Support thread for those diagnosed with Gestational Diabetes

[HighFibreDiet]

Hi, it seems there are a few of us around and I wondered if you wanted to start a support thread? There seemed to be a good thread going through 2010 but I can't find one running at the moment.

My due date is 17 July. I took the OGTT at 30 weeks (not realising that the best time for diagnosis is supposed to be 24-28 weeks). I was only diagnosed last week, given my blood glucose monitor on Thursday and have been trying to tweak my diet to bring down the readings since then. Seeing my midwife today and have to phone in my readings next week to see what they make of them!

My main problem seems to be the fasting blood sugars and the endocrinologist I saw on Thursday said if I couldn't keep them consistently down, I would go on insulin, with 'no negotiation'.

Would love to hear from other pg women with GD, or those who have been through it before. I'd also like to compare how the antenatal 'care' varies with country, as I am in Australia and it seems extremely strict over here (e.g. my fasting blood sugar levels have to be under 5.0 mmol/l).

Looking forward to getting some responses

Thanks highfibre, I'm trying hard to eat exciting food even though I'm limited! Luckily I eat a lot of the 'right' stuff normally, just need to sort out portion sizes (am guilty of filling up on carbs) and cut out the junk. Hadn't really twigged about the carbs in beans and lentils so will take a look at those :)

hubba I've been told under 5.5 fasting and 7.8 after meals. But for a higher BMI, they'd say under 7.0 after meals.

Gosh Squirrel, that's quite a difference ? my BMI was completely normal pre-pregnancy so it's not that. I've had the odd meal at 7.1 or 7.2 so by your figures I'm still OK, other than that I've been comfortably within the limits and haven't actually change my diet at all.

The finger pricking's not too fun, but if it needs to be done then fine ?
it's the difference in information given out I'm finding really frustrating. A friend of mine who's registered at Pembury in Kent was told that the limits for GD have recently been lowered and since then they've been 'inundated' with GD, so TBH I'm finding hard to know who or what I'm supposed to trust?

I agree that the different recommendations are confusing!

NICE guidelines say 3.8-5.9 fasting and

Oh that's interesting Squirrel, thanks ? I'm pretty sure that the diabetic nurse at the hospital already has my card marked as a reckless troublemaker, so good to have these facts up my sleeve ;)

Levels women are asked to stick to for GD vary from hospital to hospital. My BMI was 30 at booking and I have been told to stick to between 3.5-5.9mmol fasting and before meals and under 7.8mmol one hour after eating. I know people that have been given the same levels, but the post meal reading is two hours post meals and others that have been given under 5.5mmol and under 7.5mmol 1 hour post meals as readings, so it gets confusing.

hubba you might find your readings go up over the next few weeks as insulin resistance often goes up until the very end of a pregnancy. When I first started on fast acting insulin I was on 3 units with breakfast and my after breakfast readings were in the 7's quite often, sometimes higher. Now I am on 18 units of fast acting and my last two days' post breakfast readings have been 10.7mmol and 9.8mmol, so I am going to have to increase it again. Goodness knows what it would be without the insulin, I am eating the same things though. My fasting readings haven't changed that much and are usually over too, I started on 12 units of slow acting insulin and am now on 40, so again, goodness knows what they'd be without the insulin.

I am hoping to get a date for induction at my appointment next week. (I will be 35 weeks then). I am not worried about baby's size, I have had big babies previously with no problems and although she's on the big side, all her measurements are big, not just AC. I just worry about placenta problems etc as things go on, especially after losing my twins at 24 weeks last year. I'm hoping they'll induce me around 38 weeks.

hubba my hosp said 5.5 and 7.8 too so seems yours is veering on the low side..

has anyone else been put on metformin and instead of going down blood sugar has gone up??? since ive started on it i only had 3 readings so far but all over 8 whereas before it was not that bad?

Hubba that does sound quite low. I have been told 5.9 for fasting, and below 7.8 after meals, sounds like that is the standard one! I was also wondering what all the fuss was about - my GTT was 8 something or other, which I didn't think sounded that much over! In fact I have been quite surprised since I have been doing the testing 4 times a day, mine are always over after breakfast - and sometimes by quite a bit, which I didn't really expect!

Firawla my levels have been better since I started on the metformin, although I was still over after breakfast (only just, instead of alot over!) I also haven't been feeling as hungry or thirsty since I started taking it, which is a bit of a bonus. Maybe it doesn't work as well in some people? - complete guess, obviously I am not a doctor!

Ahh, I had another appointment yesterday with the metabolic team in the Royal,Belfast. And..despite my blood sugar being controlled perfectly with diet and exercise so far (and a different obstetrician telling me that each case is individually looked at when it came to induction), I have to go back in two weeks for my monitoring and to set a date for induction (another obstetrician yesterday then informed me that no, it was a 'blanket sledgehammer' approach) cos they wont go past my due date so I will be doing everything I can to avoid that! Whatever happens my wee son will be with me in less than 4 weeks. Eeeek!

good luck belfast! how many weeks are you? is it 40 weeks they are gonna induce you then? if your levels are good and managed well with just the diet i dont see how they could be thinking of inducing much earlier?!?

Thanks Firawla! I'm 36 +3 today. I'm hoping they will say 40 weeks on the dot for induction..it will give me time to try and coax him out myself with lots of walking and complementary therapies etc. :-)
I went on the tour of the delivery suite last night which was sort of reasssured me - I was all calm about the birth until induction was mentioned, it sort of made it real or something. I've been doing so well with the blood sugar control that it was a shock. I suppose he has to come out at some point so the menthod doesnt really matter in the end but it's a bit scary (1st baby so I have no idea what I'm in for!).

I see they plan to induce you too. Hope you get the extra weeks to find somewhere to live - that must be pretty stressful!

3kids I've found that breakfast is when mine is highest too ? combining carbs with protein seems to help. I had wholegrain toast with two scrambled eggs (plus ketchup ? can't eat my eggs without it!) and a glass of apple juice that was half water this morning, and got a much lower reading (6.1) than usual (about 6.9/7.1 normally).

I'm supposed to call the evil diabetic nurse at the hospital today/tomorrow so I'm definitely going to query the limits she's given me ? although I'm sure she'll have a pop at me for not taking this seriously, like she did before!

Good luck Belfast! I had my twin girls at The Royal last year and the midwives couldn't have been better or more lovely. I was originally booked at the Ulster then too (am at the Ulster this time) and was really put off by the building being so old when I was admitted, but the care more than made up for it. I was initially put off by the thought of induction, but I just want baby out now, I am so worried and my 10 year old DS made a card for the baby yesterday and had written on it 'hope you make it' which made me cry. Awful that children have to know that being pregnant doesn't mean you get a baby at the end.

hubba I am very jealous of your breakfast readings! I usually have two slices of seeded toast and two boiled eggs for breakfast and my post breakfast reading the last three days has been 10.7mmol, 9.3mmol and 10.2mmol. My fasting has been around 6.5 the last few days too. I/they just can't seem to keep on top of it and they are now worried about me getting hypos before lunch if they increase my insulin any more. Sorry your nurse is 'evil', I think I have been so lucky with my diabetic and obs teams, they are so lovely and friendly and always remember everything about everyone!

hi everyone, belfast sorry about their sledghammer approach, but even if you are induced you can still get a brilliant labour. I was induced with my first at 38 weeks but it only took one application of the gel, and lots of 'mobilisation' i.e. walking up and down the hospital stairs, and I went into labour that evening. He came out pretty quickly and with no pain relief (my TENS machine was at home with dp lol).

3kids and hubba breakfast is my worst post-prandial reading too and I am getting through loads more eggs than I would usually eat.

midori hope things stabilise for you, and your ds sounds lovely.

I had to phone in my readings to the nurse this morning. Initially she said it looked like I should go on insulin because of my high fasting values, but after talking to the endocrinologist they said they'd wait and see what my values were like over the next week. Seems my values can't be too shocking or the clinic would be rushing to put me on insulin. However my midwife said that the hospital she works at uses the same limits (i.e. under 5.0 mmol/l for fasting value) and they had chosen them 'based on recent research' so maybe other hospitals will start revising them downwards too.

Had spaghetti bolognese for tea tonight . I was shocked by how little of the wholemeal spaghetti was 'one portion' and then realised the shop-bought sauce had enough carbs to be another portion. I usually make my own sauce with loads more meat and less tomato, but was in a hurry today. However I was pleased to see that my postprandial value was still under 6.7, hooray!

Also went to see my brilliant physio who has given me loads more exercises to do working my thighs and glutes, so we shall see how much difference they make.

Time to get on the exercise bike.

not on the bike yet, just re-read my first para and thought it sounded like I was boasting . Not intended like that, just wanted to give a positive induction story as you can hear so many horrible ones that I thought I'd let you know it can all go fine even if you are induced.

highfibre it didnt sound like boasting, its good to hear!
my 1st was induced and wasnt really a good birth, so its good to hear these things because i really wanted to have a nice straight forward birth like my 2nd one, but then when u hear 'induction' tend to think oh no it will end up all over medicalised again!
midori that is so sad your ds wrote that :( but he sounds lovely, im sure your baby will be fine and hope everything goes well

about hypos do you only get that if your on insulin as nothing about that has been mentioned at all so far to me??

Thankyou both, he is lovely, although I am biased! We have a name for the baby already and my son insists on calling her by it and says goodbye to her every day when he goes to school and goodnight before bed every single night, giving my bump a little stroke.

Firwala I think you only get hypos if you are on insulin as they didn't mention them to me until they put me on insulin (although that was soon after my diagnosis). I haven't had any yet, but I think I've been lucky and I'm very careful to have my meals and snacks regularly. I think the insulin just increases the likelehood of your blood sugar dropping too low.

Evening everyone.

Highfibre I hope they don't put the fasting levels down - mine are never under 5!

Well I think I must have the crappest GP's in existence! Phoned up today to get more testing strips - and the Doctor actually phoned me back, wanting to know why I was testing 4 times a day, and also tried to tell me that any reading under 11 was fine . So have now had to get the hospital diabetic team to write to GP and tell them, actually that I do need to test 4 times a day, and butt out as they are obviously giving out completely the wrong advice!

Grrrr - as if I would be doing it for fun! hubba the diabetic nurses at mine seem really nice. Unfortunately the hospital midwife, and GP's are another story...I do wonder why some people choose to go into a caring profession when being nice to people is clearly against their nature..!

I think that happens with a lot of GP's tbh. When I first saw my diabetic team the nurse said if I had problems getting the glucose testing strips from my GP to let them know and they'd ring them for me. I have to test 7 times a day and she said some people get told they don't need to test so often and can't get enough strips prescribed. What a pain to have to get your diabetic team to write to them though.

I also got some crap 'advice' from a friend of a friend who is a GP at a BBQ about GD, but I think GP's mainly have experience/knowledge of type 1 and 2 diabetes and they are much, much stricter when managing GD.

I seem to be the opposite of everyone else - my readings are fine in the morning, but it's after lunch and dinner that they are sometimes high. Lunchtime today was my highest reading (8.9, so not as high as some of you) and I only had two measly mini rolls (with some hummus and veg) :( If I have another couple of high readings then I am supposed to start on the insulin which I'd hoped to avoid. Although on the plus side, I discovered this week that eating grilled halloumi with meals was quite effective at keeping the readings down, and I love halloumi!

hubba I am eating two scrambled eggs and one slice of toast every morning! It's the best thing I've found for filling me up :) Hope the nurse isn't mean to you again - I think they get so focused on one thing (controlling diabetes) that they forget to see the bigger picture.

highfibre it's good to hear a positive induction story I'm not really sure what's supposed to be bad about induction (naive first timer!) but I'm always happy to hear when it went well.

firawla I think it's possible to get a hypo without insulin, if you don't eat properly. But I guess you'd normally eat something before that happened and I assume your body would stop producing insulin if you were heading that way. Whereas you have more chance of getting a hypo from insulin if you misjudge it and have too much for the amount of carbs you've just eaten. At least, that's my understanding.

3kids about your GP, hope you can get it sorted!

Thanks Midori I hope everything goes well for you. Your DS sounds like a wee dote - he will be a great big brother. It's good to hear your care at the Royal was great, too.

Cheers Highfibre don't worry, it didn't sounds like boasting - it's really reassuring to hear a good induction report. Also, I got a shock with the shop bought sauces as well. You wonder what they could possibly add to tomatoes to make it so high! I'm off on my leave now so luckily have more time to make things from scratch.

Hope everyone has had good readings today :-)

Ooooh Squirrel I love halloumi too ? think I'll get some tonight!

Readings were a bit high yesterday ? I had a bean burger and sweet potato wedges for tea and got a 7.6 ? but seem to be back down this morning. Fingers crossed my phone call with the nurse doesn't descend into an argument like the last time?

How's everyone else today?

Morning everyone.

Don't think this is going to be a good day... had 7.9 before bed, and 9.3 after breakfast, even after taking the metformin. Really can't get a grip of these levels - even though I eat roughly the same things, some days the levels are fine, and other days always over. How does that work? I did have my tea later yesterday - but surely it shouldn't make that much of a difference?

On the plus side, went to pick up the glucose strips from the docs this morning and they have given me 100, instead of the 50 they gave me last time, so at least I won't need to fight with them for another few weeks

Hadn't thought of hallumi actually - do quite like that, and haven't had any for ages. May have to get some!

midori I can't believe how little the GP's ect. seem to know about GD. Maybe they all need a bit more training . Although does anyone happen to know why the levels are so much stricter when pregnant? Is it because of the risks to the baby?

Presume so 3kids, when the midwife called for my GTT results she was told by the biochemistry dept that my results were fine as they were under 11? only for me to get a call 5 mins later telling me that actually the limit for GD is 7.8, so I think the normal limit is much higher. I know what you mean about the readings being up and down even when you eat the same thing ? have you tried testing again straight away with the same puncture? Sometimes the difference is as much as 2!

Just called the diabetic nurse and got an answerphone saying that if I was leaving a message after 2, they won't get back to me today. Saved for another day!

I also assume that why 3kids. The levels you have to stick to for GD are those a non diabetic would be expected to be within. I think for type 1 and 2 diabetics that it is much harder to control their blood sugar and so they aren't usuall expected to be able to stay within those sort of targets.

I have had my first hypo today. I hope I don't get another, but luckily it was just before lunch so I was able to sort it before it got too serious, so I just felt a bit headachey/disorientated/dizzy and generally sick. I think it's my fast acting insulin with breakfast that will need to be adjusted and then maybe they'll increase my slow acting to help my breakfast readings as my fasting and post breakfast readings are still over, but then my blood sugar is going low before lunch and snacks don't seem to make a difference. They've never been low enough pre lunch to hypo before though. My DH was with me too, otherwise I think I would have panicked.

Evening everyone.

Well really can't get to grips with this diet thing. Had exactly the same thing to eat this morning and yesterday morning. Yet yesterday levels over when tested before lunch, but todays, although over after breakfast (as usual), were fine post lunch?? Really can't get my head around it!

midori that must be quite scary! How much longer have you got to go?

Well we are away for a week starting tomorrow, so won't be on for a while. Hope everyone is doing ok.