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

nothing specific but I thing you hit the nail on the head when you used the word "failure"......the word "issues" sort of springs to mind

and the phrase £get a grip iris!!!

hormones.. hormones... hormones... only 10 and a bit weeks to go tho. (hope it whizzes!)

Hiya Iris, I'm really sorry to hear that you're having trouble with your sugars and you're not getting much info and support from the diabetes nurse.

Would echo what the others have said - it's definitely not failure to have insulin.

My levels have stabilised somewhat, which makes me very ashamed of my diet before my GTT But I'm eating far less than I was (again ). My fasting levels are always up to nearly 6 in the morning - waking up must do something odd to the body!

For me, it has really helped to go over what I was worried about with my pregnancy, the birth and how the baby will be.

With the pregnancy, I don't want to feel like utter shite (which I had been - I'd been feeling like tepid death for about three weeks). I don't want to grow a big baby, because I'm already struggling with SPD and I know that getting heavier won't help. Plus DS was 8lb 10oz and I know that second babies are often bigger anyway.

With the birth, I'd wanted a homebirth, but only if everything had been straightforward with my pregnancy. What I really, really want is a waterbirth, which I'm hoping I can still have at hospital. I've already talked to the diabetes midwife about it and she's going to ask my community midwife if she'll go on call for me, just like she would've done if I'd been having a homebirth - that way the only thing that should stop me having a waterbirth is someone being in the pool (if everything else is going smoothly).

WIth the baby, I don't want to have to give formula if sugar levels need stabilising, so I've talked to the diabetes midwife about it and she's said that as long as I feed the baby soon after he or she is born, they'll probably only take one sugar level reading (unless it's really low, then things might change).

Sorry for waffling about me on your thread - I just hope it might give you some ideas about how to isolate what you're really worried about and work out whether it's the loss of control of the whole situation (I felt a bit panicky about things in general last week, so pinning down what I was really worried about has helped) or whether there are specific things that are really worrying you.

Always here if you need a chat - and don't be fobbed off by the diabetes nurse. If you don't understand something, ask and ask again x x x

You wouldn't be a failure if it turned out you did need to have the insulin. I do think you should talk it over with someone who has more knowledge than your midwife, though - see what they say next week when you go to the diabetic clinic.

There's nothing about having to use insulin that would make you a failure.

just as a last note - thanks & hugs to you too Jane (sorry - overlooked your name - but not your contribution)x

hi humkermunker - you are such a stabilising influence on me you know, and hearing your experiences really helps. I think I'm just so hormonally challenged at the mo that I'm going off into the deep end at the slightest thing. It's not helped that DH is working v long and wierd hours at the mo so I'm dealing wtih most of this on my own (well, with you lot actually - for which I am eternally grateful).

I am going to call the diabetic nurse tomorrow, re: my appt next wed, & ask for a scan, to see a consultant and to see a dietician to get some clarification on the whole thing. I also think it would be prudent of me to write down all my concerns so that I can make sure my key concerns and questions are answered.

Iris66 - okay, I understand. I am 'FAILURE' Queen when it comes to childbirth/parenting - and did weep like a baby when put on insulin for all those reasons. In the long term, however, I accepted that despite my best efforts I needed a bit of chemical help!

I can honestly look back and see that I did absolutely everything I could re diet etc to keep things on an even keel (when given instructions I follow them to the letter - sad, I know) but, at that point in time, my body needed a bit of extra help. So thank God for insulin .

In the end I overcame my feelings of failure and focused all my perfectionist tendencies on becoming a model patient for my VERY dishy diabetic consultant - by God, I worked to get my food diary looking good for him I blushed everytime he said 'mmmm, you've got the best levels I've seen in ages....'

On a serious note, I would def check out the growth scans (insulin or not) - you should be getting them regardless.

Your post has reminded me of how freaked out I was about GD at the time - so I do understand your anxiety completely. But a GD diagnosis can be a positive thing - honest.

cheers zippy - will let you know if the consultant proves to be a Clooney lookalike!

Last thing - my diabetic dietician (sp?) was totally rubbish and I did find that my midwives (and even my GP) gave out really bad advice as to diet etc. You're probably doing this already but check out some diabetic sites for tips on how to manage your levels/diet without completely depriving yourself. I only managed to work out an acceptable (and palatable) diet with the help of diabetic chat rooms (some specifically orientated towards GD). I've changed computers since, and don't have the links but google about and you'll find them - though the american ones use different terminology re levels etc they are really useful.

TY

Iris, Zippy's point about a GD diagnosis being a positive thing has struck a chord with me - I really feel that I needed this to make me get my diet back on track. It had been too easy to reach for the snacky option, to eat crap because I was too tired to get something decent (and because I was eating crap, decent food was bland - it's amazing, the effect sugar has on the body!).

I really feel like I had been poisoning myself, and I feel almost lucky that I have the chance to get to know how my body processes sugars. I had eaten a relatively healthy diet, and I do know what to eat, but I was eating lots of sugar-laden things on top of that, so getting worse and worse.

I hope that you get some help from diabetes nurse - writing down your concerns will definitely help you, I think.

Am usually around, so give me a shout if you need stabilising and I'll try my best - it really helps to know there's someone else going through the same thing and dealing with similar issues, doesn't it? x x x

Iris, how are you this morning?

My levels are higher today - 6.6 after the same breakfast I've had all week, which has given me 5.4 and 6.0 (forgot to take it yesterday - am SO stupid!). I'm finding this fascinating. Not many people get the chance to know this kind of stuff about their own bodies.

hi there hunkermunker - I'm much better today thanks. Hope you are too.

I phoned the mw this morning & got a different (& clearly more experienced) one. I explained everything & she spoke to the diabetic nurse & called back saying that I should now test 2 hrs after b'fast instead of 1 and that I don't have to go in until the date originally planned (week next Tue - 22nd) & if there are any problems at that point she'll make sure I have scans, see a consultant etc before considering insulin. I am so relieved. She sounded annoyed that I'd been left in such a state over it all week too, which made me feel loads better. I feel like I've got someone on my side there now.

Sorry your levels have risen - but they're still within your range though aren't they? it's strange the way your body can react differently to the same food isn't it but I agree - it's fascinating to have this insight.

I was thinking about the morning fasting levels earlier, and it occurred to me that there could be a logical explanation to why they are on the high side: the "specialist diabetic nurse" (NB not specialist in maternity/GD!) said that hormonal activity on waking causes sugar increases (I already know that when sugar levels drop your liver starts secreting glycogen to balance it up so that all makes sense) But my thoughts are that if you wake a few times in the night (uncomfortable, need a wee etc) then surely those hormones are going to kick in at each point and raise your sugar levels accordingly(? - correct me if I'm wrong - I'm no expert and this is pure conjecture) It would therefore follow (to me) that the nocturnal activities of pregnancy would naturally increase waking levels - but maybe only in those who wake a lot.

I'm going to put this to the MW/nurse to see what they say but it would make sense to me that the higher fasting level is normal in pg and there is no problem unless sugar levels don't return to normal levels within 2 hrs of eating.

Hi Iris,
Glad to hear you are feeling better.
I had GD this year with my second and wanted to say that I totally sympatyze with how you are feeling...

In my case, I was so worried about my reading that I ended up not gaioning a single ounce in the last ten weeks, and still went into insulin ! But as zippy said, I'm glad I went on, so I actually ate more decently without being worried!

Baby was born exactly on average - 7lb, 14 oz but was very skynny! He gained 3lbs in the first week out! I think I starved him! and he was just genetically supposed to be big, IYSWIM...

Anyway, just wanted to tell my story because size is not all... I did a lot of research and believe sugar levels are the best indicator of yours and baby health (BTW, by keeping your sugars controlled you have a lower chance of keeping the diabetes afterwards, because you are not pushing your body to its limits...). Accepting the insulin at first was hard, but in retrospect was the best thing!

Good luck!

Urm - just remembered something. Before you check your levels with the pin prick thing, make sure you've washed your hands. I checked mine once after passing dh a very sugary doughnut and the result was soooo high that I felt compelled to phone the diabetic emergency line, who then summoned the consultant out of a dinner party, who then was about to call an ambulance before I realised what I had done... Verrry embarrassing....

lol at your Zippy. Sounds like the sort of thing I'd do!! (and thanks for your advice too lua)

I think the reality of the effect my diet was having has finally sunk in - it had become apalling for about a month before my GTT (thank goodness I was taking vitamins or the poor baby would have hardly got anything other than sugar!)so it's little wonder that my body was having problems coping!

My sugar levels (appear to) have stabilised completely now though so I'm fairly hopeful that I'll be able to carry on as I am. I've even tried chocolate, and home made birthday cake - large slice, complete with butter icing (admittedly, the latter was in a fit of pique) to see what effect they would have but they didn't sppear to raise my levels by much at all.
Fingers crossed eh!!
Hunkermunker - like you, I'm finding it a big eye opener though the phrase kick up the arse with a size 10 boot describes the feeling better!!) and i only hope that I maintain this once the baby's born.

fantastic thread, iris. I've learnt quite a lot just from the posts on here. I didn't know about the morning fluctuations in hormone levels which has answered a query I've had for a while. I also agree that your theory about nocturnal waking seems to make sense.

Also, like you & hunkermunker, I'm glad I was diagnosed with GD. It's hard to believe that for a year before conceiving I followed the Gillian McKeith diet, I'd never been healthier in my life. Once I was pg, all I wanted was dinners & sweets which ultimately led to my GD.

Anyhow, I'm pleased your levels are stabilising. I'm quite at you for eating that birthday cake!!! I've been relying on chocolate muller light yoghurts for my choccy fix. Not the same!!!

Forgot to say, did the advice about reading the carb values on foods help??

Hello just read this thread - I had GD with first baba - probably due to poor diet and eating too many cakes and sweets! Managed to control it with diet only but ended up with 10 lb 14 oz baba girl - who is now an average 3/5 year old! I found the testing fasciniating and also experimented with small amounts of chocolate - apparently my GTT was the highest score they have had at the hospital for years!! I was only tested at 34 weeks as it coincided with xmas when they were closed and I manged to lose 7lbs in the last 6 weeks!!!