"Fat mum's have fat babies" - gestational diabetes

[SellyMevs]

I was diagnosed with gestational diabetes about 2 weeks ago, although I have been following diet advice from the obstetrician since 27wks as it was quite likely GDM was on the cards. I am now 32wks. I was started on insulin just in the mornings about a week ago, and yesterday this was upped to 4 times a day.

Up until now, GDM had been associated with my family history - my mum had it and both my grandmothers are type 1. The obstetrician I saw last week said I was just unfortunate, despite being slim, I couldn't change my genes. Everyone has been happy with my diet. Until I saw the diabetes consultant yesterday that is..

I lost count of the number of times he said the word fat in the 20 mins I was with him. I usually have no problem with people discussing my size, pre pregnancy I was a size 10 with a BMI of 25.

He asked me why I thought I had developed diabetes, I answered that it was my understanding that I've probably inherited the genes that make it more likely. He said that although it's a factor, it's actually fat mums that make fat babies and I need to address my weight. As a result of my weight, I was going to be subjected to a long and difficult birth, the baby would likely get stuck and he could end up being quite poorly afterwards.

I've put on 1.5 stone. I've moved up to a size 12 pair of jeans.. but even those are falling off of me. He says I am not to gain any more weight in the next 6 weeks and I have to be very strict with what I eat. I need to diet.

Firstly, is my weight gain really that awful? And secondly, is there anywhere I can find some good recipes? So far his suggestion for breakfast is one slice of toast and nothing else.

I already had some anxiety about delivery, I am high risk due to a rare bleeding disorder that means I have to have platelet transfusions during and after birth. I have a fear of needing emergency c section because they will need to do a general anaesthetic and the last thing I want if something goes wrong is to be put to sleep. His comments haven't really helped this. Is there someone I can talk to about my concerns? I have to see him again next week and I'm not looking forward to it, mostly because I'm worried I will have put on more weight again.

Sounds like an arse to me. I was BMI of 33 when I got pregnant, I put on exactly 12kg, which is the lowest end of the recommended amount, and had a whopper - 10lbs. No GD. There simply can't be a direct correlation like that, I don't buy it.
And a size 10/12, BMI 25 is ideal. No weight issue at all. Ignore him, he's a prat.

Ah selly I am sorry to hear you had such a bad experience with this consultant. I did too when I was diagnosed with GD in my last pregnancy - I couldn't quite believe the consultant actually! I would contact the supervisor of midwives at your hospital and go and speak with them about your concerns about this man. You really don't need to go back to him. I know it is a lot of hassle when you are heavily pregnant though :(

I have GD - no real family history and I am a small person, size 8 pre-pregnancy. They know hardly anything about GD so he is talking a load of rubbish to be honest. It is so hard to be spoken to like that though.

Low GI foods are definitely the way to go... it is also good to eat fat and protein with your carbs as this makes them go into your blood slower. I usually have full fat greek yoghurt with nuts and berries for breakfast, and if still hungry leave it an hour and then have a slice of Burgen soya and linseed bread (this is a great low GI bread). No juice or anything. Eggs are a good breakfast too as high protein and low carb. Bit of a faff though! Are you managing your other meal numbers still? Let us know if you would like any other suggestions.

I am sure you are doing a great job. It's hard work to be pregnant with GD and the last thing you need is to be made to feel guilty about it.

I had GD which I was expecting as I have got a higher BMI but also because I used to have issues with blood sugar when I was a teenager and hormones seem to do odd things to me. I was measuring large the whole way through, kept my blood sugars in control with diet at first and then metformin when the hormones ramped up. I was eating the same food that I had been the week before yet my levels started spiking. i had a baby who was only 6lb 11oz instead of the predicted 8lbs+. Have they spoken to you about expressing milk before delivery? My clinic midwife was awesome, she had us expressing a few weeks before delivery and freezing the colostrum so when the baby arrived we had extra to help stabilise his blood sugars and that way he was EBF and didn't have formula which has higher sugar levels and makes it slightly more long winded to stabilise them as I understand it.

Ps... If you are desperate for so,etching sweet eventually sugar free jelly or sugar free angel delight helped.

Pps. Make a complaint about the consultant, utterly out of order!

Your consultant sounds like an arse!
I also had GD, If it puts your mind at rest a little, my biggest fear was also needing a section under GA. I was induced at 38 weeks (policy for insulin dependent diabetics at my hospital), had a normal vaginal delivery and DS was a tiny 6lb 3oz.

How weird! Is he French? I've heard they get a lot more het up about pregnancy weight gain. But still, yours is hardly anything and you're not fat so what is he on about?

I gained 3-4 stone when pg and none of the HCPs I saw said anything about it at all.

I would phone the hospital, ask to speak to someone senior, explain what happened and say you need to see a different one.

I have had GD in both my pregnancies (requiring insulin from 16weeks in the 2nd) and was "pre-diabetic" in between pregnancies. My bmi has always been around 20.

Have had two inductions at 38 weeks. Needed syntocin drip both times but once that was in progressed very quickly and needed no further interventions.

I was planning on phoning the diabetic midwife for some more advice. She's been lovely to me so far.

Also, I am taking the slow release insulin at night.. He told me that I need to set the alarm and wake up at 3 am to check my sugars. I did it last night and I've suffered today. I have to get up at 5.45 every morning, although only for a couple more weeks. Does everyone else do this?!

What an ar5e - I totally agree. He seems to be one of these medical professionals that can see beyond a flow chart in their head. In his head - there are only is only one path :
Fat (Yes or No)
if Yes, then = Fat Baby.

In my head
Simplistic Medical Professional with no compassion (Yes/No)
If yes, then = BAD MEDICAL STAFF with NO PROFESSIONALISM.

I took the slow acting and was never told to do this. I did (often) have hypos at night though so maybe that is what he is trying to prevent?

Sorry, I haven't read all the posts, but completely agree with some pps - raise a complaint and change consultant.

The treatment you received is completely outrageous. I am about the same non-pregnant BMI as you and my MW, GP, sonographer have never mentioned it despite them all weighing me at some point. It sounds like this jack*ss is bringing weight into things simply due to your GDM. I find that outrageous and totally unprofessional.

*Sorry GD, not GDM

Hi,

I haven't read all the posts either and I'm not in the UK but here I think there are similarities. I think there are massive inconsistencies between doctors on Gd diagnosis and their opinions of weight in terms of what a healthy start weight is, what a healthy pg gain is and if weight is relevant at all.

I had a pre pg bmi of About 27. I've put on 5kg at 26 weeks. I've seen 3 different consultants so far and all of them have had a different opinion.

First doctor couldn't care less, didn't mention weight at all, second doc, told me my sugar was far too high, ordered me to diet, gave me a lecture on my diet. Made me panic about gd risk. 3rd doctor (different hospital) told me my weight is fine, baby measures 1 day behind so size isn't a concern, not to diet and not to worry about gd.

Hospital appointment again today. Fully expecting to see doc no 2 again and for another lecture and gtt tests ordered. Instead saw the first doc again and despite being weighed by the nurses none of the hcps I saw today mentioned my weight, blood sugar or baby's size!

Incidentally I am still trying to eat better anyway but not dieting.

What an arsehole.

20lb gain at 32 weeks is fine - maybe just over ideal, ... but who are we kidding that it's more than most. And it is possible that it would have been a contributing factor to the GD, but it's not like you started with a v high BMI or have piled on 3 stone.

I'd definitely complain. If he can't be nice to a pg lady, then imagine what he's like to other patients.

I agree with all the other posters. This hc professional is way out of line.
I am seeing a consultant for my underactive thyroid and they weigh me at every appt. I had a gtt test last week because my pre preg bmi was 33. Nobody has mentioned losing weight or diet. Just eat healthy, which you are doing. Also one slice of toast is not enough to start the day on when you're pregnant IMO.

Ask to change, put in a complaint.

And its my understanding that at this point in pregnacy the baby has all of their organs etc developed, they are just literally getting bigger/fatter to make it all a bit easier on the outside.
You are doing really well. Good luck.

Oh goodness please complain. What an idiot you are dealing with.

There is a strong family history in my family of diabetes. I was a size 10/12 when I first fell pregnant, BMI 24, and developed gestational diabetes at week 28. Not once did I hear the word fat uttered. I was told I had a big baby, but reassured that it wasn't a fat baby (in fact she was a skinny, but very long little thing).

My diabetes stayed with me so I'm starting this pregnancy as a pre-existing diabetic. Again, nobody has used the word fat (even though this pregnancy my starting BMI is 27 so there is some padding I could do without).

The advice to have a single slice of toast is rubbish as well. At my diabetic clinic we have a great dietician who has plenty of advice.

Sisyphus85 There is no "ideal" pregnancy weight gain. There is a weight gain range associated with good outcomes, which varies by starting BMI, but there is absolutely no evidence that the advertised "average" weight gain is anything other than bollocks generated by a diet- and image-obsessed society that doesn't like women to look like real women.

If you have a starting BMI that is normal, a 1-3 stone weight gain is normal and healthy. Please don't use language like "it's not like you piled on 3 stone", it just makes people want to diet during pregnancy which is extremely bad for their babies!

Now stepping off my soap box

Thanks whereisshe great post. That is what I wished that second doctor had said to me. I've had weeks of my husband questioning everything I eat after that appointment. I dieted for 6 months to get pg I didn't want to be dieting during as well it makes no sense at all. No doctor should be recommending it I agree.

I was told eat only one piece of fruit a day and make most of your meals meat and vegetables.

What an idiot! I have GD and no one has spoken like that to me.

First off, I had a pre-pregnancy BMI of 23.8 so maybe not slim but certainly not overweight. Weight is only ONE risk factor - plenty of slim women get GD and plenty of overweight and obese women don't. We have tons of type 2 diabetes in our family, I knew I was going to get it. I was slimmer with my previous pregnancy (nearly 8 years ago) and I still ended up with a 10lb baby (likely due to undiagnosed GD) - although I have to say, while I don't trivialise GD, her birth was straightforward and relatively easy and she was perfectly healthy when she was born.

I'm 34 weeks and have put on about 2 stone. No one has said a word about my weight gain. At the diabetes education class, it was reiterated a number of times that the GD is not our fault. It's bad luck.

The suggestion to eat a slice of toast and nothing else is awful! Yes, you may need to cut back on your carbs in the morning as lots of GD women struggle wiht breakfast because that's when there is a hormone surge and insulin resistance goes up. However, it's only part of the picture. You need to up your protein and fats instead - eating a piece of toast on its own is probably the worst thing you can do! If you can, try eggs, bacon, cold meats, greek yoghurt, avocado, nuts AND one slice of toast! I find the protein shakes really help me. They're low carb but an easy way to get protein down me in the morning when I really don't feel like it.

Are you eating 3 meals and 3 snacks a day? you really shouldn't be going hungry.

Also, this idea of dieting is totally wrong. I'm in the US and the clinic I go to asks us to test ketones in urine every morning to make sure we're not burning fat. It's not clear what the effect of calorie restriction is on the foetus and burning fats releases ketones which may not be so great. Generally women on the GD diet don't gain that much weight anyway since you have to be so controlled - but it's not a restricted calorie diet.

You definitely need to ask to see a different consultant. This one sounds appalling, both in his bedside manner and in the advice he's giving.

I had a Haematology consultant tell me that I would never have a child. I'd never met the man before, never met him again afterwards. I did do a lot of crying over many months and years about what he'd said.

It turned out that, although I'm sure he was very knowledgable about blood, he knew next to nothing about Lupus and even less about fertility issues. But that didn't stop him giving me the benefit of his ignorance.

I hope the OP manages to find someone sensible to discuss her concerns with.

You don't have to see a Consultant at all, it's your right to decline shared care. I've dedlined shared care for different reasons, having had it in my first pregnancy, because it was quite frankly a waste of time.

My second baby was 10lb 5oz. I didn't have GD (I had the GTT in all pregnancies due to family history) - was actually on some medication that is known to increase the risk of a large baby. I wasn'gt overweight at the time either. There were no problems with her birth, she was born at home with no pain relief and not a stitch. A larger baby increases certain risks, doesn't mean that your baby is automatically going to have a difficult birth and health problems.

I would complain about this fool, and decline to see him again - either ask for a different Consultant or stick with your midwife.