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!!

I take it out and inject discreetly at the table. Usually into my side but if I'm wearing wooly tights I sometimes just do it through them into my leg. I expect neither are advisable but I haven't noticed any ill effects. Normally I'm eating out with a toddler in tow so it's difficult to nip off somewhere private.

What I eat varies but roughly:

Breakfast: One slice of toast and peanut butter or cereal
Snack: Small apple and sugar free yoghurt
Lunch: Soup, oatcakes with houmous/spreading cheese and a tangerine
Snack: Pumpkin seeds and 5 dried apricots or slice of toast
Dinner: Chicken/Mince/veggy dish with 2-3 veg or a pasta dish

Drinks tend to be water, milk, tea or coffee.

I do on occasion have something sweet however I am working hard to cut that out. Looking at what I am eating I could cut out the fruit but I have a sweet tooth and I have been told I am allowed three portions a day. Guess I could add in more protein both animal and beans.

As for injections I usually go to the toilets to inject, not ideal but I am only comfortable injecting into my stomach now so I am not keen on whipping that out at the dinner table

Romily your diet looks great so I'd just increase the insulin as needed and not worry about it. The pens go up to 80 units for a reason - everyone's insulin requirements differ.

Romily good luck today,
I see the diabetic clinic as well as have a growth scan this afternoon. Action packed day
Typically my phone has died so I can't get on line and Google while I wait on consultants :( it will be a looooong day

Your diet sounds good romily, I'm not so bad with a sweet tooth but I love bread! I eat it with just about every thing and that has been the hardest thing for me to cut down on.

Yay diabetic team are happy i stay on metformin, back in 2weeks- tho blood pressure was high @165/95. At midwife it dropped to 150/80

Growth scan has wee monster drop from 90th centile to 55th so hoping all is well.
Tho im to go in on Wednesday to get BP monitored n trace on baby

Dont know what everyone else has been told but diabetic consultant said the blood levels rise until they plateau at around 36-37weeks. He also said that if the daily testing numbers go above 7 more then twice in a week they would start insulin

Hope you are all well :D

Great news curly!

Hopefully the high bp will just be because you were worried about the appointment.

Great news curly
I didn't know about the b,p mine has slowly been creeping up but not to a point where it's high mine is usually 110/65ish but been 120/80ish last couple of times so still normal but I'll be watching for it now,
I did know about the numbers mine went over in first week of monitoring a couple of times and I ws put straight on insulin which is better for me as I couldn't agree with metformin and only managed two tablets a day

Hi everyone, I feel bad for complaining about metformin now that I'm hearing how most of you are on insulin. I'm at the hospital at the moment on my appointment marathon - nutritionist, registrar, obstetrician & diabetes midwife. So far I have learned that my diet is good, I need to give up the pizza, & I will be induced between 26th dec- 2nd January - wow it all feels very final now!

I prefer the insulin to metformin pam. The injections don't hurt and it allows me to be a lot more flexible about what I eat. Only downside is the possibility of having too low blood sugars which can be a little scary but does mean you get to eat something sugary.
Also it doesn't really add much in terms of how much they want to intervene in the birth whereas starting metformin is upsetting because in most cases it is the trigger that they will induce at 38/39 weeks.

Wow heart is a spade what a nightmare! I hope you get your test sorted soon so you can know one way or the other. I've been eating a lot more sensibly since last week so hoping my sample later will be ok and Tarka is right - I just grow big babies!

What's the reason they are more likely to induce with metformin? Over here it seems you increase your dose of metformin, then add insulin if necessary - so even if you're on insulin you're still on metformin

Sorry I knew that was unclear as I was writing it. What I meant was once you are started on insulin you already know you are going to be induced (because you will have already been on metformin) whereas pre-metformin there is always a chance you can diet control. So psychologically starting metformin was harder for me than starting insulin.

Oh I see tarka, yes I see what you mean - I found it very hard starting on metformin (as you know), bit now I'm pretty much resigned to doing whatever they tell me. Knowing the baby's tummy is on the 95th percentile kind of spurred me into action too I suppose. I guess it's important to remember this complication can be controlled & shouldn't have any implications for the baby after its born, so really as complications go, this certainly isn't the worst one to have.

Do they think your high blood pressure is caused by the diabetes terilou?

Sorry for my stupidity but what does all this percentile talk mean?? No ones even mentioned it to me, i've just been told babies size is average

Hi peanut - my baby is average size (on the 50th percentile line on the growth charts), BUT it's stomach is on the 95th percentile, so it's disproportionally large. The reason is because when we have excess glucose in our blood (because our bodies aren't producing enough insulin) all the excess sugar goes to the baby, and it tends to accumulate around it's stomach. This can cause a problem if the baby gets too big as it can get stuck in the birth canal. If your baby is average across the board that is very good news as it means less chance of complications hopefully.

Aha thanks Pam...they only measure stomach at my trust so taking average size as good news....fingers crossed it stays this way.....
Can you do anything about babies stomach being large or will it just stay that way? How many weeks are you? xx

No one can seem to tell me that - I was hoping it might average itself out but I can't get any answers - I guess it depends on the baby and my sugar control from now on. I'm 33 weeks now & will have another scan at 36 so I think that will be when they decide whether it's a cesarean or not (I really hope not!). Everything else was fine & normal with the baby though so fingers crossed.

Sorry peanut - that's good news that your baby's stomach is average size - how far are you?

heartisaspade it's not down to anything you ate - its just hormones - nothing you could have done to change it. Annoying that you're finding out so late in the day though.
Over here in oz everyone has the gtt test at 28 weeks - even if you're not high risk. I couldn't understand it at the time but I'm glad now