Is birth always induced for GD?

[devoncreamtea]

Hi all,

I have a diagnosis of GD following a raised glucose level at the GTT. My fasting level was fine, but the post drink test was raised at 10.6. The test was not done exactly to procedure as the HCA left 2 hrs between blood tests rather than after completion of the drink (so an hour and half rather than 2 hrs) - but the team at hosp felt it still indicated an impaired tolerance to glucose and I don't much fancy a retest!
Since then have measured bloods 4 times a day and all within range - 4's and 5's the occasional 6. No meds. I asked at hospital if they always induce but they said it wasn't the time yet to discuss that in detail - so I just wondered if anyone had any experience with GD and induction or not?
This is my 5th baby and all other pregs and births have been totally straightforward home births, so I am a bit out of my depth being consultant led etc. I am obviously more than happy to have induction if that is best for baby.
Would love to hear about your experiences. Many thanks!

No. Not always but I had GD twice and opted for ELCS both times. Some consultants will "allow" you to go further than 39 weeks if all other monitoring is going well and baby is the right size etc.

No they don't but it does vary by area. I was diagnosed and went from diet controlled to more and more Metformin and in the last 4 weeks I had to use insulin. My diabetes nurse and obstetrics consultant said they would leave me to term as long as I was otherwise healthy and even past if I weren't on insulin. My consultant offered me (and I took) an induction at 38 weeks but said it wasn't necessary in my case.
Good luck with the testing! You may find as your pregnancy continues the blood sugars go more out of control, there are other women around who are supportive and offer lots of advice.
Oh and bear in mind you might have to stay in longer, as they need to monitor baby's blood sugar, DD is 7 weeks old now and has had no blood sugar problems but they tested her a lot in the first two days.

I was induced at 39 weeks even though my blood sugars were well controlled with diet.

Part of the reason they induced me was because there was quite a jump between the birth weights of my other three DCs (almost 1lb heavier each time) and added to GD could have made ds2 huge.

I didn't need to stay in long at all. Ds2 was born at midnight and we were home that afternoon as he had two stable blood glucose results.

That's great, thank you everyone. I've had a growth scan, where baby measured in range on growth chart - 50th centile area - and fluid all normal, so hoping that it hasn't affected growth at least so far. There has been a similar jump between my last 2 children, but one a girl and one a boy, so not sure if that might be the reason?

39 weeks is the 'guideline' at my hosp I think, so I expect to be advised to take it. It is good to hear that all was well for you all.

I had GD with my second and was given a growth scan which then determined whether I would be induced. I also had a long and traumatic first labour and a 10lb baby so think they were keen to avoid that as well.
In the end the induction went well and baby girl was born weighing 7lb 4oz.
I went home the next day and to be honest apart from being a bit sore - she came so quickly my episiotomy scar tore - I didn't feel like I had just given birth!

I was induced at 38 weeks, induction failed and I ended up having an ELCS
MY HOSPITAL induces at 38w I you need medication, or 40w if it's controlled by diet alone.

I'm in the us and had gd (gave birth a couple of weeks ago). I was on glyburide at night for my fasting but could only control meals by really cutting the carbs and exercising. I was induced at 39+4. It was a mixture of the gd, my age and having fluid on the low side plus decreased movements. They're usually much more conservative in the us with things like this but they told me there was no 39 and you're out rule and I was on meds. I did have a non stress test and biophysical profile each week from 35 weeks plus 2 growth scans. My previous baby had been 10lbs and I'd delivered her no problem so they weren't worried about size because the growth scans had been about the 50th percentile (she was 8lbs exactly in the end). The reason for the induction was concern about the placenta failing which can be more common in gd pregnancies.

Thank you. Starting to feel less panicked by the prospect, having read your stories. It sounds quite well monitored in the US then, I have heard of some women requesting additional checks from 38 wks just to determine placental health - sounds like a good idea.
bendymum I quite fancy one like yours!

I was pretty lucky but then after the rather long, complicated and traumatic time I had giving birth to DS I felt I deserved something nice and quick! xx

Hello OP,

From your home blood glucose results I would even question whether you had GD and if my sugars continued to be this I certainly wouldn't being induced - I would be having a lovely 5th homebirth :-)
The amount of glucose they load you with I am not surprised your glucose was slightly up at 1.5 hours and if your sugars are fine now in your everyday life with your normal diet etc. I would be more inclined to believe those results. I personally just wouldn't want to be labelled with something if I didn't have it as people won't know your glucose results they will just read 'GD' and make assumptions that may affect your antenatal care.

That's a good point upup. So far things are pretty normal blood wise - although I have altered my diet to reduce carbs and up protein/fat and veggies etc - which is no bad thing as I am feeling pretty well on it.

I will talk to the diabetic team next week about things. As you say I don't want to be in a 'high risk' bracket unecessarily, but do feel a bit less confident about hb given the suggestion of increased risk etc. Now the seed of doubt has been planted, I can't get it out of my head!

If I am not induced I doubt that I would make it in to hosp in time - my births have been pretty fast and faster each time - the last was just an hour! But then every birth is a bit different, so who knows?!

Thank you for your positive message - cheered me up!

I had GD (diet controlled) in second and third pregnancy. Had homebirth at 40+7 with ds2, who was 11lbs. Pregnancy after that I was much more careful with my diet and had a non induced birth at 40 + 0 in hospital - baby longer and bigger head but weighed 2lbs less.

Personally I think GD which is fully diet controlled and late onset should not be managed in the same way as type1 diabetes, type 2, or insulin controlled/onset in first trimester - there isn't enough evidence of benefit to persuade me of the worth of early induction.

Thank you 212 Good to hear your experiences. I will make sure I talk this through thoroughly with consultant next week. Definitely feeling more positive and in control now, so thanks everyone.