Gestational Diabetes - am I being unreasonable/foolish? long - sorry

[iris66]

I'm after some honest opinions here please.

I failed by GTT on Fri and was summoned to the hosp on Sun to talk testing/diet etc and be given all the kit. I've been testing more frequently since Tue as I'm really worried that I won't be allowed a home birth (pertified of hospitals following really bad experiences) and that I'll have to go on insulin (and that it will be permanent - my dad is diabetic)

When I spoke to the MW on Tue (worried that my sugar seemed to be all over the show) she assured me that this was normal for the first few days whilst my body adjusted to dietary changes. The blips I've had since Tue I can explain away and I'm fairly comfortable that my body is bringing sugar levels down to the parameters set.

Anyway I called this afternoon to give the MW an update (as she had asked) & was called straight back by the diabetic nurse who wants me to go in next wed so they can put me on insulin!!! The main reason she gave was the risk of a big baby but I've not been offered a growth scan or additional time to demonstrate that my diet has changed. This is a decision she's made after only 4 days of testing!

My question is this: Can I insist on growth scans to confirm whether my baby is growing too big before going onto insulin or would waiting have a detrimental effect on the baby (other than the growth issue)

Apologies for the ramble and if this is a no brainer but I'm really not handling this too well. TYIA

I should add that the main peaks that they seem to be bothered by are when I test 1 hour after breakfast- as I was told to, other meals are 2 hours after and have all been fine.

Seems a bit rushed to me, although it would also depend on what your GTT results were.

In your shoes I would ask for more time so that you can actually see what your glucose levels are, and so that you have had time for your dietary changes to work. The main reason for putting you on insulin should be your blood sugar levels, not the fact that you risk having a big baby.

From what I remember, the main peaks should be at an hour after eating, and back to normal after 2 hours. Sounds to me like she's jumping the gun.

Oh thank you sooo much - that's what I thought. I even put it to her that perhaps if I tested 2 hrs after breakfast it would show that my sugar was fine but she then said that they advise an hour after breakfast because of the effect that waking up has on your hormones, and thus sugar. I thought that the effect was to put your sugar up!? but she didn't seem to want to discuss it. I was totally confused.

Is this the diabetes midwife who has suggested that? Can you ask to see a diabetic consultant rather than the midwife so that you can try and clear this up - I saw a combination of diabetes midwife, nurse and consultant and it was the midwife (lovely as she was) who was least knowledgable about the condition.

You should also be given growth scans as a matter of course.

i wake up early but wait for a couple of hours before getting up because I'm usually starving. Morning levels have been 5.2 on 3 days out of 4 (I did test early one morning & then an hour later - no food/drink - sugar had increased by 0.6)
mY pre/post lunch/dinner levels have been within the parameters they gave (

They're lower than my levels were, and there was never any suggestion that I should be on insulin. I think you should ask to see a diabetes consultant as well as the midwife.

MW hasn't been too bad but clearly felt she couldn't advise me (re: 1 hr thing)so referred me immediately to the diabetic nurse - who wants me on insulin asap.
I have an appointment next wed (diabetic clinic)so hopefully there may be a consultant there. If not I'll defo ask for a scan (have no qualms going on insulin if there is a proper risk to the baby but, as you pointed out, it all seems so knee jerkish!

Bawled my eyes out after the phone call but am now getting v v over the whole thing.

I was on insulin and it wasn't so bad. Why would yours be permanent? My mother had late onset diabetes and I reverted to normal after the birth.

I took my bloods for a week before they decided. I had lots of scans later on. Baby was still huge 10lbs 9oz. I suppose be could have been even bigger without the insulin.

Some hospitals are more aggressive than others. A frendd had 2 babies at 2 different hospitals and although levels were similar one advised insulin and one didn't.

hi again iris .

those post-breakfast levels are too high i think. what have you been eating? your body is more insulin resistant in the morning (why???), so you have to eat less than you would at other times of day to increase your sugar more if that makes sense. i have pre-existing diabetes, & when i was pg with both my children, the advice i was given was that blood sugar levels should be below 8.0 1 hour after eating and below 7.0 2 hours after. different hospitals seem to have slightly different guidelines though.

how pregnant are you? a one off growth scan won't tell you much, serial ones done approx 4 weeks apart are of more use. but high sugars for 4 weeks wouldn't be a good idea. is this your first baby? if not, have you had a big 'un before?!

i know the thought of insulin is terryifying (i only need insulin when i'm pg, not all the time), but it really really isn't that bad, the needles are tiny. and it won't be for long. and it really is the best thing for your baby.

good luck!

I think I have been suffering from panic induced "lets just concentrate on the worst that could happen and freak out over it". It seems to be a recurring theme at the mo ;(
My dad has diabetes (amongst other significant health problems) and can't control his sugar at all (normal for him has become 10-15) I've been worried to death that I'd be unable to control mine.

but the insulin will help you control your sugar levels. it really doesn't mean that you've failed at anything, just that your body needs a bit of help at the moment.

hi hoxton - don't know what els to do with my diet!

yesterday
0845 - sugar=5.2
0915 - 2 Tbspns porridge made with soya milk 2 chopped prunes & 2 chopped apricots
1015 - sugar=8.8
1115 ate a small scone with tiny bit of butter
1345 - sugar=4.2

today
0645 - sugar=5.2
0730 - 1x scrambled egg, 1 rasher of lean grilled bacon & 1 plate mushroom on 1 slice toast with scraping of butter
0830 - sugar=10.3
1200 - sugar=4.7

29+4 btw

v. healthy! i think you might have to accept that you need a bit of insulin to help balance things. perhaps just before breakfast even as that seems to be the problem. are you testing after the other meals?

and no sugar has shown in my urine samples yet either!!

what size was the baby at your 20 week scan?

yes - 2 hours after

yesterday
lunch 6.8
dinner 7.3

today
lunch 6.4
not yet done after dinner one

consistent with dates (and I know the dates are correct as DH was only in the country for a week that month!)

Can't help on the home birth angle but wanted to echo hoxtonchick and jane 313 - insulin is no big deal. I had GD and from minute I was diagnosed I was so strict with my diet but still, a week later, ended up on insulin. I can honestly say, it was the best thing that happened to me - I stopped freaking out about my readings and was able to eat a reasonable amount of food.

However, I did bawl during the injection demonstration and for the first few days when I had to do the jabs (I'm a bit phobic about needles!) - but after a week or so it was second nature and I even started showing off by doing my 'jabs' in front of friends!

What I'm saying is, going on insulin is NOT a sign of failure - or even an indication that you will def. end up diabetic after pg - I didn't. What I do know now, is that I have a risk of future diabetes and that I have to watch my weight, diet etc. That knowledge puts you ahead of the rest of the population who haven't a clue that they are similarly at risk.

I'm so sorry that you are going through this - I do know how scary it is. If it's any consolation dd weighed in at a massive 6lbs 15oz after my GD, insulin dependent, pregnancy.

listen to zippy! i am a hardened person with 'real' diabetes, but she was in the same situation as you.

ps my dd was 6lbs11, ds 7lbs10. big babies are not inevitable.

Think I'm going to do as WWB suggested and insist I see a consultant. DH is unable to come with me at the moment but I feel in a much better position to a give reasoned argument now -- rather than presenting as an hysterical hormonal pg woman!!

Thank you so very much for all your support and advice (and for being so patient with me when I rant!) WigWamBam, Hoxton & Zippy ((((hug)))) . I feel much better (ie calmer) now. need to go for a calming bath I think.

Meant to say before - I agree with the person who said it depends on the hospital/consultant whether you get insulin or not - some are just more cautious than others.

Is there a specific reason why you are worried about going on insulin? (Not withstanding being worried about long term diabetes re your Dad which I totally understand).