Anyone else got gestational diabetes? Top tips welcome!

[Angelico]

Hello all

Currently 35+2, got diagnosed with GD a couple of weeks ago after repeat GTT ('passed' the one at 25 weeks for raised BMI, seems to have come on around the 30 week mark). Got finger pricker etc last week so 6 days in to blood testing and aiming to control with diet only as due for CS at 38+4.

Have't seen dietician yet and struggling to find conclusive info online. Certain foods (pure orange juice, sweet stuff - even a couple of bites! - mashed potato) seem to send blood sugar high (highest reading ever today 9.3 after mash and literally 2 bites of DH's banoffee! ). I was wondering what other people have found useful foodwise? Any good suggestions for meals?

A typical 'good day' for me (ie super low blood sugars)...

Breakfast:
Slice of brown toast with either cheese and beans or scrambled egg. No orange juice.

Snack (11am or 4pm depending on what I'm doing):
2-3 oatcakes with cheese / hummus

Lunch:
Bowl of leftover dinner from night before (see below) or homemade lentil and tomato soup with cheese and ryebread.

Dinner:
Steak stir fry with noodles, spag bol with wholewheat spaghetti, stuffed chicken with roasties and veg, oven cod in batter with oven chips and plenty of veg.

I would love to hear some other good suggestions for meals or any warnings about particular foods. Or if you just want somewhere to vent feel free to jump on board :)

Good luck at the clinic Angel. I think everywhere seems to have slightly different thresholds but I hope they don't give you a roasting! My nurse & consultant were very strongly in favour of the insulin when I'd only had a 7.8 reading so I thought I was ok, it was a bit of a shock. However I'm getting used to it and this morning it was 7.2 so it seems to be working.

Thanks for the other responses re breakfast and also ketones. I don't think even plain porridge works for me as I've never had a good reading on it so I'm sticking to eggs or PB on granary toast. And drinking plenty of water.

31 weeks today so only 7 left till I meet my baby and hopefully all this will be over. Then on to the next set of worries!

Nice thread, thanks Angelico.

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 is 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/Shreddies 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.

Not sure yet what impact this will have on my birthing options (will find out after the 36 week scan on Wednesday), 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.

Also of interest to us all... the NICE Guidelines on Diabetes in Pregnancy, which is available in multiple versions (quite liking the Quick Reference Guide myself).

Smicha hope your appt went well!

Thanks for more food ideas (esp dark choc WalkingDead!). Tidypidy didn't know about the dawn thing - v interesting! Zoobaby that link was good about the GI thing - thanks! I have a Patrick Holford Low GL recipe book which I must dig out as it's something similar, has low GL cereal mixes etc. Friend used it and found it v good when she was losing weight to ttc.

Clinic went well today, they were actually really pleased with my blood results! :o I have been keeping notes so they weren't worried about the odd high reading because there was always a reason (e.g. the two succulent bites of banoffee...). They did warn me that BS may go nuts in next few weeks, in which case I will probably have to have baby in a hospital with SCBU.

Forgot to ask for advice about steroids - duh! Have been given them as option for CS at 38+4 because hospital doesn't have SCBU but have read they can send BS mental and mean early hospitalisation. What to do?!

Lunch today: slice of Burgen toast with applewood cheese and ham and some lovely Tesco finest soup - puy lentil and vine tomato - was gorgeous. Gave a satisfactory 6.7 reading post lunch!

Glad to hear your clinic went well! That's great news that they are pleased with the results, I always get a bit stressed before hand that they're going to tell me off and they're always nicer than I expect them to be!

I had a scan and baby is fine and growing as normal, they expect him to be about 7.5lb which is apparently average, but they're worried about me as I had ketones in urine again and I've lost weight so I'm now on overnight insulin as my fasting levels were always around the limit. I have to try and get more carbs into my day and gain weight!!! Never thought I'd be being told to gain weight at 8 months pregnant!!!! If more carbs still means high readings I have to introduce fast acting insulin before meals. All a bit rubbish, but I know it's for the best.

The team at the hospital was great and I've got to go back in 2 weeks for another scan and then they will give me a date for induction which, because I'm now on insulin, will be before 39 weeks... which means I will definitely have a baby in around 3 weeks and that is scary!

As for where to give birth, I know that in my hospital the midwife led unit is out of bounds for anyone with GD so I'll be in the very clinical consultant led unit. Bit gutted about that as the new midwife led unit just opened yesterday and is apparently one of the best in Europe!

Thanks for starting this thread Angelico, it's really good to share this experience!

Oh I'm glad it went well Angel. Funny how different hospitals have different responses - it sounds like your readings were similar to mine but my consultant and nurse were very insistent on the insulin!

I've also been told that I will definitely be induced or have a CS at 38 weeks because I'm on insulin so different to you Smich. I know we can refuse to go along with inductions etc but I'm loath to go against medical advice, even if it's inconsistent.

It does suddenly feel amazingly soon - I feel like I've jumped from 12 to 7 weeks left in no time at all. 3 weeks though, wow. Hope people on this thread will come back and let us know how they got on.

Brilliant news Smicha that your bean is okay! It's a curse about the insulin stuff but you'll get a handle on it I'm sure. Might end up there myself And 3 weeks today... there should be new beans in the world :o

Blonder I've been thinking that myself about how different hospitals seem to have different protocols. It is all a bit strange - you would expect there to be one set of guidelines. It is tough if you wanted to avoid induction etc - I was having a CS anyway for a completely different reason so it hasn't changed my game plan any.

Last meal out tonight - our visitors are leaving tomorrow. Love them to bits but boy is it hard managing to eat well. We were supposed to be going to a restaurant where I knew I could get food, then ended up in a pub where menu was awful for GD. I ended up having a steak ciabatta and caesar salad. Only ate half the bread. Happily blood sugar was 6.9 - was expecting it to be about 20 with all that white bread

And the big hospital where I go for GD stuff is also hooking me up to that 'telehealth' thing where I can send my blood sugar by download rather than having to drive 40 miles to be seen :) Will save so much time, it's great! :)

Sounds like everyone is making progress, have got appt with consultant tomorrow so will have first discussion about my readings; so far they seem ok two hours after a meal (eg 5.something) but before meals are under 4. Do you think that means I should be eating more? Oh and I locked up my sharps box today (pg brain!!) so am hoping to get a new one tomorrow!! Am now 37+1 and it feels like baby is going to be here before I know it, don't know where the summer went!!

I had GD with DD3, although I suspect I may have had it in all my pregnancies as DS2 was 10lb born at 38 weeks and DS1 was also 9lb, although I was tested with DS2 and they said I didn't have it, but levels at which GD is diagnosed have changed since then. I was only 'just' over the limits when tested at 24 weeks with DD, 6.1 fasting and 8.1 2 hours after the glucose drink. However, but the time I delivered I was on huge amounts of slow and fast acting insulin and never managed to get my fasting readings or breakfast readings within limits really, although the clinic were always pleased with things and DD was born at 37+6 weighing 6lbs 15oz, so only 25th centile.

I was told by the dietician that it is vital in pregnancy not to cut carbs too much and advised to carb count and have 40g carbs for breakfast, 50 each at
lunch and dinner and then 2-3 snacks of 10g of carbs each and 10-20g of carbs for milk in coffee, so 180-200g of carbs a day. In 'normal' diabetes terms that would be classed as high carb!

I would have things like:

• Breakfast:

2 slices of seeded bread with marg/peanut butter or 2 poached or boiled eggs, maybe sometimes a small bowl of porridge instead, sometimes bacon/eggs and toast.

• Lunch:

wholemeal pitta bread with greek salad and celery and cucumber sticks and radishes or filled with salami/ham and cheddar and then popped in the toaster. Then an apple or yoghurt.

Dinner:

Small jacket potato (sweet potatoes made my readings high) or a small portion of wholemeal pasta with roasted peppers and chicken in pesto, small portion of wholegrain basmati rice and curry etc...

I sometimes had a small amount of chocolate peanuts as a snack or a scoop of Ben and Jerry's after dinner, which didn't affect me negatively. I also admit to cheating once or twice and using my 50g of carbs to have 2 of Asda's choc choux buns for lunch and nothing else.

Sometimes readings are just high and you don't know why. Sometimes things affect you when they 'shouldn't'. I never once had a morning reading under 6 and post breakfast readings were usually 9 or 10, a few times 11.something, which scared the crap out of me, but the diabetes team didn't seem phased. My friend is a type 1 and she'd be thrilled with an 11.something reading, so I suppose it's all relative.

Good luck and try not to worry.

I had GD in pregnancy, and was amazed at the terrible advice I was given, one dietician said not to worry about carbs, I should stick to a low fat diet for best results.

I was initially really upset that it had happened, and felt so guilty that I might have given my baby a bad start (luckily my lovely DH gave me good support and advice, and pointed out my hormones were making me irrational!!!).

I kept a food diary, ate little and often and steered clear of sugar in all its forms when I could. My babies were all under 6lb.

What stunned me was that when I went into hospital for delivery my meals were not at all appropriate, and when I asked why not they said it didnt matter!

Relax, do the best you can for you and your baby and try not to worry.

I'm not offering this as a recommendation but if I knew my reading was going to be a point or two over i just didn't record it.

Havent had chance to read the whole thread and will try to catch up later. I am currently 36+4 and was diagnosed with GD at 28 weeks. The first week was very stressful as i tried to be diet controlled and it just didnt work for me despite huge diet changes. I am now on fast acting insulin and a slow release at night. each week my needs increase but i have excellent care at the hospital. I have been told to follow a low GI diet and avoid sugar where possible. Mornings for me are always the worse and often have high readings unless i eat a pure protein (ie full english) that i obviously dont fancy or want every day. I am planned for induction at at 37+6 and all well on scans.
My tips
Best Bread - Hovis Wholemeal Granary
Best natural yoghurt - Total Greek yoghurt
Best fruits - grapes / kiwi/ cherrys/ strawberrys
Snacks- my fave is Nairns fine milled oatcakes with a smear of nutella

whoops hadnt finished.
Snacks - pepperami, cheese slices ie gouda / jarlsberg/babybel, 2-3 richtea fingers, tea loaf ( homemade), scone with a little jam and lots of cream
Carbs - new potatoes, gnocchi, noodles, brown basmati.....if i have pasta make sure you have lots of meat and cheese based sauce.

I have to say i found the diet very confusing initially but now its fine. We have continued to eat out and have take aways. With take outs i usually give myself 2 extra units but eating out as long as i am careful i have my usual doses. If i have been a bit naughty then exercise is the key, even a slow waddle around the block makes a huge difference to my sugars, or sometimes i just march in the living room much to my DHs amusement. I too initially lost weight....i lost 6lb in the first 6 weeks but have since put on 3lb. Ketones for me were usually dehydration and resolved on drinking water.

Just seen the question about steroids.....i had steroids but only because my DD was a premmie. I had to be admitted to hospital for 36hrs as had to go on a sliding scale insulin drip as the Dexamethasone sends your sugars haywire. This is the same drip i will have to have in active labour......

That's really helpful mrsv, thank you for posting that.

Great advice midori / maya / mrsv2 - thanks, especially for 'food lists'. I find it really useful knowing what other people are eating :o

Happy hope your appt goes well with consultant. Mine was really lovely and really pleased with blood sugars which made me feel that I was doing something right. She said she'd let me off the odd high reading where they were family parties etc - it's really the morning and day to day readings they are interested in. Apparently any morning ones under the 5.5 are great, probably because of the dawn phenomenon mentioned up thread.

I'm desperate to stay off insulin but in some ways it seems you can eat more normally if you are on it. Last night was trying to be 'good' with the ciabatta - only ate half and had salad instead of sharing chips etc with DH. 4.9 at bedtime and 4.6 pre-brekkie this morning - but had lots of ketones this morning so not sure if I actually didn't have enough carbs. Might experiment with a bedtime oatcake and peanut butter. On the other hand might not have drunk enough. It's tough!

For me insulin was a relief......I felt I had more control and the diabetic team have been excellent. They have no issues with me upping doses on occasion to counteract a treat meal and they know I stick to a good diet overall. I hope I will continue some of the diet post birth to lose weight and stay healthy as I would hate it to be forever and I know it's a risk. I miss fruit juice the most..... But I was drinking gallons of it Pre GD. Also found I became constipated on the high protein diet so was given sugar free laxido which has been great.

If you're carb counting then Carbs and Cals is an excellent resource either as a book or app for smart phones. It shows pictures of food in varying portion sizes with the carbs and calories detailed.

Glad to hear it's all going well. I'm 16 wks with DC3 and convinced I'll be diagnosed with GD before long. I keep testing my blood sugars during the day and so far nothing over 8.2 so fingers crossed ...

Just had a read through..... Fo those they are worried about babies sugars post birth. I have been recommended by the hospital to start colostrum harvesting this week to put in the freezer, so I'd the baby has any problems they can be rectified with that rather than formula. After a bath tonight I will try to hand express s few drops into a syringe, label and freeze. This is recommended from 36weeks onwards. It doesn't work for everyone and is more successful if you have already had children but it's worth asking your hospital about if it's of interest to you.

Just read mrsv's advice re colostrum expressing. There's some more info over here for anyone interested to know about it.

My consultant was totally about colostrum expressing when I asked him this morning and told me to stop looking on the internet for my advice (that's a true quote) . Haha. Obviously I agreed with that particular gem of advice.

Hi I have been diagnosed with GD today I have 2ds and was fine with them so am a bit shocked as I just assumed I'd be fine. I know I am overweight but am kind of dreading someone else chastising me because of this fact, is this what the dietician will do?

I realise it is not the end of the world but I am gutted, probably because I really thought I'd be ok. Please someone come and slap me round the face and tell me to get over myself.

I am not very over weight but at no point was duet for weightloss mentioned to me. Just healthy options and the low GI diet. I have had 2 weekly clinic appointments and I get weighed each time. Initially I lost weight like most people on here. Personally I can honestly say that I haven't been questioned about my Pre pregnancy weight although post pregnancy I know I need to lose and maintain to help reduce risks.....

Tidy fingers crossed you escape!

MrsV and Zoobaby thanks for the tip / link about expressing colostrum. Where do you get syringes to do that? I'm a first timer and really know nothing about this stuff!

Dino sorry to hear you are in the club :( I very much doubt anyone will chastise you - everyone I've seen has been lovely. I'm a bit overweight too but they actually told me I don't class as having any risk factors - think you need to be substantially overweight before they see it as a definite risk. In fact at the GD clinic I have been surprised both weeks by how slim most of the people there are (bumps aside :o). Consultant said that it's the pregnancy hormones blocking insulin and that it will go away 90% of the time - but that losing weight afterwards is important because we will now have a 50% chance of type 2 diabetes. She said that being a size 8 won't stop you from getting it but it gives you slightly better odds than if you're a size 16. Bit of a shock the high likelihood and tbh makes me think twice about another pregnancy too.

Got telehealth set up today so no more 80 mile round trip to hospital, hurrah! :o Also had my first low reading - 3.4 pre-lunch. Not way low but a bit of a surprise as I've had a few high readings but no low readings.

Out of interest what have you been asked to maintain your readings at..... Mine is pre-breakfast below 5.9 and 1hr post meals below 7.8. Anything above 8.0 is classed as a high reading and above 8.5 I have to give extra insulin

Pre-meals I've been told to be between 3.5-5.5 and 1 hour after meals no more than 8.0. Last week I had 5 readings over 8.0 but they weren't worried as I'd been able to find a reason (2 of them were small amounts of orange juice). Consultant said that a lot of things that will give high readings at the minute aren't 'bad foods' in themselves, just that hormones are blocking insulin. I was only drinking the orange to help me absorb iron tablet.

mrsv mine are officially meant to be below 7.8 but in reality anything over 7 is flagged up.

I finally got my breakfast reading under 7 this morning (6.4 in fact) with 6m of insulin but now I've had a dinner reading of 9.0. My lunch and dinner readings have all been fine till now. I feel like crying. Had same dinner as friend who eats low GI and she tested hers which was 6.4. It's my appt tomorrow with the nurse so doubtless they will want me to start taking insulin in the evenings too.

Just feel like my body is failing me.