Blood sugar testing - diabetes

[DreamingOfTheMaldives]

Hello

On Monday, I was diagnosed with Gestational Diabetes and have been given a finger stabber to test my blood sugar. I have been told to test on one day before meals and the next day 1 hour after meals and then repeat over the following days.

I'm a bit confused really, how am I supposed to compare what is affecting my blood sugar when I have different data from one day to the next.

For example, for lunch today I had a pasta salad made with a small amount of pasta, salad veg, chicken breast and cheese. I also had a yoghurt. I was testing my blood sugar one hour after the meal (11.2!)

Tomorrow - I made double portion of pasta salad so will have this again and will probably miss out the yoghurt as I want to see what affect the yoghurt has had. The problem is I will be testing my blood sugar before eating so won't be able to compare my blood sugar score from today with that from tomorrow.

It really doesn't make sense to me!

I have actually recorded both before and after scores because it seems ridiculous not too but that is not what the nurse asked me to do - I was just wondering if anyone else was told to test alternatively before and after meals from one day to the next?

If I were you I would call the nurse to check.

She's not working today so I can't unfortunately - it will have to be tomorrow.

She definitely wants me to test alternatively as she actually marked in the record when I should test.

Just wondered if anyone else had the same instructions.

I'm not sure about gest diabetes but my 3 yo has t1 and we test her just before meals and 2hrs after.

Like you said, if you test at different times each day it won't give the full picture as to what is going on with your sugars.

My friend had GD - she tested before her lunch and two hours after every day, also she was told to really restrict her complex carb intake and up her fibre and protein. So Pasta salad is why your reading is so high - it is in effect pure sugar once converted in your body.

p.s. I feel sorry for you - i honestly do not know what I would do without my carbs in pregnancy - it is ALL I eat TBH, with veggies.

p.p.s - she was also told to have some carbs in her diet (not to cut out completely as that is also not good) but to have her carbs at lunchtime - and introduce things like wholemeal pasta, and more veg or protein for evening meal - plus eat smaller but more often, and snack on things like green apples, or nuts etc. If confused get your doc to refer you to a decent dietician?

It does seem weird that you're testing at different times of the day, my dad is type 2 and always tests in the morning before eating.

My dad found that fruit, especially fruit juices such as grape, made his level really high. He'd been focusing on his food and not looking at what he drank so it was a bit of a shock! He also found it best to eat tea before 6, and that if he went for a walk in the evenings he could get away with eating a bit more sugar as the exercise works it off. Not sure if it's the same for gestational diabetes but how something there helps!

I was diagnosed last week and also been told to test like you on alternate days.

My nurse told me to write in the comments section anything I thought relevant e.g. something i ate which could be high in sugar or a change in food times and think they just want to get an idea of what your body does and how it uses the sugar. A fasting reading and an after dinner to see any trends, any times they could try and change meals etc.

I've been doing readings for a week and also on tablets so can see my readings reduce over the week.

They need both sets if results but I think to ask us to test 7-8 times a day is unfair and unreasonable and so they ask alternate days and look over a week or so.

It sucks completely.

Perhaps testing a bit more and keeping a food diary for a week or so might help and would give a really good indication of what foods cause a rise in blood sugar for you.

Do you see a dietician as well as a diabetes nurse? They might be able to give you some info sheets about what foods to perhaps avoid (although sometimes this doesn't work out, dd2 was recommended to have weetabix for breakfast as toast and low sugar jam was getting her into the 20s but weetabix was even worse)!

Also be careful of sweeteners we have no end of trouble (truvia was very high in carbs despite not being sugar so had same effect on bg!)

Good luck.x

Find it amazing that there's such variation in what people are told about blood sugar testing in GDM. I'm 17wks with DC2 (have got a GTT coming up in a few weeks) and was diagnosed with GDM at 28wks in my first pregnancy.

Interestingly I knew several other ladies with GDM and only my friend and I (both at Kings College in London) got away without meds or insulin to control.

I had to test first thing in the morning (fasting) then 1hr after breakfast/lunch/dinner - thus knowing when I'd eaten something "naughty" and being able to moderate my diet well (and knowing how to carefully sneak v v occasional treats in!).

I can't see the logic in pre-meal testing as its not like regular diabetes so you're not going to have hypos and if your high before lunch then unless a carb free meal (which is frowned upon - we're pregnant not on Atkins!) your sugar will be higher.

You'd think the NICE guidelines would have ironed out these sorts of inconsistencies.

OP - hope you've seen or are seeing a dietician v soon, it was a multi-disciplinary clinic @ kings so I was out from the results & into the dietician, but know that this again is inconsistent field

Best of luck with it

I've decided to test before and after meals this week to try to get a decent picture of what is bad for my blood sugar and what is good. Also, trying to eat a variety of food this week for the same reason.

Teaandflapjacks - I was told to make sure I have some carbs with every meal. I only had 30g pasta in my pasta salad - the rest was salad veg with half a chicken breast. I have put the food into myfitnesspal and the carb in my pasta salad was only 22g so not a great deal. I'm going to have it again for lunch today, minus the yoghurt (which has carbs from sugar) and see what reading I get.

My DH and I tend to eat mostly pasta or rice dishes for dinner as it is quick, easy and cheap. When he is working away, which he is at the moment, I will take a sauce out of the freezer and then just cook some pasta or rice. Means I get something decent to eat for no effort. Finding it hard to think of what to eat, other than meat/fish with veg/salad and potatoes which I don't really enjoy too often - also it's expensive and a lot more faff (especially when I'm home alone.)

Anyhoo, I am seeing the dietician on Tuesday so hopefully he/she will be able to give me some advice.

MrsGSR - I was told to eat fruit but stick to one portion at once. I made sure I only had 80g grapes. I have avoided the grapes this morning so will see if that makes a difference. I walk my dog in the evening but tend to do this at about 6pm and then sort out dinner when I get home. I can't eat as early as 6pm (although it has been rather late this week at 8.30pm/9pm, for various reasons!)

Ariane - I have a food diary which I am completing religiously as well as putting the details in to MyFitnessPal to make sure I am having a decent number of calories.

Sparkle - sorry to hear you have been diagnosed too.

Sparkle and LoftyJen - I've decided to test before and after meals this week and then discuss it with the dietician/doctor/nurse on Tuesday (apparently I am seeing all of them as well as having a scan!) Before and after tests may be more than they've asked for but I think it will benefit me by giving me a complete picture, so it's tough. It's not like it costs much more to test that often and I'm already getting used to being a pin cushion!

I was told that due to my GTT scores, it's unlikely I will be able to resolve my blood sugar with diet alone and will probably need medication or insulin. Really don't want to end up on insulin as I'm worried I will never get off, even after baby is born, so I'm going to do my best with food etc to avoid that happening. Not going to be bullied into insulin before I've had chance to give diet/exercise and medication a proper go first. Here's hoping my scan on Tuesday shows baby and fluids looking normal, otherwise I may have to think again!

Sorry if I haven't responded to anyone and thanks for all your comments.

I fully sympathise - actually since being pg I can't stomach any meat at all - just makes me sick! Without my marmite on toast and pasta I don't know what I would eat TBH. Plus it is a right faff thinking about what to cook - my DH works away too - so I do what you do, and make a large vat of a tomato sauce etc and just reheat that with some pasta and cheese, or make veggie rice and have that for a few days. I also can't stand wholemeal pasta and think it is slimy...! having a right panic in case it wasn't about what the frig would I eat. Congrats with the pregnancy though - and best of luck xx

oh also - you can make a fuss about the insulin in the first instance and insist on doing the testing and diet route etc if they try and foist it on you. TBH I have read a stack of stuff on insulin and not really convinced it is the best option for GD or type 2 since it keeps you in a loop. There are some good studies on that I think if you google.

gah - god knows what happened to part of that sentence - it should read 'i had the GD test and was worried if it would be ok - was having a right panic in case it wasn't - about what the frig would I eat.'

That does sound like an odd testing pattern. I had GD in my first pregnancy and so have been testing since 13 weeks in this one. First thing in the morning, and then 2 hours after breakfast, lunch and dinner aiming for under 5.6 in the morning and under 7 after each meal.

Pasta is the worst... I think if I have a chocolate chip cookie it would be a lower reading than a small amount of pasta.

I don't eat meat so cheese is like my best friend.

The easiest thing to do is to eat every three hours and make sure there's more protein than anything else on your plate... Meat, cheese, nuts, eggs?

For breakfast I have a cheese omelette with mushrooms, for lunch tuna salad or cauliflower cheese, and for dinner fajitas which are amazing and keep my blood low.

It's a bit boring but I'm dreaming of cake after the birth

I've also been diagnosed with GD this week (28 weeks)

My testing pattern is similar to CuriousGeorgie which is 4 times a day except I've been asked to test only 1 hour after each meal so it goes as follows:

Test before breakfast
1hr after breakfast
1hr after lunch
1hr after dinner

I don't know why its only an hour - the actual printed diary the gave me to write in said 2hrs but they crossed that out and wrote 1hr! Doesn't give much time at all for the sugar to break down.

They are just being kind and not making you test before and after every day. You just need to look at your patterns over a longer time period to make comparisons.
So compare Mon, wed, Fri on before food bloods and tues, thurs, sat on after food bloods etc.

Some tips for keeping your readings low (sorry if they have already been mentioned):

Exercise can dramatically decrease your bs so if you eat something naughty try to have a quick walk before the hour is up.
Protein will help your body deal with the carbs so make sure you have some with each meal. I couldn't eat bread on its own but could eat pb on toast, for example.
Avoid low fat products as they tend to compensate by adding sugar.
Sugar free Jelly pots are nice if you're craving something sweet.
Most specialist diabetic products still contain some sugar/carbs and have a laxative effect - not worth it IMO.

Ps. I guarantee its the yogurt giving you high readings. Lactose can be a difficult sugar to process.

They will give you metformin before they try insulin. I wasn't able to control with diet alone (I eat pretty low carb generally so no real scope for improvement) but was able to keep levels steady with metformin. Tbh by the end I would have been happy with insulin as you can adjust the level depending on how much carbs you have eaten so you don't have to be so restrictive.

They have given you that testing regime because the testing strips are very expensive. You can still build up a pattern you just have to look across two days not one. You don't need to know the "change" in levels before and after eating, just the overall level. They are not really comparable as they are looking at different things.

Focus on the after food tests to check whether your dietary changes are making a difference.

The before food tests are measuring your "fasting glucose level" and are measuring how your body releases sugar when you haven't been eating. It's a good measure of how your endocrine system is managing generally but won't help you determine if you are eating the right things.