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

I really feel like my team have no clue what they are doing. Not at next clinic until 38+3 (am 37 weeks tomorrow) but is meant to be the nurse who will take the decision whether to put me on insulin or not? Whichj i think seems crazy. Don't know what to think and they didn't want to discuss things properly with me until next appt. Makes me want to scream.

Anyway, lunch was a fail as well - veg soup and wholemeal pitta FFS. I guess more protein for me. I'm not testing for ketones (they only tested at last clinic) but they have told me to up my carbs. Even though I know it sends blood sugars out. This whole thing seems unnecessarily over cautious to me. Especially as GTT was only 8.2

Would be happy to have all these debates if I was say 25 weeks or so but I am frigging full term tomorrow - what difference can it all make now?

Star you sound as frustrated as i do - is it me or is care for GD particularly shit?

I'm definitely dissatisfied LGG. The thing that pisses me off is that, having been labelled with the GD diagnosis, I am having the protocols applied to me without anyone taking into account any other information. Like, say, the fact that I was small to begin with and have lost weight during this pregnancy; my health (BP etc.) is good and has been throughout; the baby's health checks have all been normal and so far she's measuring normal for gestational age; my readings are mostly normal and I haven't had any as high as 10. At my next appt I'm going to ask them to factor these things in when they consider my individual care, because at the moment I feel like a cardboard box on a fucking factory belt.

If they are going to class me as high risk, I want to know their thoughts about what that risk actually is, to ME and MY BABY, taking into account the actual information they have in front of them about us.

So yes, I feel your pain And I agree that at this point in your pregnancy they need to give you a damn good reason for any decisions they want you to make.

Evening everyone.

Congratulations squirrel. My DD is also called Charlotte! You will have to fill us in on the details when you get chance!

LadyGG that does sound entirely ridiculous to put you on insulin at this late stage - as you say, what difference can that possibly make now? Sometimes I think these people follow things entirely to the letter, without using any common sense! I guess you could just refuse to do it - after all they can't make you!

Welcome Star.

Well after having got my levels down the previous week, this week they have been all over the place again. Probably not helped by a manic stressful week with me rushing around the whole time with one thing and another! So am guessing they will not be too happy with me when they ring on Monday. Am so knackered though I am starting to get past caring...

So if lots of people are having their babies in the next couple of weeks, this thread may get very quiet....I'm not even 33 weeks yet

I think I'll be around for a while 3kidsnobump, I'm 33 weeks tomorrow

Star I completely agree about the lack of individual care. I thoroughly researched my situation and came to the conclusion that the only negative birth outcome which I was at higher risk from was the risk of shoulder dystocia. And even that wasn't a hugely high risk. I found a study that said women with untreated GDM had a 16% chance of babies with shoulder dystocia as compared to around 7% if not diabetic. However that study didn't say whether treatment reduced the risk or not - and I consider that by changing my diet and doing more exercise I am already undergoing 'treatment' whether I accept the insulin or not. I also found that shoulder dystocia is more likely if giving birth in hospital (due to the ways of managing the birth) so I'm happier to have my baby at home in order to minimise this risk.

Nothing else that is commonly mentioned regarding GDM was actually a risk that applied to me - i.e. perinatal death, macrosomia or even hypoglycaemia in the newborn. And I'm expressing (small amounts of) colostrum in order to deal with that last eventuality, should it occur.

The risk of the child or me having Type 2 diabetes when older, yes that still applies but the meta-analysis I saw showed that the risk wasn't actually reduced by treatment of GDM while pregnant. So maybe it is caused by something else that they haven't found out about yet? In any case, that's something we might have to deal with in later years, but doesn't actually justify the protocols many of the hospitals seem to be following.

Furthermore, no-one at the hospital has given me the chance to talk about any of this. Or even given the impression that it's my choice whether to accept the investigations and interventions they are suggesting. Let alone give actual figures for the increased risks. In fact I get the feeling that they haven't even been given the figures themselves and are purely following protocol handed down from somewhere. The obstetrician talked to my midwife, sure, and she told him that I probably knew more about GDM than she did! But when I said to him "I am unconvinced that there is anything more than a slightly increased risk of negative outcomes in my situtation" he pretty much glossed over it and went straight on to saying I needed a CTG. Just because that's what they do for pregnant women with GDM at 36 weeks, or whatever I was at that point.

Anyway, not long to go now [phew].

That is really interesting HighFibreDiet, would you be willing to PM me some links to the research you found? I'd like to have a look at it before I see the team on Tuesday morning.

It bugs the hell out of me too that they talk about interventions as if they're already a given. The specialist mw said to me 'hospital policy is that we won't let you go over 40 weeks if you're on medication'. Er, I think you'll find you won't be doing anything unless I let you! It's so bad, I think, that they phrase it in a way to make less uppity unsuspecting women think they don't have a choice, when actually the HCPs can't do anything without consent.

So having been mulling things over for the last 48 hours, I think the things I want to talk to them about are:

• what the actual risks are for me and my baby, e.g. I'm not convinced that macrosomia applies as my baby is measuring normal so far;
• what exactly they intend to do once the baby is born - what the procedure is should she have low blood sugar, how they intend to support me to feed her, what they know about harvesting colostrum, how long we might need to stay in for and what their policy is on feeding during this time;
• how they are going to factor in my holistic health information when working with me to plan my care, i.e. looking at my overall health and that of the baby alongside my sugars instead of just looking at the sugars in isolation;
• bitch nurse to be removed from my case.

Does this sound reasonable? It's hard to filter out the things that are pissing me off but aren't necessarily immediately relevant from the things that are the most pressing in practical terms. Not sure whether I can be bothered to fight them for use of the birth centre, although I do want to know exactly what and who I can expect on the mainstream labour ward.

Hi! I just found this thread and although I has my DD last July, I had GD. I live in France and things seem a bit different here so I thought it might be interesting to compare.
In fact, I had to go to an education day and the "rules" here are strict - I had to stick to limited amounts of particular foods - and I had to weigh them to be sure! I had to have the following every day:

First thing in the morning, I had to check my sugar level
Breakfast: 60g of bread (with butter if you want) and a hot drink without sugar.
2 hours later, check blood level.
Lunch: 100g carbs with a portion of meat (1 piece meat/1 egg /2pieces of ham for example) As many vegetables as you want. A tiny bit of cheese/milk based product. These were all obligatory.
2 hours later, check blood level.
2 snacks during the afternoon, 2 hours apart - a milk product (sugar free yoghurt) and 1 piece of fruit (also obligatory)

Dinner - as lunch

2 hours later, check blood level.

It was a pain and I spent the whole time checking my watch and weighing rice but I didn't have to go on medication and my blood sugar levels were constant the whole time. There were a few treats along the way - 1 piece of 70% dark chocolate was allowed in the evening and there are some french plain butter biscuits which were allowed instead of fruit.

Hope that's interesting/useful!

Good grief sleepy that's very prescriptive! Especially as people seem to react differently to the same foods. Glad that everything went well in the end though. And I have to say that although I'm not under hospital care any more I am still being careful with my diet and measuring my blood sugar levels because I think that's the responsible thing to do. I've had two kids' birthday parties this week and I know if I weren't monitoring my blood sugar levels I would have allowed myself lots more cake and junk food!

aStarInStrangeways the main article I referred to was ?Effects of treatment in women with GDM; systematic review and meta-analysis?, Horvath et al., BMJ 2010; 340:c1395. Published online April 1 2010. The link is www.ncbi.nlm.nih.gov/pmc/articles/PMC2848718/. But if it helps, I will pm you my e-mail and can send the whole thing I wrote to explain my decision. I got it wrong above, though - treatment did reduce the risk of shoulder dystocia from 16% to 7%. I'm not sure I have a value for the risk in non-GDM pregnancies.

Ok update time

Appointment was fine

Saw MW for basic checks

Saw Consultant and a diabetic doctor in the room at the same time, so they could explain things, I told consultant what happened at last weeks 'non' growth scan and she promptly ordered me another one so she coud see the measurements She filled in a card and sent me down to book it for before the clinic next Monday - and she would see me then. I went to the scan reception and they tried again to book me for a liquor volume. I was very firm and said no - my consultant wants measurements.

Saw the dietician, she was lovely and explained loads to me about how to keep my glucose stable. I really listened and have been following what she said and so far the three readings I have done have been fine

Saw diabetes nurse who gave me the monitor and showed me how to use it.

So this week I've to follow the dieticians advise, take readings and record them 4 times a day, phone the diabetic nurse on Friday and let them know my readings so far and then scan Monday morning and see consultant Monday afternoon. (I'm going to keep a food diary in case any of my readings do go high so we can pinpoint the culprits)

Last night before dinner - 4.6
Last night before bed - 6.0
This mornings reading - 4.6

If I have a week of those readings I will be very happy and also - thinking what were they worried about. At least checking my readings makes me feel in control and I know how to avoid gettng high ones (well just now anyway)

sleepy your diet sounds very rigid. Mine was just guidelines. Mostly the dietician said to reduce the amount of fruit and fruit juice and lactose from yoghurt etc in my diet (I have always beng a fruit fiend especially in the summer with all the lovely berries in season) and just replace some of my fruit snacks with carrot/celery/cucumber sticks etc which really doesn't bother me, I could quite happily munch on those too.

I automatically reach for the fruit bowl or for a yoghurt when I am peckish - probably because I had the 'healthy' choice drilled into me by mum, ie get some fruit not crisps or chocolate.

Dietician reminded me that I can have nuts or rye crispbread or wholemeal crackers with the veggie sticks and hummus or a little bit of cottage or soft cheese. I love that stuff so I just feel daft for not considering these things as options before.

Thankfully - other than fruit, I don't have a sweet tooth at all, so no cake or chocolate cravings for me :) But hide the haribo, fruit gums and jelly babies from me for the next 7 weeks or they could be my downfall.

Eviepoo so glad you're finally getting some proper answers :) The restriction on fruit is one of the hardest things for me too, I love the stuff and it's a pain having to steer myself away. Your readings also sound a lot like mine have been, so here's hoping this will impact as little as possible on you.

HighFibre thanks so much for all the info :) I saw my a/n diabetes team today and thank fuck it was all very positive. I asked a lot of specific questions and got specific answers. They're happy with my blood sugar control, don't expect it to cause problems during labour, were reassuring about how they will support me to have the labour and birth I want, also how they will support me to breastfeed - they even gave me info about harvesting colostrum. Only once I'd mentioned it though, which still makes me that you have to know what to ask for before getting that sort of help. The mw asked if I'd bf DS and looked astounded when I said 'yes, for 13 months'. Even that made me mad I am truly hormental today.

Anyway, it was all good. And DS has now been to so many appts with me that he is able to find the baby's heartbeat pretty much on his own While the mw was chatting as I lay down, he wandered over, put a glob of gel on the end of the sonicaid and stuck it on my tummy.

In case anyone is wondering, I did tell bitch nurse's lovely colleague that I wouldn't be dealing with bitch nurse anymore due to her rude and unprofessional attitude. Felt good.

hi there, just found this thread..i was diagnosed last week, am 34 weeks this week. the problem is my fasting glucose, always above 6. anyhoo, i have moved to israel with my husband and just thought i would share a wee snippet of the medical care i have recieved here. it sucks.
i took my OGTT in the labs of the hospital where i am to give birth, and was told by the midwife that my fasting glucose was too high. i asked if this was a confirmed diagnoses of GD..eh...yeah she said whilst ushering me out of the door. do i need a special diet? asks me...eh...yeah...dont eat too many carbs, come back next week and see the 'high risk' OB...oh and yeah...monitor your blood sugar...byee. i dont have a glucose monitor says me...well find one says she.
great stuff....i recently graduated with BSC Nursing and know my stuff with regards to diabetes..dad had type 2 from the age of 45.
so i go to my appointment last week with high risk doctor...old crazy looking guy, old school doc. who thinks patients shouldn't ask questions. scanned me..said i had PH which could be due to genetic abnormalities...but no, is probably due to GD. Wrote me a prescription for 'insulin' which i can pick up at an pharmacy. Nurse says...u know where to inject right? me dazed and confused stumbles out of door with tears welling and badly written prescription in hand. head realing with words of genetic abnormality and shock at poor medical care try to find pharmacist to sell me insulin. nobody will because, as i noticed, dos only wrote 'insulin' on script. have to wait till next day to go to see doc..told him how i felt about poor care...how can u just presribe someone insulin without a teaching program...moaned and questioned him alot. told me i was taking it all very hard. twat.
so, after 3 days i have aquired insulin NPH, 600 shekels ( about 100 quid) for the whole kit and kaboodle. back at lovely doctor tomoz. cant wait !
this is apparently the best hospital in the area. cant wait till i get my work visa...i want to kick some arse and teach about holistic patient care.
i think this may be a new concept for them.
so ladies...please treasure the NHS with its specialist diabetes nurses, dieticians and free insulin !!!!

Evening everyone,

Welcome MrsM - gosh that all sounds like a nightmare! I guess we do forget how lucky we are with the NHS! You must be due just before me - I am 33 weeks today!

Well they have finally decided that the metformin is no longer working well enough, so have to go on Monday to get all the stuff for insulin - after I thought I was going to get away with not having it a couple of weeks back...so please tell me it's not as bad as it sounds giving yourself injections....

Hi everyone! Have been enjoying bingeing on chocolate and cake now baby is finally here :) it tastes so much better after a break!

The induction went well in the end, I definitely have no regrets over it :) was in hospital for 2 days while they induced me with pessary/gel. They didn't start contractions, but got me dilated enough to break my waters. That didn't progress things either so I ended up on the drip. That made things very painful quickly, so I went for an epidural. Was the best pain relief I've ever had!

During labour they monitored my blood sugar, but it stayed in their limits of 4-7. Outside of that, they'd have put me on glucose/insulin drips.

After baby was born, they started monitoring her blood sugar. At first it was ok, but then dropped low. She was also very sleepy and not demanding food, so they gave her a couple of formula top ups which seemed to perk her up a bit. Then we had a couple of days of regularly waking her to make sure she fed often enough. I didn't realise how hard it was to wake a sleepy newborn! Finally, my millk came in on day 4, and since then she's been much hungrier :) I'd been so focused on my diet during pregnancy that I didn't really think much about what might happen to the baby after.

I think that's it for the diabetes monitoring! Just the 6 week GTT to confirm all is ok :)

hey 3kids...injecting is fine..the needles are so fine that you will hardly feel a thing, granted its a bit difficult to actually push that first needle in but after that..no probs ! finger pricking is definately more painful!
saga from the middle east...was back at hospital today, seen a different doc who i have to say was alot more helpful. she wants me to monitor my glucose levels 6 time a day, and has titrated my NPH up by 2 units. i have to return in 2 days with results, have ultrasound and fetal monitoring which i had today also...all fine ! she seemed to be more cautious than previous horrid twat doctor and even advised that i may need to go to hospital to be monitered every 3-4 days.
its 3 am. the man in the mosque is singing and i cant sleep. twitchy legs and STARVING, dont want to stuff my face with houmous just yet as i dont want to disturb my fasting glucose test.
sucks !

and congratulations squirrel ! well done you !
i just posted on another thread about breast feeding and if the baby becomes hypo. do they have to give formula top ups?? did this cause you any problems in bf so far?? worried about this !

Hi mrsm! The hospital only gave her small top ups, just enough to get her blood sugars back on track. It doesn't seem to have interfered with breast feeding at all :) I guess it can do if they give too much, but they were very keen on getting breastfeeding established so they deliberately went for small amounts.

lol at your ds, aStar and I'm really glad your appointment went well. Same with your appt, eviepoo. Shocked at that first doctor you had to see, mrsmazarib. Fancy just writing 'insulin' on the prescription! . Glad you've seen someone a bit better since.

So glad to hear your news, squirrel. It's interesting to hear about your babe being so sleepy. That's what ds1 was like, and I'd always assumed our problems breastfeeding were a combination of really bad support in hospital and me being on beta-blockers (because my blood pressure didn't come down even after I'd had him). He had seizures on day 3 due to hypoglycaemia and I do wonder if I had undiagnosed GD that time round. He was the smallest of all of them, though, and doesn't show any sign of being diabetic at this point. Makes me realise I should concentrate a bit more on expressing my colostrum for this babe, though. I haven't managed to store very much, and I've only taken fenugreek once as I didn't really enjoy it.

Congratulations, Squirrel. Glad she's here safely and breastfeeding is going well. Am really concerned about them giving formula. tbh would prefer they give glucose intravenously if necessary. But with DS my milk was quite slow to come in and I can only squeeze out the tiniest drop of colostrum right now so can't see harvesting being an option.

Update on me. Spoke to nurse yesterday and she's not happy with my blood sugars. She mentioned insulin but when I asked whether it would be worth it (am 38 weeks tomorrow ) she said they will probably decide to induce instead. So I see the consultant on Weds. I really hope I go into labour first but no signs as yet. Anyone have any experience of induction? Will it be any quicker with it being my second baby?

Hi there,

Just imposing slightly if you don't mind :)

had my GTT yesterday (bang on 28weeks) and I hate lucozade!

Am pretty convinced it will come out positive so have just been reading a couple of the first pages here to get some ideas on how I can control my diet. I think even if my GTT comes back normal I will try and do some changes as I know I eat far too many carbs. I am obsessed with bread, potatoes and pasta.

I am measuring at 31weeks already so am quite big. My first DC weighed in at 9lb 5 at 40+12 (induction as overdue)

I'm really worried about having a big baby again, especially as this one is possibly going to be even bigger (I was always on target for my measurements with DC1).

Can I ask if anyone had any symptoms before having to do a GTT that pointed to GD?

I only had to have a GTT as I have PCOS. BMI is normal. No GTT in 1st pregnancy as PCOS was undiagnosed then.

Am in UK.

Hello Coconuts. With hindsight I was more thirsty and tired than normal but aren't all pregnant women? They decided to check me as had some glucose in urine and was measuring big so they decided to do GTT following a growth scan that confirmed size concerns. I had none of this in first pregnancy either.

Good luck anyway, hope it comes out negative for you.

Thanks LadyGG My urine has been clear so far, only issue is the huge bump. Also tiredness but that might be anemia, also have flashing eyes sometimes and very dizzy at times but again, could be anemia. Don't want to jump to conclusions before I know the results.

Will keep my eye on this thread just in case, and will report back Tues :)

Thanks for taking the time to reply to me.

Hi coconuts - yes now I look back I was definately extremely thirsty, and also very very hungry - especially at night. Had to get up in the night to drink/ eat every single night, without exception!

Only realised that was a bit weird after I went on the tablets to control the BS levels, and finally started to sleep a lot better! Well obviously hope you don't have GD, but come back and chat if you do! I had my test at 25 weeks, which seems like ages ago now (currently 33.5!) On the plus side my diet has improved so much I have lost loads of weight - so there are always good points as well as bad!

Hello all, welcome Coconuts and congrats Squirrel ? so exciting!

I have to admit, I've been slack at testing my glucose recently since it's always fine. I've got the nurse again tomorrow, she'll write 'BS mainly on target' as she usually does in my notes, despite the fact they're ALL on target. Grr.

I also find out tomorrow whether the placenta has moved and if baby is growing OK since he seemed a bit small last time. I'm really not worried about his size, though ? they estimated him around 5lbs two weeks ago, at 36 weeks, which seems plenty big enough at that point. And I don't know a single person whose baby's estimated birth weight was anywhere near the reality, I don't think it's a very exact science. So long as he's healthy, that's all I'm worried about.

Coconuts I didn't and still don't have any symptoms of GD other than a result of 7.9 on the GTT, but as you can probably tell from my post, I don't have any issues with my blood sugar either? just a couple of traces of glucose in my urine at around 30 weeks, but since the GTT I've been clear.

Hi just wanted to come on and say my GTT was clear but thanks for any advice and letting me gatecrash for a day :)

Hello all,

Seems to have been very quite on here recently - have we had any more babies yet?

Coconuts glad to hear all is ok. Hubba how did your appointment go?

Well I have been doing the injections for a few days now, but they have only started me on a tiny amount & my post breakfast readings seem to have been worse . Anyone else find this? I'm wondering if its just stressing me more worrying about doing the injections tbh. I am wondering, since I haven't got that long to go anyway if it's all a bit of a waste of time really. I think by the time they get the levels right I will probably have had the baby anyway!

On the plus side, even though my levels haven't been that great for the past couple of weeks, all looks fine on the scan, and although baby is above average, still not too massive, so hopefully it will stay that way!