Gestational Diabetes - Large abdominal circumference

[PamRavenscroft]

Hi, I'm 31 weeks and was diagnosed with gestational diabetes a few weeks ago. I'm trying to control with diet & exercise but my fasting levels are often very slightly over (5.1, 5.2, 5.3). My hospital has a very low cut off point of 5.0 for fasting. I was prescribed metformin but asked to wait till the results of my growth scan, which I had today, before I started taking it. All baby's measurements were nice & normal except the abdominal circumference which was on the 95th percentile. I am trying to work out the significance of this - obviously it means the sugar is going to the baby, but other than its tummy it isn't 'big'. I hate taking medication when pregnant but am I being an idiot for not? As my levels are so borderline I have been reluctant to start on meds but after today's scan I just don't know what to think. Any advice, previous experience etc. would be hugely appreciated! I lurk on the Jan 2014 thread but haven't posted yet - I'm hoping Tarka will see this!!

[TarkaTheOtter]

The thing is though if you control your sugars then there should be no sign you ever had gd - baby should have normal birthweight and blood sugars. But it isn't a sign that the gd was never a problem, just that it was effectively managed.
For example, my dd was only 7lbs when born and had normal sugars but I failed (although only just) the postnatal gtt. I have prediabetes when not pregnant so despite dd not showing any signs of it, I definitely did have diabetes in pregnancy.
I do think they can be overcautious though - some of the levels people on this thread are asked to maintain are really strict, which means people are medicated when maybe not necessary and this automatically leads to more intervention in labour. But levels over 6 on a low carb diet are very unusual for non diabetics.

[TarkaTheOtter]

heart I do agree with you - I don't understand why hospitals don't follow the NICE guidelines in this. They are already far stricter than the levels non-pregnant diabetics have to stick to. I remember with dd all the literature I was given said it was only 10% of gd women who needed medication - I bet some hospitals are having much more than that if they are expecting women to get scores regularly under 5.

I also think that like the previous pp, a few weeks of normal bs results should be used as a more accurate guide of how much sugar baby is getting than the gtt.

[SidandAndyssextoy]

Just found this thread.

First. I wanted to say that NO ONE can make you have an induction. It is YOUR choice. They can tell you why they advise you to have one, but they can't force you.

I was diagnosed with GD in my second pregnancy and loathed the medical route it threw me down. I fought back and had a home birth after diet controlling all the way through, and my hospital medicates 90% of pregnant women. I had fasting readings in the mid-high 5s which I didn't admit to, and all other readings were in range on a low-carb diet.

Since the birth, I have done a lot of reading, and am pretty sure I am insulin resistant and very possibly heading for type II diabetes. My fasting levels were similar when not pregnant when I tested myself, a level that my GP would probably be happy with but I'm not, so I'm dieting and exercising hard. If I do get pregnant again I will refuse the GTT and monitor my own levels as I'm convinced (a) that I have a blood sugar issue anyway, which I control through diet and exercise, and (b) that the stress of the diabetes clinic was unecessary I'm a responsible person and if my own monitoring shows big issues or scans flag up problems I'll cooperate, but I found the sledgehammer/nut approach very distressing last time.

[TarkaTheOtter]

At my hospital your levels would have been considered fine side and you wouldn't have been challenged about the home birth. It pisses me off that hospitals don't follow the NICE guidlines and are so heavy handed.
Monitoring your blood sugar levels is just as reliable way of testing for gd as the gtt anyway but I imagine some people do lie as there seems to be a massive stigma associated with gd. Which is why from the hospitals pov the gtt is more reliable. I think in some ways it would be better if the gtt was offered to everyone like it is in lots of countries.

[SidandAndyssextoy]

A lot of the stigma is the same as diabetes itself I reckon - the link with obesity. I've seen things on here where women have said 'I don't deserve this, I'm not even overweight'. I AM overweight but pretty sure for the same reason my blood sugar is out of whack, and that's genetics. Very bloody unfair.

Yep, I am careful all the time to eat food that keeps my blood sugar even (well, apart from Christmas!) so I'm actually a safer bet measuring my own levels than someone who is slim and oblivious to any problem.

[curlywurlyllass]

Congratulations heart!!!!!
Hope your lad continues to gain weight and you have a lovely Christmas with him :)

I too have had my wee boy :)
He is now 5days old and approx 2.7kg (was 2.88kg at birth but dropped a lot and started gaining again)
He was encouraged out early as my blood pressure and pre eclampsia was worsening (I was induced 3 times starting at 35+4 but was 'unfavourable') so at 35+6 they decided on emergency C section which was a little traumatic.
My 1st blood pressure reading in theatre was over 228/110 and no theatre staff had seen one that high before apparently!

We were getting hugs with our little James when his breathing worsened and he was whipped away to intensive care :( it's been a worrying time but he is now doing well and is on minimal.supports.
his poor wee heels are healing after the glucose tests and it seems we are both back to normal where diabetes is concerned

in the 4 days before my EMCS I was having hypos in the mornings, then it worsened to before every meal. Unsure if this was another factor in needing to get my precious boy out early.

Good luck to those nearing their due dates, hope you can enjoy a carb free Christmas. I love my boy buy I would rather have him growing stronger inside me and have a crappy sugar free Christmas

[terilou87]

Congratulations curly & heart hope you both had a lovely xmas with your bundles of joy!
How's everyone else's xmas been? Did you all manage to keep your sugar results down? Mine have actually been really good despite not being over strict with diet
Well c sec for me in 3 days eeek I can't wait to no longer take insulin and finger prick test!!

[stopgap]

I can't wait to leave that stupid finger prick device at home, terilou.

My results went beserk over Christmas, and I've reached the conclusion that the only thing that works to keep my sugars down is going to the gym. My midwife continues to be unflappable about the whole situation, even though my fasting numbers are always between 5.5 and 6.0. Likely I'll be induced on my due date, but no sooner.

I'm almost 36 weeks and on a regimen of twice-weekly scans and twice-weekly non-stress tests. Baby is now 4.8 pounds according to the most recent sonogram, so still small, but not especially so.

Best of luck with your c-section, terilou! How many weeks are you?

[dobedobedo]

I don't want to hijack this thread, but you all seem v knowledgeable on GD.
I'm 21 weeks pregnant and for the past couple of weeks, I've worried that I might have GD. I'm overweight (although have lost about a stone since becoming pregnant - not on purpose!), 30 years old. When I eat sugary food or drinks, I feel shaky, my heart races and I'm terribly thirsty afterwards, sometimes within 10 minutes. I'm tired all the time, mind you, I was always tired before I was pregnant!
I keep thinking "nah I don't have diabetes!" but then, I'll have a glass of shloer or some Christmas chocolate and feel like I need to lie down again.
My next mw appointment is 7th Jan. At my last one, they picked up sugar in my urine, but I also had a kidney infection so they said I probably just had leaky kidneys. Am I okay to wait until then before raising concerns about GD?
Between now and then I plan to eat low GI, cut out sugar and exercise more. Exercise is difficult though, I have sciatica and I broke my ribs just before I got pregnant in a karting accident so getting out of breath was impossible for months, and is still quite painful now!
Will controlling my diet help or be enough? Should I drink more? I drink at least a litre of water a day, double or more some days. I'm clueless about all this.

[Andanotherthing123]

Hi dobedobe I would request a GD test at your new MW appoint. The test isn't a big deal and it's better to know if you've got it then you'll be given support on what to eat etc. I didn't have any 'symptoms' or so I thought and was only sent to a test as my sister had it in pregnancy. This is my 3rd baby and I really thought doing the test was a waste of time-got a surprise when the results came through! Looking back, I was drinking more and I felt much less tired once I started the right diet, so I'm glad I did the test. Hope that helps.

[terilou87]

Dobedobe I feel like you say when my sugars are high. And when they are too low, so it is possible you may have gd ask your mw for the gtt. I think they usually wait till 28 weeks to do it though.
stopgap I'm 38+2 today, my fasting numbers are the same as yours unless I get up in the middle of the night for a snack and I am tired enough without getting up to eat.

[sisterofcaleb]

Hey tarka - if you see this - did I spot on another thread that you had your baby? How did it go? Hope all is well :)

[PamRavenscroft]

Hi everyone, not sure if anyone is really posting on here anymore but I just thought I would update quickly - baby Harriet was born a week ago (induced at 38 weeks due to predicted size) - well she was only 7lbs after all the fuss they made - so I have learned that growth scans can indeed be completely wrong.
It's nice to be able to eat normally again although I'm trying very hard to maintain my good habits. I tested myself a few times after the birth & my levels were still high so I don't know if that means the diabetes hasn't gone away, or whether it's just hormones. I've run out if testing strips now so dh has told me to stop stressing & not worry about it till I have my repeat test in 6 weeks. I'm hoping the reason they wait 6 weeks to test again is because it can take that long for everything to settle down again.
I hope everyone is doing well & those of you who have babies now are settling into things nicely.

[Ilovekittyelise]

hi. i meant to post on here the other day with further anecdotal evidence about "seeing whats expected" at scans!

so, im type 1 so have the same growth scans at 28, 32 & 36 weeks. i always control my blood sugar very tightly with hbA1c mid fives, expect normal size baby (son was 7 8 @ term) etc.

at my 32 week scan she didnt mention whopping ac (although i saw the line she used in her measurements and it was miles from edge!) so wasnt until i got to consultant this was discussed. diabetologist then getting all freaked out cross examining me on what was going on between the 10-15 readings a day i had uploaded from my meter. obstet bit more pragmatic.

come 36 weeks i wasnt taking chances. we had agreed i would be allowed to go to t+6 & there was no way i was goibg to have early section due to biased growth estimates.so got to scan, which was with same sonographer, and said i wanted her to print the 3 ac measurement views and explained why. anyhow, she went through in detail showing how large variability can be and how rib cage can expand showimg bigger ac etc. anyway, she basically admitted she over egged it the first time and lo and behold his estimated 36 wk weight was 6lb (so probably 7-8 @ term).

i would encourage anyone with gd, t1 or t2 to have the 3 measurements of ac shown to them in detail and printed off for consultants opinion.