Gestational diabetes - has anybody not had it the second time?

[connyrabbit]

I was diagnosed with gestational diabetes at the 36th week. Nothing major, it was enough to adjust my diet, no insulin shots needed.

It seems that if you've had it once, you're very likely to get it again, this time for most of the next pregnancy.

I'm pretty certain that it was my own doing, I needed to eat constantly, high carb stuff, in order to quench the permanent sickness I had from start to finish.
Obviously carbs are the last things you can eat when you've got GD. Which means that any subsequent pregnancy will become enormously challenging, for me and for my co-suffering family.

I got treatment for the sickness but that didn't do anything, so I'm not expecting to be able to sort that problem. But is there something one can do to prevent GD from happening again if I were to get pregnant?

Or should I just never get pregnant again?

Thanks all!

Hi Conny I had GD with my 4th pregnancy, and it was bad enough by the end to need insulin. I am now 30 weeks with my 5th, and managed to pass the GTT at 27 weeks! Don't know if this means that I will avoid it for the whole pregnancy, but it is certainly better than when I failed it the last time at 24 weeks, and months of dieting and medication!

Can't give any advice on how to prevent it though....maybe I have just been lucky .

Hi 4kids, good to hear that it's going well so far!
Have you been particularly cautious in your diet since you're pregnant? Have you had specific warnings from your GP because of risks of GD happening again?

I'm waiting to find out, my consultant said I had a 50% chance of getting it again. Just to reassure you, your diet will have had no impact on you getting GD last time. There are three main causes, being overweight, being of certain ethnicities and being predisposed to autoimmune conditions. Obviously the latter two are unavoidable.

With diabetes your body can't produce enough, or resists the effectiveness of, insulin so your blood sugar rises when you eat carbs. But eating carbs does not make you produce less insulin or be resistant to it. It is sensible to limit sugar intake in subsequent pregnancies because if you are developing GD it exposes your baby to lower average blood sugar levels but it won't affect the GD itself.

I have GD (predisposed as older than 35 and have a mother with proper type 2 diabetes) so it wasn't a massive surprise when I failed the GTT. However, I was massively surprised that it isn't the end of the world when it comes to food and certainly not all carbs are evil.

The dietician carefully explained that it is all about the Glycaemic Index of food. In other words, how quickly or slowly the carbs are broken down, so you have good, average and bad carbs. Now, colour me surprised cos I thought that the GI Diet was a Hollywood fad diet thing. But it's not, it's a very good and helpful thing to understand.

Some useful info here... www.diabetes.org.uk/Guide-to-diabetes/Food_and_recipes/The-Glycaemic-Index/. A quick google search on Glycaemic Index will also be helpful.

Find a reference guide about GI indexes and figure out what works best for you. For example, pasta works extremely well for me (and my entire pregnancy weight gain will probably be due to eating that everyday) whereas Weetabix blows my readings sky-high. Also you'd be surprised to see that chocolate is on the "good" list but is not recommended due to its high fat content.

Not sure if you can prevent it occuring again but having some knowledge about GI might minimise the chances.

BTW - it's actually not so bad having GD. You just have to be uber organised to take readings and have medication/insulin when required. I figure that all this structuring of my day is good training for when baby arrives. I've also been receiving excellent care from my hospital and, although I have to visit more often (appointments and growth monitoring scans - seeing the baby on the monitor more often - yay), I feel that they really are doing the best for both my baby and I.

Not sure yet what impact this will have on my birthing options (will find out after the 36 week scan), but I'm pretty sure the midwife-only birthing centre will be off limits and I'll be based upstairs close to the doctors and machines.

I had GD in my first pregnancy, and it was just bad enough that I needed insulin a couple of times a day. I read a lot about it at the time, and the NICE guidelines were useful:

www.nice.org.uk/nicemedia/live/11946/41320/41320.pdf

In the middle of page 62, there's some detail about the recurrence of GD - they say something like 30-80% depending on various risk factors.

FWIW, your diet had nothing to do with it. And they tend to test earlier for it if you've had it before, hence picking it up earlier in the pregnancy.

I am hoping that I won't get it next time, but my plan is to eat what I have to in the first trimester (like you, I had to eat a lot to stave off the sickness but went off a lot of foods) but then to switch to a low GI diet when I can.