Gestational Diabetes, Blood Glucose 10.5mmol, Reason for Concern?

[midori1999]

I had my first GD clinic last Weds. They asked me to monitor my blood glucose, stick to a healthy diet with sensible portions of complex carbs and see them next week.

I can't seem to get my fasting blood glucose down, but this morning after breakfast my reading was 10.5mmol. Do I need to do anything about this, is it a reason to worry? Or quite normal?

there isn't a medical reason to avoid insulin.

Some people don't like taking it, but it is often the best thing. I's be careful taking th advice of friends - talk to doctors. More than one if necessary.
Germany has a very good record in diabetes care.

I've been diabetic for 15 years and have to take insulin, but I also feel that if I had Gestational Diabetes insulin would make it much easier.

Don'tt ake my word for it though, find out more.

I have since had quite a few readings over 10mmol and am more relaxed about it now. I've seen the dietician and she has suggested I need around 180g of carbs per day, whereas I was having only around 100g when trying diet control anyway and it wasn't even working.

From what I can gather and have been told, synthetic insulin acts in the same way as the insulin your body produces and your body won't recognise a difference, so it is very safe. It has also been used for years in pregnant women with no known side effects or contraindications.

I'm now on a fair bit of insulin and they'll put it up again at my next visit as the GD is quickly getting worse and I am consistently still getting high fasting readings and higher than my target post meal readings. I have been told to stick to my 180g of carbs per day and they'll adjust my insulin accordingly. I am still losing weight as it is and there's no way I would be able to control with diet alone.

Baby seems well but is on the large side, over the 90th centile, but I have big babies anyway, even without GD.

fallingandlaughing don't know but I am scared of going to insulin especially since it's only my second week on the diet.

my morning sugar is around 5.2. is it good? no idea.
midori1999, what are high fasting values

my post-meal readings this week apart from 2 x 7.6 and 1 x 9.0 were within the range. do you think they will allow me to keep the diet and won't get annoyed about skipping the tablets? they did the scan at 33 weeks and my daughter's weight is in the very middle of what it's supposed to be.

What ranges have they given you to stick to? I have been told under 5.9mmol before meals (which includes my before breakfast/fasting reading) and less than 7.8mmol 1 hour post meals. My fasting are usually in the high 6's and post meal readings most often somewhere in the 8's at the moment, sometimes higher. (hence the suspected need for more insulin)

I know my consultant wouldn't be worried about a few readings over target, especially if I had eaten something that had obviously caused it, but my readings were consistently over even when not eating enough carbs, which is why they started the insulin.

They were very particular about the fact that I mustn't restrict carbs too much in order to keep my readings low as it could be very harmful to baby potentially. I was previously having something like an omlette, eggs and bacon or fruit and a yoghurt for breakfast to try and keep readings low, but then something like a wholemeal pitta/some ryvita for lunch and a small portion or brown rice or wholegrain pasta or a few boiled potatoes with my dinner and then snacks of a low fat/low sugar yoghurt or fruit and I was told that was nowhere near enough carbs and although it might be OK for a week or two at the end if I had managed to diet control all the way through, it really wasn't good for baby for longer than that.

Apelsinnka "High fasting values" are your blood sugar levels after a long period of not eating - i.e. your morning reading on waking up. 5.2 is pretty good I would say - I was never able to get mine down below 7/8 which is why I was put on insulin. That said though, you must be prepared that your levels are likely to get higher the further in pregnancy you get, and you may still need to take insulin, regardless of how good your diet is. Don't feel that you have 'failed' for being unable to maintain control through diet - there may come a point where it is impossible for you to control it yourself without some help from insulin.

Insulin is really nothing to be scared of - the injections don't hurt, and as Midori says, it has been used for pregnant women for a very long time, and mirrors the job your body would usually do but can't at the moment. If you are put on insulin you will have a lot of support from your diabetes nurses to ensure you are getting the right dosage.

I was diagnosed with GD quite late too - around 29/30 weeks if I remember rightly. I was able to diet control for 2-3 weeks then had to start on insulin. The amount of insulin I took gradually increased as my pregnancy went on. DD, once she was born, maintained good blood sugar levels and I was able to exclusively breastfeed her with no issues either.

I have since been diagnosed as Type1 diabetic and am entirely insulin dependent, but that's another story!

5.2 is great. I can't comment on your other values as the targets for Gestational Diabetes are tighter than for Insulin-Dependent Diabetes (which I have).

I understand that you are scared of the the insulin. But your body produces it, it is a natural thing, everyone has insulin in their body anyway (uness they are insulin-dependent diabetic!). So it is as natural as blood, or tears, or gastric acid. The fear of injecting is much greater than the reality, which is quite routine.

Don't worry about doctors getting annoyed with you, worry about what is best for your baby. Your blood sugars don't seem too bad so far, but as the others explain, they will get worse without treatment. They best thing for your baby is to anticipate this and follow medical advice to control things.

I don't want to scare you, but remember that Gestational Diabetes is a very serious condition, which has extremely serious risks for your baby. These risks can be avoided if you follow medical advice, so keep in touch with your doctors and discuss all your worries. In a few weeks you will be able to hold a lovely, healthy baby in your arms!

midori1999, they told me 4-5.5 in the morning and below 7.5 1hr after meal.

I have a tiny piece of bread for breakfast (or a 125ml plain yogurt) in addition to an omelette, I usually have fruits twice a day (two plums and then a banana for example), a decent portion of lentils or buckwheat for lunch, but for dinner I don't eat extra carbs. does it cover the carb need? I actually do feel much better and energetic then before they diagnosed me...

fallingandlaughing and MrsKitty thank you for all your advise!

That certainly wouldn't be anywhere near enough carbs from what they've told me, not sure on the lentils/buckwheat, but excluding that it is only about 50g of carbs per day absolute maximum, probably more like 35/40g.

It is different for everyone, but I was told told to have 180g of carbs a day, fairly evenly split to help try and keep my blood sugars even. I have 40g with breakfast, (2 slices of wholewheat seeded toast, wholemeal bagel, small portion of cereal) then a 10g snack (apple or pear) 50g carbs for lunch, 10g snack, 50g with dinner then 10g snack later. The other 10g is used as milk in decaf coffee. I can obviously include proteins such as meat, eggs, fish, cheese etc with each meal and have been told I don't have to count veg in my carb allowance.

From what I can gather, if you don't eat enough carbs then your body can start producing keytones which are not at all good for baby. As I said though, the advice for everyone is different but the dietician and doctors I have spoken to were pretty adamant I should keep the carbs sensible then control with insulin. I was only diagnosed as borderline GD at 24 weeks but since Then my levels have gone mad and I'm still not quite 29 weeks.

Have they given you the option of seeing a dietician or any diet advice?

Exercise can really help keep blood sugar lower too, so a short walk after each meal could help.

midori1999, lentils and buckwheat are 50%+ carbs, but low GTI ones, I do eat at least 200g of them (cooked weight) for lunch. My sugar is good after lunch. Breakfast is more of a hassle, after two pieces of bread once sugar was very high, also I worked out that yogurt and fruit at the same time don't work, neither 4 table spoons of muesli with milk (only 2 and that's too little). The doctor said that there is something with hormones in the moring which make breakfast harder. But then if I have a tiny piece of bread and a banana 1-2 hrs afer breakfast it's ok. Banana has plenty of carbs.

The rest 30 should come from the vegies, which also have some. I will try to calculate the actual quantity today and discuss it with doctor on monday, they didn't give me carb target so far. I just realised that I can't exclude them and was trying it out by myself.

I will ask them about keytones test. never heard of it. I saw the dietitian, but she wasn't that helpful to be honest. Young and in a hurry.

I am not very good with excercise though, maily count on my extensive walking, if it gets worse I will have to do something about it.

I found/find breakfast the hardest too, apparently more people have most insulin resistance in the morning. I was finding I was over my limits without having any carbs at all. Plus my before breafast reading was always over. They were quite adamant that I must include carbs at every meal and even gave me quite a lecture about it.

Advice does differ for every person, so do check, for you the advice personally might be different.

One thing the dietician did say to me was that carbs are carbs and low GI is good, and probably better for you healthwise in the long term, but your body will turn all carbs into sugar and 10g of carbs is 10g of carbs and your body will react to it similarly regardless of what you eat that 10g of carbs, so it will do the same thing to your sugar levels. From what I can gather though, protein, fibre and fats will slow down or help slow down absorbtion of carbs, so combining those with carbs will help keep your readings down.

Hopefully they can get a more helpful dietician for you. I've been really lucky, the diabetic team at my hospital are outstanding and I see them weekly.

midori1999 which hospital are you with? your dietitian gave you a much better advise

I have just been diagnosed with GD at 29 weeks. I have been told to keep my pre breakfast below 5.5 and after food reading below 7.5 so far my pre breakfast levels have been 4.6, 4.4, 4.9, 4.6 and my after breakfast range from 5.3 to 6.9, after lunch range from 6.1 to 7, and after evening meal are around 5.2, 5.9, 5.7 and a 7.3

I am eating:
30-40g carbs breakfast
10g carbs snack
30-40g carbs lunch + 10-20g dessert
10-20g cabs snack
30-40g carbs tea + 10-20g dessert
10-20g carbs supper

My typical day is:

Breakfast - Porridge

Snack - Cereal bar

Lunch -2 scrambled eggs on w/meal small toast
Dessert - mini twister ice lolly

Snack - fruit

Tea -chicken & salad with 1 small slice of w/meal bread
Dessert -fruit

Supper - Low cal hot choc drink

I worry about too much fat and know eggs arent good and can only eat so much tuna / salmon a week - finding a healthy balance is difficult.

I am not on insulin or tablets, do my readings sound normal ? They scared me with the still birth risks and big baby risks. My blood pressure was ok, my urine ok and my belly measurements were in range. I have to have extra scans now - first one being tomorrow at 30 weeks. I worry my levels will be a cause for concern???

Any advice please????

I have to go for a GD test in a few weeks. I really, really want a homebirth - but I'm guessing if I'm diagnosed as having GD that I wont be able to have one?

I had Gestational diabetes and was put on a fair whack of insulin, breakfast is the hardest meal by far, couldn't have any cereal at all. Bergen bread is pretty good, takes a bit of getting used to but I did well with that, also cheese and crackers were a favourite snack.

By the last few weeks I was able to judge for myself how much insulin I needed before a meal, also had the long acting one. It is hard though I was constantly having ++++ ketones and lost a lot of weight, was told to eat malt loaf before bed .

Have you had any hypo's Midori? I did have a few, usually around lunchtime, not nice

Ct148 - why are you going for the test? Like all pregnancy interventions it is something you are being offered, you don't have to take it and there are consequences both to taking it and not taking it.

AnnetteL, I think that sounds fine, the levels they have given you are even tighter than mine! (5.9 prior to meals/fasting and 7.8 1 hour after) I couldn't control with diet though and am on a fair whack of insulin now. I don't have many deserts really, just fruit, yoghurt (Muller light or weight watchers ones) or sugar free jelly. For lunch I like wholemeal pitta bread filled with either a greek salad or salami and cheddar cheese and toasted. (I microwave the salami a bit first so it's hot, just in case!) I have it with celery and cucumber sticks and radishes and sometimes a sliced avocado as I am craving salad veg at the moment. For dinner tonight I have had home made chicken curry with spinach in it and brown rice. I have boiled eggs and toast for breakfast most mornings, there is no longer any limit on how many eggs you can eat per week. The bread I like is Hovis Seed sensations dark, it's got a lovely texture to it. What cereal bars have you found for 10g of carbs? The lowest I have managed to find is 15g. Penguins however, are 12.6g, so I do very occasoionally 'cheat' and sneak one of those.

ct148 they can't really stop you having a homebirth, but if you are diagnosed, how well controlled you are would determine how sensible it was really. I would personally suggest taking the test, if you have it you have it, but if you have it and it is undiagnosed, the risks to your baby can be very high.

VforVienetta, luckily I haven't had any hypos so far. I am very careful about eating regularly, so I am not sure if that helps? I'm also very careful about how much insulin I take, although I can't really increase it fast enough at the moment to do anything else except keep me just under targets. My DH lives away at the moment, so if I did have a hypo and it got severe my 10 yr old DS would have to deal with it and I'd prefer him not to. I've been lucky enough not to get any ketones either, but the dietician was extremely strict about how many carbs I should eat and that I must eat them.

Good for you Midori, I had conflicti opinions from the consultants and the dietician, it was all very confusing. I gave up any kind of sugary treat, biscuits and chocolate ect.

It was odd tough, on the occasions I did give in and have fish and chips or a chinese takeaway my sugars were pretty good. I didn't have bad hypo's, just felt shaky and lightheaded when I had gone too long without food, I carried sugar tablets about just in case, but food usually solved it.

I think because I was already fat, the reduction in my calorie intake due to the diabetic restrictions meant I would always have ketones +++, due to losing weight.

I should go back and eat what I did then, it's easy to diet when there is a baby at stake

Hello can I join in with this thread? Or should we start a new 'support thread' for GD? I was diagnosed last week. I'm coming up to 32 weeks now (dd 17 July) and I'm only just coming to terms with the diagnosis, especially as I had also been hoping for a home birth.

I didn't really appreciate the way I was treated in the hospital. I was there for four hours, lumped together with four other women with GD, and we were herded from one talk to another. There was very little feeling that I was being treated as an individual, and I also felt that there was absolutely no middle ground - now that my blood sugar values are known to be over their limits, I am officially 'high risk'.

I'm in Sydney, Australia and it looks like their targets are even stricter than in the UK. I have to try to get my fasting blood sugars under 5 mmol/l and post-prandial under 6.7 mmol/l (1 1/2 hrs after meals). Plus the endocrinologist told me 'there really is no negotiation about the fasting value' and that it was likely I would be put on insulin at the next appointment.

I have only been testing my blood sugars for two days now and of course the first day the values were all higher than the healthcare providers would like. I've managed to have two readings today below the limits, basically by limiting carbs more than they suggested, eating nuts as snacks and walking a lot before I take the reading. I've just had my 'supper' (100g yoghurt) and I'm planning to go on the exercise bike before bed.

Breakfasts seem to be a real difficulty and certainly I have been having high readings even after porridge with nuts and no fruit whatsoever (and the portion size was smaller than they recommended because I couldn't finish it). So I've read through old posts and had some ideas. We previously tried to eat low GI foods so I was eating multigrain bread anyway but I might have a look for german-style rye bread as I like this and people seem to recommend it. And I told dp to buy lots of eggs at the supermarket today. :)

ct148 I have found a few (very few) stories of women with gd who managed to have a home birth (try looking at the homebirth.org website) but I was strongly advised against it in the clinic on Thursday. However they aren't very supportive of home births over here full stop, whatever your situation. I have an appt with my independent midwife tomorrow and will ask her lots of questions, and I'm also waiting to hear back from the IMs I used in the UK because I really respect their experience. I had two successful, straightforward home births with them and never took the GTT so I don't know whether my values would have caused concern or not. I am still not quite sure whether it was a good idea to take the test this time round...

Hiya, I have been diagnosed of GD. Surprisingly, I haven't been asked to check my sugar levels before breakfast, but I need to check an hour after breakfast, an hour after lunch and an hour after dinner. I have to keep my readings under 8. My readings after breakfast are always under 8, but the one after lunch seems to shoot up at times. Today it went upto 10.7, and I can't tell you how depressed I am! I stick to a strict diet and I think it's the nuts (all sorts brazil/ pistachios/ cashews as snacks) that's causing it. It sounds strange, but the days I am at home and not working and have some other snack, the readings seem to be fine.
I don't want to go on insulin or any other form of medication, but wanted to know from other ladies if occasional high readings are a cause for worry.

Hello friends,
I was diagnosed with gestational diabetes in 28 weeks now I am 31 week pregnant... I am monitoring my reading from the past 4 week but my fasting reading is still high means it's like above 90mg and less than 122mg.
And my after meal readings are pretty good in control.... Even my late night reading also in control now.
I am taking metformin also two times a day plus following a strict diet and exercise too but still my fasting numbers are pretty high....
Please help me what should I do to control my fasting reading... I have tried everything but nothing works.
I am so tensed because of that. 😢

Thanks in advance

Try a middle-of-the-night snack. And Google the dawn effect.

If it doesn't sort it, it's definitely worth a try.

As to the OP. Stop eating/reduce the carbs and go for meat, veggies, tiny portions of fruit, plain yoghurt, no sitting down straight after meals. Always, always combine carbs with some protein and fat. Nuts are good too.

All brown bread isn't the same either. Some of it contains pretty high amounts of white flour, which spikes blood sugar. Just look for bread you can eat without spiking your blood sugar and stick to that. Pumpernickel bread should be good.
Reduce carbs at every meal and fill up the remainder with meat and veg (with low glycaemic load).

I was not formally diagnosed as I refused the fasting test and chose to monitor instead. The first two weeks I had serious spikes, but now I'm on a diet of egg + tiny slice of bread for breakfast, salad and a tiny sandwich for lunch, I seem to get on fine.
Roast potatoes seem to be great for me, weirdly. Boiled potatoes are an absolute nono, mayo and sauce or not...