula as a result of apparent low BS. I have been called back since for a GTT which came back fine. What confuses me was that on sending of for my notes, reasons given for the way things were handled was gestational DM. However, this was never confirmed to me and, as I said, this diagnosis was made on one instance of BG over 7. I felt absolutely fine and had none of the symptoms that you mention.

I'm sorry this is so long - I've never written it down before and, tbh, still have trouble accepting the way things turned out literally overnight in the last days of a textbook pg which resulted in an unwanted induction, and, more importantly greatly contributed to the fact that DD was ff.

Sorry, I've waffled Thank you for sharing your story.

[forevermore]

Thanks for sharing. I had GTT last time and delivered five weeks early a 6.5 lb baby so probably over ten lb full term for sure. Also at top of growth chart again but so far GTT at 16 weeks normal and one scheduled for 28 weeks. No sugar in urine so far (26 wks). Lost a lot of weight prior to this pregnancy and got fit but now all down the drain since I have placenta previa and can't exercise which the best way to control gestational diabetes. Fingers crossed.

[forevermore]

DD1 also forced on formula and I was also saddened by this. Was hoping it would be so so different this time

[Tyniclogs]

Thanks Olivo, best of luck with things I hope you're in the clear.

Not waffle at all Eyeball! It would appear that my placenta stops processing sugar properly in the last few weeks so it could have been the same for you. What's so frustrating is that you're left to piece together this information yourself, as you say, you're left with feelings of frustration about how things turned out. I certainly have a tonne of feelings about the induction and eventual c - section the first time round which led me having to have CBT about getting pregnant again! Are you planning any more pregnancies?

[olivo]

can i ask why they have to give formula? and do you have to stick with it or is it possible to bf as well/eventually?

[Tyniclogs]

Sorry to hear that Forevermore, I hope your levels stay ok. I shall be alert to formula feeding as I breast fed the first one soley despite massive resistance from the midwives insisting he would be too hungrey. That was before any mention of Diabetes though.

You're right, exercise plays a big part but really hard to do when you have a massive baby bearing down on your fanjo! In the past few days since starting the diet though I've had more energy to move about and am definately feeling better for it.

[Tyniclogs]

My messages keep crossing over! Yes I'm interested to find out about this formula feeding for low blood sugar in the baby. I shall ask the Diabetic team next Friday when I see them. As I said I managed to breast feed and will insist on doing so again unless someone gives me a plausable answer.

[forevermore]

They told me to prevent blood sugar levels dropping because baby would still be producing too much insulin to overcompensate for the high sugars in utereo. But not convinced now tbh. I am sure colostrum would do the same? My baby never established bb therafter and not much support, but that's another thread

[Tyniclogs]

That's horrible to hear Forevermore, it really makes me angrey that you weren't supported. Surely breast milk is always going to be the best thing for the baby as is going to be easier for the baby to process? I know I had a terrible time fighting off midwives all insisting they were right and very nearly caved several times due to to my doubts and exhaustion. I hope you don't beat yourself up over it.

[EyeballshasManBoobs]

That's exactly what happened to us forevermore. DD was born at 3.15am and had heel prick tests every few hours. I was left in my room at 9pm with a leaflet on hand expressing and a small bottle. No other instruction. After an hour a mw came back, looked at the empty bottle and asked me if I'd even tried. She then said they'd have to give dd formula otherwise she would get sick.

At this point it had been about 18hrs after dd's birth, I had had no sleep and was terrified of everything that was happening.

By 2am her BS was 1.2 which, yes is low, no question about that. So at 2am the morning after she was born she was rushed down to SCBU where she had a cannula put in. I was brought down at intervals and given an electric pump and told to use it. I asked for a screen because there were parents of other babies around me and it was like I had asked for a bottle of scotch. 'What do you need that for?' I never did manage to express a single drop and dd never latched on.

I went to a bf clinic when dd was four days old and being ff. They were lovely but not very helpful and tbh, my confidence was so dented that I never had any chance of success at bf.

Sorry, I'm waffling again. Like I said, I've tried not to think about all this too much because I feel there was so much that could have been done and wasn't. And in my mind it started in that diabetic clinic.

We aim to TTC in the autumn and I'm not going through that again. I will do everything in my power to make sure that any bf support I can get is in place and easily called upon asap.

[Tyniclogs]

Stop apologising Eyeballs! Sounds like you need to talk about it a bit especially if you're planning again. I talked a lot to anyone that would listen after my first and it helped me get my head straight. I know when you say things you can feel as though they are trivial, but to you it feels like the last straw. There were so many things with my own experience such as your 'screen incident' that you look back on and just want to scream about! It sounds like you had a really horrible experience and bewildering if no-one was explaining what was happening.

It's so easy for the professionals (ehem I use the word loosely) to forget the loss of confidence you feel when you've gone through a birth coupled with complete exhaustion and just the shock of the whole thing. I hope your next one will be a better experience.

[OurLadyOfPerpetualSupper]

Hi. Thought I'd share my experience. 14 years ago I had Ds1, 10lb 5 oz, low BS, then his temp dropped so was wheeled to ICU, spent 2 days there with a feed tube e and a canula 'in case of infection', ff through the tube and the few meagre drops I managed to express (comment from one nurse: 'is that all?')

I managed to establish full bf subsequently, thanks to NCT counsellor, but I'm sure I overfed him as always anxious about the dangers of low BS.

I did feel awful through that pg but the test at 24 weeks or thereabouts was fine - I did put on 41/2 st and ate a lot of carbs to stave off sickness though.

About a year later the NCT produced some research questioning the fact that large babies were routinely being tested for low BS and subsequently hospitalized. Afair they found that different hospitals each had their own protocols - they had different levels for deciding whether a baby was 'at risk', and different weights as to the cut off point for testing. Basically there was no standardization.

They also claimed that the risks of low BS apply mainly to premmy babies - something to do with a lack of ketones in their system, which full-termers have and which enable them to cope with temporarily low BS.

My recollection of this is somewhat hazy and I couldn't find anything on the current NCT website, so don't know whether anything's changed.

After reading this I decided to have my next child at home, to avoid this happening again. She was 11lb 12oz, and we were told by my GP to 'keep an eye on her' - she was fine.

Incidentally, DS 2 was only 8lb 10oz, but I'd given up sugar by then, and I can vouch for feeling much better as a result. Sorry this is long, I suppose my main point is to vouch for a sugar free diet, and to research in to the whole 'testing big babies for low bs' thing.

[Heebychick]

Hi, i'm not sure if this thread has finished now but wanted to hear more about tyniclogs and how you are doing now?

I am 36+2 and have just had a ++ glucose so have had blood test and have to call on monday for result, same as you if it's over 7 i will have to see GD team to discuss options. We know this baby is big, Head circum was 97th centile as was abdomin at 32 weeks and previous DD was 9lb 12 1/2oz. I had GTT at 28 weeks and all normal but i wonder if it has developed late.

I had to have a EMCS last time due to labour not progressing as large baby which was back to back so have been debating ELCS this time. It's all a littl worrying and i still have no idea how i will give birth! plus it seems to be breech too! grr.

[Tyniclogs]

Hello Heebychick, I had my final appointment at the hospital today which was at the Diabetic Clinic...deep joy! Loads of waiting around. I've been testing my blood sugar 4 times a day for the past two weeks and have had up and down readings. I was interested to see what they'd say. There was a question about whether I would have to inject insulin for the next 6 days as I am going in for a c section on Thursday but the consultant spoke with a collleague and they said it wouldn't make any difference to the baby or me at this stage. She did say however that this is based on hospitals policy so a different hospital may have different guidelines to follow.

I had the results of a blood test which identified that I haven't had the GD for very long so it has definately developed later than the 28 weeks GTT. However I am carrying a very large baby (I'm wagering 10lb +) so something must have been happening along the way.

I asked about the formula feeding and low blood sugar and was told they would only insist on this if the baby was really not feeding on the breast and it's blood sugar was very low.

So, I have the next six days in which to continue to lay off the sugar but at least I no longer have to test my blood sugar as they've already established it's high. I'm starting to really have mobility problems now so c-section day can't come any sooner for me!

Hopefully after that it'll just be a GTT at post 6 weeks to check my levels are back to their normal chocolate munching self!

As for your situation it sounds identical to mine (apart from my 11lb bruiser!) I also had an emergency c-section and back to back. I did really try to think myself through a natural birth but just couldn't mentally get my head round it all again. I'm feeling very happy to be going with the elective this time round.

[llareggub]

I had GD, which was diagnosed relatively early in my 2nd pregnancy. They also suspect that I had it in my 1st pregnancy, but it was undiagnosed.

I stuck rigidly to the diet they recommended, and as a result my BMI is 6 units lower 7 weeks post-partum than it was at my booking-in appointment.

For me, getting GD has been a real shock to the system, as there is now a 50% increase in the risk of me developing type 2 diabetes later in life. My consultant told me that I can delay it for a considerable number of years by making lifestyle changes, which I am determined to continue doing. I feel so much better without sugar, and I am 1 and a half stones lighter today than I was at the start of my pregnancy. I am also exercising as much as I can.

I'm not convinced by the formula pushing. The NICE guidelines state that breastmilk is more effective in stablising blood sugar in babies born to mothers with GD, but I got the impression that the medical staff preferred formula because they could record intake. With my 1st pregnancy I went with what they told me to do. With my 2nd I expressed lots of colustrum prior to the birth so I could use that if necessary. I didn't need it and DS2 was born weighing 7 pounds 9, so not huge at all.

[olivo]

I am grateful to read everyone's experiences, as i have now been diagnosed with GD. i have growth scan next week and an appointment with the diabetic team. it has only been my second day on a reduced sugar diet and i have struggled. I have no idea really what i should be eating ( obv no biscuits, cakes, ribena and chocolate but do i have to cut down on fruit and fruit juice?) and have been so hungry these two days.

[llareggub]

Definitely no to fruit juice! You need slow releasing carbs, I found the low GI diet worked for me. Exercise helps too. TBH if your GD is quite bad then you need insulin. It is nothing you've done, so don't beat yourself up about it.

[olivo]

i thought that, llareuggub, but had been told to take my iron tabs with juice! will have a look on t'internet for a low GI diet. What with being a fussy veggie with a passion for chocolate, it'll be a testing 10 weeks!!
i dont know how bad it is, they said nothing major to worry about and that diet should control it.

[llareggub]

If it helps, I found that bacon sarnies or egg on toast was perfect for breakfast. I then had tuna wraps with salad and hummus for lunch, with a healthy meal for dinner. For me, my GD seemed to be at its worst in the morning but OK in the evening.

For snacks I'd have a plate of apple and cheese. The cheese lowers the GI content of the snack, and satisfied my sweet tooth. Sainsburys do a very nice chocolate bar with no added sugar, and I had that as a treat every now and again.

I used to check the labels on food. Anything that had more than 15g per 100g of carbs that turn to sugar was reluctantly put back on the shelf. Your best bet is to avoid processed foods where possible, and eat lots of veg.

[thoughtforms]

Hello, I've also got GD - we found out three weeks ago today. I wasn't able to control it by diet (we followed the GI diet), and so have to take Metformin in the morning and evening, which is helping A LOT!

I'm now getting nice low average readings - I'm 31 weeks tomorrow, and baby is right on track for being the right size, though they're monitoring me.

Anyway, my main reason for posting, I found out last week about Colostrum Harvesting - it's something offered at my local hospital for free to any mothers who attend the diabetes clinic, and starts from 36 weeks - there's several classes (I'm at St Helier, Epsom also run these). The idea being, you take your stored colostrum when you get to the hospital, and baby gets it to start with to be able to cope with the sugars, which in turn means you're less likely to have formula having to be an option. It's something my midwife brought up in my antenatal class. Worth mentioning, anyway!

Oh, and if anyone is interested, I can cut and paste a low-GI pizza recipe (it's a bit of a faff to prepare, but hey...) - you can only have two slices, but it's very filling, and I do like it! It's just from my GI Diet book. It keeps well in the fridge too!

[EyeballsandherSunburntNorks]

Very interesting thoughtforms. I had dd at Epsom so am interested in this for next time.

[Heebychick]

tyni that is really strange that we are so similar, yes apart from that whopper baby - you grew that one well!! So glad you don't have to have the insulin, and like you say with only a few days to go it must be a relief. How many weeks are you? Did you ask for ELCS straight away or was it decided because if the GD?

I am getting results on Monday so will know more then, i'm very thirsty and keep getting dips if i am late to eat lunch etc, i crave bad foods all the time so if i have to cut all them out i shall struggle i'm sure!
Lots of luck for Thursday - totally understand about the mobility, and it's hard with another DC around huh! i have a very demanding DD which is quite tough.

Interesting to hear about colostrum harvesting, i might ask my hospital on monday about it, have any of you heard about private rooms in hospitals being available for hire/booking? not sure it's at every hospital but it would be nice to have some privacy eh!

[Tyniclogs]

After the birth last time I had a lot of questions to ask and ended up writing a letter to the hospital and requesting a meeting to go through how the birth had gone and why it had ended up in an emergency c section. I was treated well and recieved an apology for things not having gone as well as they could have. I asked at the time about an elective c section and was reasssured that it would be ok as the baby had been so large. My fear when I became pregnant again was that I would be told it wasn't possible but didn't face many objections. I stated my case clearly that it was to do with the issue of control and I needed to feel I knew what was going on. The consultant rightly encouraged me to think that I could give birth naturally but I am very glad to know that the pregnancy will end on Thursday and it won't be the scary unknown of last time.

The GD wasn't diagnosed until after the c-section date being set but as all the risks associated with GD are being dealt with by the c-section it seems the best thing in my situation.

I'm now 38 weeks today so I'm not even close to the 42 weeks I was last time, the thought of another 4 weeks carrying this baby just doesn't bear thinking about. I am guessing from how I feel that I am carrying a 10lb baby at least!

I agree about bacon sarnies and eggs for breakfast seemed to give me ok levels. It's definately hard work and I have immense sympathy for those that have diabetes full time.

[Heebychick]

Wow that is strange as i had exactly the same feelings and reasons for concern - the feeling of being in control. I have had 4 meetings so far with different consultants and they have all 'assured' me that i can give birth naturally and a VBAC is far safer and easier, and i know it probably is but ... there is a big concern of mine that, like last time, i will be there hooked up to a drip with no idea of what is going to happen next for 12 hours and hundreds of midwives, doctors, consultants etc coming in to have a look at me and all the time we were sat (me lying obviously) and in the end not getting anywhere. I got to just 4cm last time and even though i had lots of ideas of being in the pool, relaxed, calm, full of energy etc i really didn't know what was going on and i hate that in life. So nothing i wanted happened and in fact no one told me that she was back to back until i'd been in labour for most of the first day.

Like you i went so overdue last time that i really cannot cope with it being that way this time.

I am going to push for a final scan on Thursday, there is a doubt of baby's position so if they are still in doubt i shall ask for one, to check growth etc and that might give me some backing for changing my mind.

There's a huge part of me that would love a VBAC but i'm so unsure that i will get through without damage to certain areas!

I will also use the GD as a back up too if it's confirmed on monday.

Did you feel that the Dr's were disappointed in your choice? i feel mine would be somehow.

I have heard that an ELCS is so much better than an emergency one, you will have all your energy and you'll be totally prepared.

How old is your other DC (DD or DS?) did you have a concern that the section would make it harder to cope with the older sibling? that was my main concern i think.

I'm really keen to know how you get on and i would love to keep in touch and pick your brains as much as poss - if you don't mind!