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

Evening everyone.

Well after having prepared myself for going on insulin, my post breakfast reading was just under....so they have said they are just going to keep a close eye for now...!

Eviepoo in my area you are referred for the full diabetic stuff if the GTT is above 7.8 after 2 hours - mine was only a bit over - can't remember exactly what, something like 8.4. I was a bit sceptical at first when they wanted me to do all this testing, but I have found it extremely difficult to keep the levels down, and that is with taking metformin as well. When I saw my consultant this week he said they have changed the guidelines recently due to research showing outcomes are much better if GD is controlled, even if it is only a mild case, so I would definately question it.

Eviepoo my GTT was 7.9 after the glucose and they've decided I have GD, so I'm stunned that they aren't even bothered about your result! It's great that you don't have to have all the restrictions of GD but definitely worth mentioning your concerns to the midwife.

I had a scan this week, and they reckon the baby is on the small side, not large, so that is one less thing to worry about! But, they are talking about inducing me early now, at 38-39 weeks (I'm currently 36) which I think is the hospital policy for anyone with insulin controlled GD. I'm a bit nervous about the thought, but also am quite looking forward to being able to eat chocolate and cake again!

mummysweeangel staying in hospital on steroids sounds a bit grim, I hope it doesn't come to that.

midori wow, next Thursday sounds really soon! How exciting to meet your baby so soon :) Fingers crossed the induction goes smoothly! How many weeks will you be when they induce?

evie think your results are similar to mine, and my hospital has lower levels to diagnose GD (7.8 after 2 hours). Definitely say something to your midwife if you are concerned, although in my experience the community midwife didn't know anything about GD and the specialist diabetes midwives are the ones to talk to. As for diet, the main advice I got was to have small portions of carbs and snack more often, but i think exactly how many carbs you can tolerate in one sitting varies from person to person.

3kids I was sceptical at first too, but have had enough high readings now that I am resigned!

I was diagnosed with GD during my last pregnancy and I was obsessed with my diet as I was determined not to have to take insulin. I went a bit mad though and by the end I was nealry eating nothing as I didn't want to chance my glucose levels going to high. Not a good thing to do though as you need your energy. Anyway I made it to my induction without having to take insulin but I had keytones in my urine which pointed to me being under nourished. I suppose what I am saying is try your best with your diet but sometimes nothing other than insulin will keep your levels down and it is probably better for the baby if you take insulin than starve yourself.
I am pregnant agian with number 3 now so i am waiting for my glucose test!! I imagine it will be positive again!

Franglomum, you're right that too little carbs or not enough food is potentially harmful. It's potentially extremely harmful. In my case I got a bit of a lecture for cutting out too many carbs (although I was still eating a small amount of carbs with breakfast and a sensible portion with lunch and dinner) and it wasn't controlling my blood sugar levels anyway. Insulin is not in any way harmful to baby and your body treats it exactly like insulin you've produced yourself. Certainly despite having to inject four times daily it's made my life much easier as I know what I should be eating, so I stick to that and then adjust my insulin accordingly. It also means if I want the odd 'treat' I can get away with it by adjusting my insulin. My hospital don't have any blanket policies regarding delivery once you are on insulin either, they take every patient on an individual basis. Good luck with your test!

squirrel, next Thursday feels like a million years away for me! My DH has requested a Fathers Day baby, so he's hoping I go naturally before next Thursday.

Baby was estimated at around 7lb 5oz at my scan yesterday, so if that's right will be a bit under 8lbs at delivery next week. It'll be interesting to see how accurate it is. I wanted another big baby, so I do feel a tiny bit disappointed to be getting a small one, but as long as she's Ok is the main thing!

Hey ladies -

was reading in the paper this morning that a lady from Inverness who had GD had a 13lb 10oz baby the other day - she was expecting a big baby, around 10lb but not as big as this !!

I am dying to know how big mine is this time, especially being that my first was 9lb 11oz born 2 weeks early without me having the GD !!

I am all set now for going into hospital on Monday afternoon - really sad and anxious about leaving my DS longer than what i expected :( but not alot i can do about it now and hopefully this time next i will have had my section and it will all have been worth it and rib cage wont feel like someone has re-arranged it with a baseball bat

My insulin levels got increased again yesterday, up to 14 with breakfast, lunch and dinner and 12 before bed - readings werent too bad yesterday but at one point i had "moderate" levels of ketones - will really be glad when this is all over -

Hope you are all well this morning - least its almost the weekend -

Midori - i take it we are both next for our LO's to be born !! Feels weird thinking that this time next week we will have new babies !! Hopefully happy and healthy ones !

x

mummuysweeangel, good luck for Thursday!!! I am so excited now. Do you think your baby feels big? I think mine feels small, plus she's a girl, so bound to be a bit smaller than if a boy I think. My first son was 9lb at term and the midwife kept insisting that the scans were always wrong and with my size there was no way he'd be bigger than 7lb etc etc. Second was 10lb exactly at 38 weeks, but 3rd was only 6lb 14oz at 37 weeks, so much smaller although not really that small for his gest. age. Have they said at your scans how big your baby is expected to be?

My friend had a 12lb baby at term, no GD. I had always thought she had a c-section, but recently found out she had a vaginal birth. I didn't mind having a 10lb'er naturally, but 12lb, ouch!

Hey midori - my cousin had 2 homebirths with her children, her first weighed only 6lbs and her 2nd weighed over 10lb - she had no pain relief and no tears/stitches - said the 10lb birth was easier than the 6lb one !

They have told me that my bubs is above the 95th centile - but havent given an estimated weight, they said they dont like to as it really isnt that accurate and as much as i feel my bump is huge - i cant really work out how big i think this one will be as i have only gained (as of today) 5lbs - so i dont know if its a case of the babys been getting everything i have eaten and is a big huge whopper and i myself have actually lost weight, or if he isnt as big as what they think - but then i cant imagine that to be the case especially with his abdominal circumference being above the 95th centile etc etc.. and with the weight of my first child aswell -

So excited now too midori !! just hope everythings ok with baby

franglomum it's funny you should mention diet, I'm worried about not eating enough either! I've only gained about 1lb since 32 weeks when I was diagnosed (now 36) and it's obvious that I have actually lost weight since then (my arms and legs look thinner). Plus I've had ketones in my urine at the past two checks. No-one has mentioned anything to me though, I just keep getting told to carry on as I am.

midori lots of walking? I've heard that's good for bringing on labour! Plus it keeps the blood sugar down ;) Fingers crossed for the fathers day baby :)

mummysweeangel ouch at the 13lb10 baby!!

franglomum - probably sounds like a stupid question, but how do you know if you are eating enough?

I am now a stone lighter than I was before I got pregnant, and have definately lost quite alot of this since changing my diet due to the GD - can tell as my clothes are getting too big, even though I am getting more pregnant!

When I saw the dietician, I told them roughly what I was eating, and they said that was ok - however since then have had to cut more carbs from my breakfast to get the levels down.

hey everyone, well after a worrying week last week my midwife said she was supporting my decision not to go on insulin and to still have a home birth, hooray! I believe I have fully investigated the risks and know what I am doing, plus I completely trust her to do the right thing in the event of something going seriously wrong (particularly shoulder dystocia). Anyway my levels have never been particularly high and the baby is a reasonable size - based on the growth curve from the sonographer she should be about 3.6 to 3.7 kg at 40 weeks which is just the same as ds2 was.

She said she'd speak to the hospital today and after that I could call to cancel my next appointments and just carry on with her, hooray! . She also said she was impressed by how much I was doing to keep my blood sugar levels down. I know it's not necessarily what I'm doing - I could have been unlucky and have them rise whatever I tried - but at least I've shown that I am being responsible rather than just saying I'm having a home birth no matter what and I don't care if the baby turns out to be huge or anything.

Looking forward to reading a couple of birth announcements in the next week!

Anyway it's nearly bedtime for me, so I'd better work out what I'm doing tomorrow (busy week this week) and then hop on the exercise bike for a bit. Night night to everyone.

Highfibre that's great news! So pleased your midwife is being supportive :)

I've got the start of a rotten cold thanks to a germy colleague coming into the office last Fri ? bah! So working from home and feeling sorry for myself. Had my first NCT class on Saturday, I'm now concerned that because of the GD diagnosis, I won't be able to have the birth I'd like. I've got a growth scan next Mon so as long as baby isn't huge at that stage, I'm expecting to have to grit my teeth and insist on a) not being induced and b) being able to get into the birthing pool if I want. I haven't had a post-prandial reading of above 7 for about a month now, so I don't see the problem (and I've been eating the same as usual ? white pasta, even ice cream and meringues!). Fingers crossed!

Just a quick update. I had my baby girl at 13.09 this afternoon. She was a touch under 7lb, so the scan was about half a pound out. she obviously didn't want to wait until Thursday's induction! The midwife I had was one from the home from home unit and she was absolutely brilliant! I managed with gas and air only, although at the end I'd have taken anything on offer!!! baby's blood sugars have been borderline to good, she's had three good breastfeeds so far. (35-45 mins) not bad as they got a line in for my insulin/glucose drip but didn't have time to set it up.

She's amazing!!!

congratulations midori that's all great news and so encouraging for the rest of us too.

Fantastic news midori I was wondering yesterday whether you got your father's day baby... not quite but I guess it will co-incide in a few years time!

congrats midori, well this is only my 2nd week on finger testing (7 x a day) and as i have my DS off school with a sickness bug, ive phoned my diabetic midwife and she said my results are that good, she doesnt want to see me until next week, my lowest reading was 4.4 and my highest was 6.3 so all is well here :)

Hello, looks like I need to join you ladies .

Just got the results of GTT back and came out as an 8.2. Haven't spoken to the Diabetic nurse yet but the Antenatal Assessment unit said they will treat me as if I have full blown Diabetes even though only "Impaired function". Boo. Knocks my homebirth on the head.

Will try and catch up on rest of thread when I have time (at work at the mo, feeling a bit shell shocked)

Am 35 weeks by the way and they picked this up due to sugar in wee and measuring rather large - growth scan showed baby weighed 6lb9oz at 34 weeks! Can anyone tell me what to expect in terms of treatment and delivery options? They are hopeful it could be controlled by diet. And is it true they would induce at 38 weeks anyway? And how do they approach the labour? Are you monitored through the labour or would they leave you alone at all? All new to me.

Congratulations midori. Your baby shares a birthday with my DD1 - she was 5 yesterday! How was the labour? Did they let you get on with things without too much interference?

Welcome ladygonegaga. I think things seem to vary depending on your area and hospital. I guess as you are 35 weeks already it isn't too long to wait anyway. The worst thing I have found is trying to fit in all the extra appointments! Nobody has told me exactly what will happen with the actual birth, may bring that up at my next consultants appointment!

Aw, Midori, such good news! So pleased for you :)

3kids I find that the worst bit too ? all these extra appointments plus trying to get my work to a point where I can leave in confidence? Ladygonegaga I think if your daily readings are good, you could insist on the home birth? see how you go with controlling your levels and take it from there.

Hi everyone!

Welcome ladygonegaga :) I was also a bit shellshocked when I found out that I had GD - think it takes time after being low risk for so long to come to terms with being higher risk and possibly having to change your plans. I guess they will monitor your sugar levels for a week and then decide what to do - my hospital waits till 36 weeks before deciding anything, but obviously that's only next week for you.

I spoke with the consultant yesterday who was very helpful. He said that my having GD on its own wouldn't necessarily be enough to induce at 38 weeks (mine's borderline and I'm on a small dose of insulin once a day), but I also have raised blood pressure so he'd still recommend that an induction at 38 weeks was a good idea. Apparently neonatal outcomes are fairly stable from 38-40 weeks (longer if you don't have GD) but they are more concerned about some rapid deterioration than anything in particular. On the other hand, if I was against induction, they'd be willing to monitor me frequently (daily?) for a week or so longer. In labour, they will monitor blood sugar, and if it starts to get high then I'll be hooked up to an insulin drip. They also suggested I bring in the sort of snacks i've normally been eating.

Given all this, I will probably go along with the induction at 38 weeks as I know that first babies are often late and the chances of having to be induced are fairly high as they will want to by 40 weeks at the latest. So I might as well get it over with! But it was good to talk over the alternatives, and I definitely didn't feel pressured to go along with the doctor's recommendation.

I hope some of that information is useful to those of you facing the same choice :)

Evening everyone.

Well after almost being put on insulin last week, my levels seem to have really come down over the last few days, although am taking more of the metformin tablets now, which hadn't seem to make any difference initially - has anyone else found this? Haven't had any readings that are over for at least 3 days now! Yay!

Squirrel they had mentioned about keeping glucose levels between 4 and 7 to me as well in labour - which I was wondering about. I know with my previous babies, eating was the last thing on my mind! Hope it is ok not to eat stuff in labour in that case then!

Hello to LadyGoneGaga. Squirrel posted the NICE guidelines earlier on which say what they recommend for antenatal care and during labour. Here they are again: www.nice.org.uk/CG063fullguideline But as we've all found the practicalities vary from hospital to hospital, as many places are starting to be a lot stricter about their limits. The NICE guidelines are up for review but they haven't published new ones yet. As I recall, the guidelines say the hospital should offer induction at 38 weeks but it doesn't say you have to accept. And in terms of GD it seems there's no grey area, either they say you have it or you don't, even if your levels are what would be called 'impaired function' outside of pregnancy.

If you're with a hospital homebirth scheme they will probably feel unhappy about you giving birth at home - even with my private midwife it was a bit of a fight. But my feeling is that you have more rights in the UK, in terms of insisting on what you want. If you feel you have the energy then there's a lot of information here on the homebirth.org website and I can even send you my own stuff I wrote to explain why I still want a homebirth. But it depends how you yourself feel about the risks. I'm still eating a low GI diet and monitoring my blood sugar levels so it's not as if I'm trying to ignore what's going on.

I have to call the hospital now to cancel my next appointments. I'm feeling a little bit apprehensive - I hope I have a nice midwife on the phone instead of one who argues with me!

My midwife has told me that diabetes in pregnancy tends to mean it takes longer for milk to come in after the baby is born. So I started expressing colostrum today. I just posted a long message in the breast and bottle feeding topic explaining why it's important - it's here if anyone wants to read it.

congrats midori!!!

highfibre thats interesting to know about the milk, i had not been told that

i have been put on small amount of overnight insulin this week & seen on notes they put inducing at 38 or 39 weeks so similar to you squirrel, i will also probs just go with it if that is what they suggest as i always go overdue so whether at 38/39 weeks or 40 i think it would still end up as an induction, i would be suprised if not as both my others were over 41 weeks

3 kids i found the metformin tablets not really making much of a difference either altho the insulin has seemed to

Hi everyone, thanks so much for all the congratulations! I am exhausted as Abigail hasn't really slept much until today, but she is so beautiful and utterly worth some sleepless nights.

Highfibre, so pleased it looks like you'll get the homebirth you wanted. Brilliant news! I personally think the hospital staff do 'go on' a bit too much about GD and shoulder dystocia, seeing as at least 50% of babies with shoulder dystocia at birth are lower birthweights anyway. It would be interesting to see actual figures for percentage of GD births where shoulder dystocia occurs, or even LGA birthweights, as most people I know who have had GD have had average sized babies. Obviously sugar control is a factor, but I think the fact that this 7lb baby was born at the same gestation as my 10lb son, where I didn't have GD says a lot.

Re: the breastmilk. (one of the reasons I actually came on to post) I too had heard it can take a while for milk to come in if you have had GD and so started colostrum harvesting at 36 weeks. I have to admit, it was quite depressing and hard going, it was very hard to get any colostrum out at all (half a ml or less per express) until the day before I went into labour. I didn't end up using the colostrum I stored, but also didn't feel I needed it. My milk started to come in yesterday (so classed as day 2) and although I know from experience it will still change over the next day or so and then continue to increase with her demand, it is fully in today (day 3), so much so I've had to express a few mls before feeding so baby can latch on as I am slightly engorged. She did feed like a trooper (read: continually!) yesterday though, which I suspect helped! I would probably still express colostrum prior to birth again if I had GD, don't get me wrong, there are good reasons for it and it's a good idea, as you never know if you'll need it, but I hoped this would help reassure anyone who was worried as I know I worried a lot about getting breastfeeding established in light of the GD myself.

firwala sorry to hear you've had to go on insulin, but it does make things a little easier so you can relax sightly about food and just have to restrict things as opposed to being outrageously restrictive and still eat some 'good' carbs. I have to admit, the one thing my GD clinic weren't great about was feeding after the birth, they just kept saying 'we can give her some formula if she needs it', despite me saying repeatedly that I wouldn't want her to have formula after she was born unless it was absolutely essential. I had to get the info on colostrum harvesting myself, even the BF person at the hospital hadn't heard of it!

So who's due next then?