Gestational diabetes support thread

[NoRoomForALittleOne]

I thought I'd start a support thread for those of us being tested, just diagnosed or being treated for GDM.

So collapse on a sofa, grab a low carb snack and come and chat about blood tests, finger pricks, diet changes, medication and birth plans...

Hi lurker!

I had GD last time and now as well...

Main thing my diabetes dietitian said was to reduce carbs but to have some at every meal.

For me my body can't cope with carbs at breakfast. Some times I can have large jumbo oats porridge but most time nothing car by - have taken to have as breakfast a yogurt and two babybel...

My morning readings fasting were my issue...

No juice but some fruit OK.better middle of the morning or afternoon than with the meal, for me...

If you control with diet you should be OK. As I was on insulin at bedtime (and am again) I was induced at 39w last time and will have a section at 38 this time.

This time my AC is too big, poor child...
You will get extra scans and will be seen by the diabetes team every 2 to 4 weeks... At least in the royal free not sure about the Whittington...

Hope this helps. Feel free to pm me and we should meet for lunch again before my maternity leave...

Thanks all. Wave to Tiny. Yes to lunch again. Hopefully clinic will be in touch tomorrow.

Glad you are out Noroom. Could the high blood sugar be due to your body compensating for the sickness? Thanks for the sliding scale information.

I am still thinking I would prefer not to have insulin/glucose if I can avoid it and same for induction. (So you are not mad mini pie. ) I think that is because I feel it is messing around with my body unnecessarily but would be willing to test my blood sugar at the time and see how it is and make a decision at the time. I also think inducing often won't work if your body isn't ready to give birth. I am fairly sure ds will be along by 40 weeks on his own accord (dd came quickly at 38 weeks and was ready by then) and would like to wait till then. Not really planned mentally on going past my due date this time so will be happy to get him out after that.

Lurker - I do wonder about the blood sugar causing mcs. I didn't know I had pcos with my 1st pregnancy and had an mmc. However, around the time that it died I had a blood sugar crash and was on the floor in a shopping centre whilst dh got me a sugary drink. I do wonder if that was what caused it. (I have always had problems with my blood sugar crashing if I ate too much sugar so used to avoid it most of the time.) I then had a second early mc. I then went on a low gi diet and my pcos went (according to my skin, cycles and ultrasound scans) and since then I have not had a mc and 33 weeks pregnant with dc2. A book on pcos said there was much higher chance of mc but this isn't something the nhs believe and has never been formally proven.

My blood sugar has gone loopy in the last couple of days. Had 2 high reading which I didn't expect from meals that were previously low and I wasn't ill which also sends my levels up. The only thing I can think is that both times I didn't have a snack between meals as too busy and was starving by the time I ate. Does that sound plausible that maybe my sugar levels get too low and then surge when I eat? It does feel a bit like Russian roulette as I hold my breath when I test and have no idea what number will come up! I have discovered that chocolate fondant and ice cream as part of a 3 course meal is ok so may have to do that more . Typical when I finally see a doctor on tuesday I get two spikes!Â

Ah good to hear you are home NoRoom.

Thanks for info about sliding scale - 4-7 still sounds pretty strict to me though, I bet some non GD women would be outside that range some of the time during labour... Will have to ask more questions and do more reading.

I know there's an increased still birth risk in going over, and obviously that would be appalling. However none of the studies have looked at diet controlled women only, so the increased risk could just be for women who are medicated or who also have other stillbirth risk factors like being over 35, obese etc (which I don't have but often go along with GD) ... nobody really knows... I will have to ask about monitoring tomorrow.

I know this seems like playing with fire but the trouble is that induction itself carries quite a lot of risks for both mum and baby - especially if your body/baby is really not ready to deliver yet and you end up with the drip to force it along - so it's a question of weighing one set of risks against the other. I'm not very confident the midwives will do that for my particular case, they'll just want to follow "the rules" iyswim. Argh.

lurker welcome, and sorry to hear of your MCs (and LIG too). Diet advice that seems to be working for me:

• Cut out sugar and baked goods (bread, cake, biscuits, pastry) pretty much entirely - especially in the first few weeks while you get more under control. Also mashed potato, breakfast cereal and fruit juice. Watch out for added sugar in other things (eg ketchup gave me a high reading the other day, oops).

• Switch your other carbs to low GI. Basmati rice, al dente pasta, lentils and beans, pearl barley, Nairns oatcakes are all "good" carbs. New potatoes aren't bad.

• Whenever you have carbs try to have them with some protein and/or fat not on their own.

• If you're used to very carb heavy meals, cut down the carb portions and add more protein and veg instead. Your plate should be about 1/3 protein, 1/3 carbs and 1/3 veg, or possibly even 1/2 veg and 1/4 protein 1/4 carbs.

• Small snacks between meals are very important to keep blood sugar regular. Cheese, nuts, hard boiled eggs are good low carb/high protein snacks.

• Fruit is generally ok in moderation (as all the fibre in it counteracts the sugar) but not mango, ripe banana, melon or pineapple. All veg is fine I believe.

LIG that's good that your DD was ready by 38 weeks. Unfortunately I really don't think I will be by 38 or even by 40 - DD came at 34 weeks but that was a random one off (so say all the doctors at least) and as I say my mum went v late both times. Thanks for saying I'm not mad

I definitely think your high readings could be due to no snack. That's when I found the same meal was giving very different readings - low with a snack, high without a snack.

That's really interesting about your PCOS clearing up on low GI diet LIG, I may have to give that a go post birth (though maybe not till I've stopped breastfeeding as I will need the cake I think...)

I have discovered I can eat cake and biscuits mid afternoon and then still have an ok reading after dinner - I'm sure that's not how it's meant to work though!! DH says I am gaming the system

Thanks all. I have stocked up on oatcakes and nuts and am currently tucking into a boiled egg with lentil, chickpea and bean salad. So far so good but it's dh' birthday tomorrow and we have a rare chance for a meal out. Minipie do you mean normal white basmati rice and al dente pasta or do I need to get wholemeal/brown types?

Still not heard back from clinic. Am assuming from what I have read that even if my blood sugars stay stable I won't be allowed to go past 40 weeks or use the MLU/birth pool. Is that right or does it all depend on what happens over the next few weeks with my bloods?

My nhs consultant did not deny the link between PCOS and MC but said that it probably wasn't the cause for me as my insulin and clotting results were normal. Well not any more, so I am beating myself up for not losing weight and eating more healthily before ttc (though actually I was slimmer when I had my first mc - it went a bit wrong with the comfort eating when ttc took a while).

Btw I am 27 weeks and age 34. My BMI pre pregnancy was about 28.

Dd arrived at 40+5 so am assuming I would go over with this one too if not induced.

As a Mil please may I ask your advice. I am hosting a big family lunch at the weekend and this would usually be a full on roast dinner.

However, my DIL also has GD so I want to make things that she can enjoy as well as the rest of the family, without it seeming obvious. I am now going to do a buffet style, so please tell me what you would like prepared if it was you. Particularly what to avoid serving.

I found Rosst dinner ok. Just went easy on the potatoes and had extra meat and veg.

a roast is a good idea. What about roast sweet potatoes or new potato's as an option for your dil? or just meat and veg and go easy on the roast potatoes?

The trouble is if I do a roast every one will expect roast taties, batter puds etc. my DiL has been told to lose weight but she loves all those things, so I would rather do something else. Are mashed potatoes ok?

I don't want to draw any attention to her as I know she would hate that.

I am not explaining myself very well, but I just want her to be able to eat the same as everyone else. She is so lovely, and having a very difficult pregnancy.

Florentina how thoughtful of you to come on and ask the question. Roast is fine but your DiL will need to exercise some self-control over the amount of roast potatoes/mash/Yorkshire puddings consumed but she could have a modest portion. If there are plenty of different veg so that she can fill up on meat and veg then that is a good option. Roasted or mashed sweet potatoes are far better for her than 'normal' ones. Are you planning a pudding? What drinks are you thinking of having as these can be a bit of a nightmare with GDM as well.

Also, if she has been told to lose weight, then exercise and portion control are probably the key things for her. Unless she is eating loads of sugary stuff, I doubt that a diet change will be enough of a change, if you see what I mean?

Also worth bearing in mind if she is on indulin or not. If she is on pre-meal insulin it would help her to know that dinner will be served in 30 minutes...

No I was not going to do a pudding. I was thinking maybe a gammon joint cooked in the pressure cooker as that does not have fat. I have never cooked sweet potato,so,that seems like a good idea. Have to find out how to do it. Can it go in the oven with the roasted veg? maybe a chicken as well as there are a lot of us.

No one really drinks as there are lots of little ones too and most will be driving.

Is cheddar cheese and wholewheat crackers ok instead of pudding. And for the evening sausage rolls,ham salmon and salad. How does this sound.

Alternatively for the evening a shepherds pie, or chilli.

Hi all. NoRoom - glad you're out.

I've had two weird spikes recently so keeping close eye on things - i was doing so well and I don't want to go onto insulin which is the next step for me. Argh.

LIG and Lurker - i have bad PCOS, diagnosed as a teenager, treatment etc. On the miscarriage thing, my consultant was very very clear: the statistics that show higher chance of miscarriage in women with PCOS are MUCH MORE about the fact that in most cases, PCOS is not diagnosed until a woman is older. ie the higher incidence of miscarriage is actually more about age - miscarriage rates rise over 30 and again as the women's age goes up. Her point being, bluntly (and amusingly for me at the time), that a 23 year old woman who only ovulates three times a year probably has a much higher chance of getting pregnant simply because the reality is that most 23 year olds have a lot more sex than women over 30. So these women get pregnant with PCOS without even realising they have it. And their miscarriage rates are the same as for any other 20 something woman.

I checked this again when I got pregnant this time as it was spontaneous ovulation not Clomid as it had been the first time and I was worried that meant the egg was less healthy!

PCOS and insulin resistance are closely linked. Hence the suggestion to follow a low carb, low GI diet to help lose weight and control PCOS. It's also why metformin is regularly prescribed for women with PCOS.

Final PCOS point - if you have PCOS and this is your first child, you may find a lessoning of the symptoms post baby. Sadly my ability to gain weight very easily remained, but my cycles did become somewhat more regular and I clearly do ovulate now at least some of the time - DD's imminent birth proves that! .

florentina if you have the kind of family who expect spuds and yorkies and your DIL is the kind who would really struggle to exercise restraint then I would skip the roast. If they're open to a more varied roast option though, then sweet potato and butternut are great choices and can be roasted with the other veggies or alone with olive oil and a few herbs. Sprinkle some cinnamon on at the end of you like too - makes them extra sweet.

Even though I need to lose weight, I've found that on GD, the low carb thing has made all the difference and haven't worried too much about fat. And I currently weigh nearly 3kg less than when I got pregnant and I'm nearly 38 weeks. So I wouldn't stress too much about the type of meat - something higher in fat but super appealing may make the lack of proper potatoes less depressing. For everyone.

Florentina can I just second the person who commented on how thoughtful you are being? My MiL certainly wouldn't take the same considerations!

I think the metformin is upsetting my tummy a bit. Generally feeling crap. Although my sugars have been stable since starting meds, I now have an unsettled tummy, PEP so the most unbelievably itchy skin, leukocytes in my urine so I'm fighting something off, and too add to it all I fell down the stairs this morning. 37+2 and had enough!

Coaster - they swapped me to slow release metformin because of the dodgy tummy. It definitely helped. If you don't have an appointment already lined up, call your diabetes team and ask.

Thank you all for your suggestions and kind words. She had a really bad pregnancy with her first and has been so I'll with this one. My heart goes out to you all. Reading this thread has Been an education. I hope you are all delivered of healthy babies.

I will be watching closely from now on

Sounds like you have a plan Florentina.

So I had my 32 week growth scan plus appointments with diabetes team and obstetric consultant today. I just want to cry. Baby has an abdominal circumference that is "off the charts" and estimated weight is over the 90th centile. There is now talk of c section rather than induction I've also had rapid acting insulin added in at breakfast time despite my mid-morning hypos even though I've only had a few post-breakfast results slightly higher than my target. I can't tell you how gutted I am. They are so concerned that I have to go for an extra growth scan in two weeks time and I have to phone the diabetes team in a week's time. As cute as the baby's chubby cheeks were on the scan, it's really not the news I wanted to hear.

Sorry you haven't been reassured noroom. I am new to all this but dd was a fairly big baby and no one ever commented except in a positive way. I hope your next appointment brings better news.

On my way to diabetes clinic to fetch testing machine. Mw said my fasting and 2 hour readings were normal but my 1 hour reading was 13. Is that very high? It sounds bad compared to the readings quoted over the last few days but obviously I had drunk that nasty drink.

Yes, 13 is very high. At 1 hour it should be less than 7.8. However, if your two hour reading was fine then your body is dealing with the sugar just slower than it needs to.

yep, 13 is very High lurker...
i didn't get a 1h reading and my 2h reading was actually lower than my fasting one, but the endocrinologist said it was because I had a spike and then a crash...

NoRoom, my baby is on 50th for most measurements and 95th for the AC... I was going for section anyway for other reasons, but still worried a bit...

Only 4 weeks to go anyway...

Ah right, the midwife said it should be under 10 so was "a bit high" but I thought 10 sounded generous from what I had read (unless my hospital uses a different drink?). Anyway, I have the full results now - 3.9, 13.0, 6.8. She said the first and third were fine but 6.8 sounds high too for 2 hours after?

Anyway, I have the machine now and this morning's post-breakfast reading was 5.7 which is OK I think? (I had granary toast and peanut butter as recommended on this thread, though tbh am hungry again already) and she was quite reassuring. She actually said the new NICE guidelines are that you don't need to be induced until 41 weeks if your blood sugars are under control with diet and the baby is growing OK and that's what they have been doing at my hospital for a while now anyway. I have a scan and consultation on 13th March.

Sorry for being so me, me, me. Don't feel I know enough yet to be of much help to anyone else, but echo what others said to florentina - you sound a lovely MIL. I think one of the most supportive things you can do is let your DIL help herself to what she wants to eat without pressuring her to "just try a bit" of pudding or whatever. Doesn't sound like you will be doing that so you'll be just great. Cheese and biscuits sounds good, especially if you can make sure the selection includes some hard cheeses and oatcakes or wholemeal crackers.