Gestational diabetes: what should I expect?

[hellbell]

Just got back from 35 week check with MW and have 4+ sugar in urineand she seems to think that I am a contender for Gestational Diabetes. Am off to hospital to have the Glucose Intolerance test first thing tomorrow morning. I am a bit confused because I eat well and healthily and exercise and have not put on stacks of weight. Can anyone let me know what to expect over the next weeks? Cheers

Well at least you're at the end of the road (nearly). I had gestational diabetes with both. Basically, you will have weekly blood tests, urine tests etc. They may also scan because often babies in this case are on the big side (though neither of mine were).

If your ratings do soar then you may have to inject insulin and monitor your blood sugar with a little pricker several times a day. I had to do this with DS2 and the injecting was not a prob at all but I did get really exhausted with the finger pricking.

Hopefully you can avoid it. My advice is eat little and often and cut out all sugars (including hidden sugars) and you might be able to ward it off a bit longer.

Thanks climbanymountain. When you say all sugars does that mean fruit and carbohydrates? I have real trouble eating anything sweet at the moment, it leaves a hideous taste in my mouth. It is a relief to know that the baby may not be a giant!

I have had a 2+ sugar in urine at about wk33-35 in each of my 3 pregnancies. I refused to do the GTT, arguing that if I could control it properly by diet, then I did not need to be considered to have GD. I did not want to be labled unnecessarily, and end up having my labour options limited as a result.

You need to be very very strict with your diet for the next few weeks, until you give birth and for some weeks after. You must get hold of a list of Glycaemic Indices for foods (I'll have a hunt in a mo') and eat as much as possible from the lowest ranges, limit the mid-ranges, and avoid the high ranges completely. This may stabilise your blood sugars and allow you to complete the pregnancy in a perfectly normal and safe way.

If, however, your blood sugar is not well-controled by diet, you must, for your safety and taht of the baby, comply with the medical advice.

Once I had proven that I could control my blood sugar by diet, I had no more supervision than any other 3rd trimester pregnancy. I went on to deliver 3 healthy, large babies, normally, and with no problems.

Here it is.

BTW, when I said "eat as much as possible", I should have said "choose your foods as much as possible".

I also bought a packet of Diastix (I think that's what they're called) from the chemist, and tested my urine every evening, so that, if my sugar level rose I would not have to wait until a scheduled mw appt to discover this.

I could always tell when my blood sugar rose too high: I would feel like shit - nauseous, and with a thirst that could not be satisfied.

Thank you PC. In what ways could my options for labour be limited?

Thank you very much for the link. Looking at the list, I seem to be eating mostly from the Low GI list! So it shouldn't be too hard to keep to the diet.

I'm not sure, but I think it's continual foetal monitoring, and possibly a drip so that your blood sugar can be accurately controlled. CFM means you're trapped on a bed, so you are more likely to end up with interventions.

I don't mean to be presumptuous - just because I prefer not to have interventions, doesn't mean that that is your choice, too. I have a cousin who arrives in hospital in labour and demands (and gets!) an epidural immediately. That's how she chooses to labour.

Also, with GD, the baby can get very large and fat, which makes it harder to birth them vaginally.

No, don't worry about sounding presumptious. I would prefer an active birth and got the feeling that it might not go that way if I am diagnosed with GD this time after having pre-eclampsia with DD! I didn't have much physical intervention but obviously needed drug therapy (which I would have preferred not to have had...oh well).

support thread for GD sufferers

I had to have insulin for both pgs but felt okay thoughout. DDs were induced at 38 weeks but were of normal weight - 7 lb 10oz and 7lb 12oz.

HB - you ask about monitoring during labour. With DS1 I had eclampsia (as opposed to just pre-eclampsia) and GD. So would put slight health warning on my subsequent experience, however I do know others with GD had same experience at the hospital in question.

With DS2 they were very careful. I was monitored continuously during an induced labour (it is common to induce with GD). When I say monitored, I was connected to a glucose drip so I was almost immobile. They tested me very very regularly and deliberately slowed my labour.

Re food, I'm sure you have plenty of info but my GD specialist did include fruit in no nos. This particularly related to sugary ones like grapes and I was told to swear off the fruit juices, pickles, beans all of which have a lot of sugar.

I didn't have a GTT the second time. I was asked to monitor bloods from 29 weeks.

I had an insulin drip as well as the drip to progress labour and was constantly monitored and had to monitor my sugar levels every hour during labour.

P.S. remember to bring your insulin if you go to be induced - I thought I would have been on a drip by the evening so didn't take mine with me. I got told off by a midwife.

As previously said -- low GI diet (there are lots of low GI diet books and websites out there). Plus have (low GI, obviously) snacks between meals and try to include some protein in every meal (so nuts are a good snack, for example, or have cheese or eggs with things). Fruit juice I was told I could have 100ml with a meal, which is hardly anything so I just avoided it altogether. Other fruit I was told was OK, though (and my blood sugar stayed beautifully stable).

I had a VBAC at 39+5 and actually managed no intervention (other than gas and air) -- I got to hospital at 9cm dilated and continuous monitoring (or any monitoring to speak of) just wasn't happening as I was in my stroppy transition phase. DD was a long lean baby so didn't appear to have been affected by GD in any way.

Thanks everybody. I have not had the results yet. Will yet you know. I will use your advice about diet just in case. Funnily enough PortandLemon I can't stomach fruit juice, but have been craving almonds. Thanks also for the advice about insulin MBPWMN I will try to remember. Just one more question. How long did everything take to settle down afterwards?

I was tested a fortnight after. Had to do a fast and bloodtest. I was really worried because docs said that after having it twice I would probably have it for good. However, I did go back to normal. Sayiong that I have been told that I will definitely get diabetes in later life.

Crikey CAM you have had it hard! The stats I saw said that if you have GD you have a 50/50 chance of developing type 2 diabetes in later life, but I am glad that you reverted to your normal state after your pregnancy.

I haven't been "properly" tested yet (I am not doing anything that requires me to fast for 12 hours when breastfeeding a 6 week old, thank you very much) but when I've checked my blood sugar it's been fine. I'll get them to do a proper GTT in a few months.

It has been a bit of a wake-up call in relation to future Type II diabetes, so I'm trying to get fitter and move towards a lower GI style of eating in general in order to sway my odds into being in the half who don't develop it.

Here's hoping you don't get it HB.

I had a blood test just recently and am clear for type II.

I need to lose weight now to prevent the likelihood.

Hi had GD with my 1st pregnacy,it was only discovered at 32 weeks as I has excess amniotic fluid. GGT showed GD, was able to control things with diet. Bloody hell I would have nearly killed for a Magnum in late pregnancy. Had to take blood sugars three times per day. I was so strict and rigid of when and what I had ate as the baby has shot from the 50th to the 98th percentile in a fortnight. Labour was so much better than what i expected and read about, I went myself at 38 weeks ( induction had been talked about) and has a very normal labour.

The protocol at my hospital was that if your diabetes was diet controlled only that you had no special labour restrictions I had take by blood sugars ever hour through labour, I was contantly monitored because the babies heart beat got a little fast at one stage. However I was never in the bed and had a very active birth despite external and internal monitoring of the baby. My DS was delivered very easily and weighed only 8lb. Unfortunalty I now have impaired glucose tolerence, and very high risk of diabetes, made it a bit mad as I weigh only 8 stone and excerise all the time and have a good diet no processed foods etc, not fair can't have very many treats any more. Take care during your pregancy and hope it all goes well.

Thank you all for your good wishes and advice. It sounds more of a nuisance than an all out nightmare, and it does depress me a little to imagine that I could be at higher risk of type 2 in years to come. Is this a call to not get pregnant again???
MBPWMNN, good to know you are clear.
Just found out my credit card has been cloned. Never rains does it..?

Agree with the low GI diet advice on this thread.

I had GD diagnosed late in second pregnancy (36 weeks) and ended up giving birth to a baby just shy of 11lbs - at home thank goodness, and all was well.

Have to say - I never had even a trace of sugar in my urine. And my blood sugars were only borderline abnormal on a GTT.

I was told by the diabetic specialist that it's not really understood why some women with GD have giant babies and others don't.

By the way - DS was definitely not just a normal 'big' baby - he very much looked like a child who'd had too much sugar in the womb: massive cheeks, huge chest and stomach, double chin, man boobs. He wasn't especially long and his head circumferance was average. He's now a very slight little boy of 4.

Hi Fabsmum. Do you mind my asking if you know of anyone who had a huge baby and was able to breastfeed? (BTW you can be proud of any stretch marks!!!) Results of GTT tomorrow. Fingers crossed.

Hi Hellbell, yes - me! DS is on the 98th centile (I had the GTT but was negative; he was just a giant...) He's 7mo now but was exclusively breastfed to 6mo, and we're still going strong on the bf even now he's having solids.

If you do have a big baby you might well get people saying that your milk won't be enough, but that really isn't true: your body will make what your lo needs (and if you find yourself struggling do find someone to help you - or come back to MN!)

Good luck with the results

Hello everybody! Well good news. My GTT came back well inside the parameters and I am all clear! I can't thank you all enough for your support. CB thanks for the BF news. I wish you all the best. I will let you know what happens in the next 3 weeks. EDD 20th June.