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'm only on 8, 7, 12 after meals then 4 at nighttime. I've been having loads highs AND loads of hypos and the consultant reckons I am both very glucose intolerant but also really sensitive to insulin .

Tough day for me today. I had a scan which shows he is still measuring large and they have said that if the next scan shows the same trend then they are likely to induce me between 34 and 35 weeks which came as a real shock. Also likely that he will spend a couple of days in the special baby care unit which is longer than we expected so I am now unsure as to how breastfeeding will work out.

Another scan scheduled for just before xmas after which I think they will start to discuss dates etc I have also been told to be very vigilant about movement and to go straight to hosp if I there is any reduction.

They are taking great care of both of us however the whole thing is just scary.

Oh Romily what a shock! Glad they are looking after you though.
Could you look into expressing for baby whilst they are in SCBU? They should be able to lend you a fancy hospital pump. I know a few people with twins that were quite premature and didn't latch straight away but they were all able to get there eventually. If baby is a good weight then SCBU not definite anyway right?

Regardless of weight he will go there until he can stabilise his blood sugars.

I will express before birth and once he is here if I m not allowed to breast feed then I will express every two hours until I can bring him home and then hopefully we will be able to establish breastfeeding although it will be harder.

Romily, the pump route may just work. My friend's baby was born at 38 weeks, but had a serious lung condition. Said friend pumped like crazy while baby was only getting intravenous medicines, and while the first week or two was a bit of a struggle they soon established breast feeding, and friend went on to EBF for 21 months.

I am prepared to work at it and seek as much help as needed to breast feed so fingers crossed!

So emotional about the whole thing. I just want to be with my baby when he comes not in the next ward and having to go and visit him. I think it will be really hard to be away from him and I am struggling to get my head round everything.

I know I have to do what is best for him it is just becoming less and less what I hoped it would be.

Best of luck with everything. It must be so hard. My readings are also becoming more and more unpredictable (I'm 33 weeks) and even more confusingly, the baby is measuring small.

That's rubbish romily. So early for an induction. Try to put your faith in the fact that this will all be what's in the best interests of your baby & hopefully you'll be holding him
& feeding him before you know it.

Thank you all for being so kind, it just came as a real shock as I had 38 weeks in my mind and since he is just above the 95th percentile I really didn't think it would mean such an early induction. Maybe by the next scan he will be back in range and we can wait longer.

romily shocking news, but at least you get to meet your little man soon, my sil had dn at 34 weeks and she was absolutely fine and scbu were brilliant there was a midwife around dn every minute of the day and night and sil hardly left her side only to go sleep and eat. so atleast you will be in the best hands and fingers crossed bf works ok for you.
tarka I'm wondering if it could be that my fasting results are over because by the time I eat tea its around 8-9 o'clock then I stay up till about 12 drinking decaf tea then I'm up at 6:30 to get kids ready for school maybe I'm not leaving long enough without food or drink. Well I'm trying a lower dose of insulin to see what result I get in the morning and of still no different I'm going to try to eat with the kids at about 5 and just have water rest of night I'm determined to get the fasting numbers down!!

Randomly teri it might also be worth trying a snack at 11.30pm ish just before you go to bed. Could be you are leaving it too long between eating at night and testing in morning and your liver is releasing too much glucose before your morning test - worth a try too. I've read on other forums that bedtime snacks can help lower morning readings.

Hi there, I have a rotten cold & my after dinner reading was quite high tonight - not over, but much higher than usual - I know illness can make blood sugar go up, but do I increase my medication or just wait for the cold to go away? If anyone has any experience of this I would really appreciate any advice.

I'll try the snack tonight thanks tarka my reading was 5.6 before I took kids to school and I tested when I got back it was 6.1 still with nothing to eat so it could be that I am leaving it too long,
pam I was I'll last week and readings were higher for two days my diabetes nurse said not to increase it but my readings were only a little bit over normal,

Thanks teri, I'll just keep an eye on them. Almonds or cheese worked well for me as a bedtime snack.

I've tried everything to get my fasting numbers down. Snack in the evening, snack in the middle of the night, no snack, carb-only snack, protein-only etc. etc. and my first morning number is anywhere between 5.4 and 6 (I have to be under 5).

Last night I went out with friends, and while I was careful with the bulk of the meal, I had half a fruit and eggnog custard, forgot to take insulin at bedtime. . .and my morning number was still 5.4.

Stopgap that was the same kind of thing that happened to me. I'm actually wondering if night time insulin does anything. I'm goimg to mention it to diabetes nurse next week.

pam Ill try cheese tonight iv not got almonds I don't really like them do you think walnuts will work as well?

I think all nuts are good as long as they're plain & not salted or flavoured etc...

Tarka u may b right, think i may b next on thread to have little one arrive lol
im still stuck in hospital till birth :(
But getting induced on Sunday afternoon, C-section possibly Tuesday if i havnt progressed!

Think i was kept in for a variety of reasons- high blood pressure, protein in urine indicating pre eclampsia. Factor in the gestational diabetes too and was put on a shed load of drugs to try and control things.
I had steroids tues n weds and blood sugars wernt too affected so didnt need an insulin drip. However i had x2 hypos yesterday and now on my second of the day :(

Think thats what made them decide to plan for delivery early next week!

Exciting times

romily i too am wondering how BF will go being taken so early, but i have learned so much staying in hospital- mine have medula swing electric pumps u can use. Girl had her baby early and was expressing every 3 hrs, including through the night

Cant remember what else i was going to say- im a little wiped out still and find it hard to concentrate

Speak to u all again soon

curly Sunday is so close, eeek how exciting thread baby! sucks that your stuck in hospital till then though,
I hate hypo's I had one this morning they make you feel lousy. Hope ya feel better soon and fingers crossed for a. Fast labour and sneeze birth

pam I tried the cheese it didn't work 5.4 this morning iv got some nuts to try tonight, fingers crossed they work I'm also going to try eating tea a bit earlier than usual. Really hope it works I feel like nothing will ever get them down, but plus side is I'm now 36 weeks today so only 2 weeks left can't wait for this pregnancy to be over and get to see my little man!

I can't believe they want you to get readings below 5! The NICE guidelines are below 5.9! I don't think I've ever had a morning reading below 5.

In fact my consultant told me to have a snack before I drive if my levels are below 5.

I didn't know that I need to read nice guidelines I think, but yeah they said between 3.5 and 5. I think under 7 1 hour after food is steep too. What does your fasting result need to be?

I have been at two hospitals teri and one was 3.5-5.0 like yours, the other 4.0-5.5. Neither offered any explanation for why they weren't following the NICE guidelines!

You should ask your consultant, I am only 13 weeks and past 4 days my numbers have all been 5.3 or 5.4. My husband gets just over 5 too so I think it can't be that weird!!

My fasting numbers are the same between 5.2 and 5.7 even if I don't take the bed time insulin, I think I'm going to see what the nurse and consultant says about nice guidelines.

My other results are fine just fasting but if I go by nice guidelines all my results are good.
Well iv had my tea earlier and will be having a few nuts before bed if that doesn't work I give up and I'll be following nice.

Just wanted to wish you all luck! I have had type 1 diabetes for 27 years and am expecting my first baby. Bit nervous about the implications this will involve but I am sure everything will be fine.