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...

How's everyone managing?

A question for those who are on/have been on insulin - what time did you inject? I'm exhausted and would love a super-early-catch-up night but I guess that I can't because I need to take my insulin at the normal time. If I nap on the sofa until then, I'll end up unable to go back to sleep for a bit and it will defeat the object of trying to get more sleep. Any ideas?

I just took it before I went to bed rather than at a set time.

Like Tarka I always used to take mine just before going to bed. If you find you have a strange result tomorrow morning just make a note of taking insulin early so that it is explained in your record rather than consultant thinking the dosage needs adjusting. I reckon you will be fine though.

Morning ladies

Well I still don't have any blood testing strips - I finally got my prescription ones Friday afternoon, only to find they are also the wrong ones and don't work with my machine! Pharmacist refused to swap them for the right ones as he didn't have a prescription for the right ones and so he wouldn't get reimbursed. So I now have three boxes of useless testing strips (one bought, two prescribed) and none that work! Haven't tested since Thursday argh

I have left messages with GP and midwives asking for a revised presciption but nobody is replying.

In the meantime I'm trying to be "good" but been staying at friends this weekend so it's hard... eg breakfast options were toast, cereal or croissant, all v nice but not GD friendly!

Snacks - I am relying on nuts a lot.

Saw my consultant today, GTT all booked for April

minniepie I can't believe you are having to wait so long.

I had my first meeting with the diabetes specialist on Thursday, on Friday morning my gp surgery called to say my prescription was ready to collect. I took it to fill out at pharmacy on the same day and got everything I needed except for the lancets as they didn't have the right size. I'm going back today to collect them though and I had enough from my meeting with the specialists to last me until today anyway.

I can see your pharmacist point about swapping them and he his paper works needs to tally up but really your diabetes consultant (or whoever issued the original prescription) should really be more on the ball then that. I hope it gets sorted soon for you.

Thanks ILive - it's no one person's fault really, combination of me taking 2 days to give the request to the GP (oops), then GP taking 2 days to process it, then it turning out to be wrong but by then it was a weekend so 2 more days till I could contact anyone ... So frustrating. All because the midwife put the wrong name on the original request. Anyway hopefully I will speak to someone who can help me soon!

I hope you get sorted soon minipie so that you can start recording some numbers and seeing how things are going.

I saw the diabetes team, had a growth scan and saw the obstetric registrar today. The diabetes team are very happy with my results now that I'm on insulin and they've explained when to increase my insulin dosage (if I need to). The growth scan was a bit frustrating but predictably so. I'm not going to believe that the results are particularly accurate until I've had the next two scans. As for seeing the obstetric reg, well, I'm still processing it all. I knew from my research what to expect but I feel like I'm being catapulted towards a highly medicalised birth that is scary. It is policy here for women on insulin to be induced at 38 weeks and for a minimum of 24 hours stay on the postnatal ward. I'm to having sliding scale insulin and continuous monitoring during labour. None of this was communicated to me particularly gently and it seems that policy is so rigid that I feel like a piece of meat.

Finally got some! About to do first test since Thursday, one hour after dinner... eek

That's what I've been told about birth NoRoom - and even if I am diet controlled I will still be induced (but at 40 wks not 38) and will still need all the constant monitoring during birth and 24 hr post natal stay, in fact they will do all that even if I go into labour naturally. So no chance of my wished for MLU rubbish isn't it?

I wanted a pool birth at home. The registrar said "well, you can't have that now" to which I reminded her that, yes, actually, I legally could. No, it's not a wise idea for a whole number of reasons but I could if I chose to. I will be going with IOL at 38 weeks because I've read the evidence that goes with the suggestion. But I'm not very happy about it

I'm sorry you had an unpleasant experience NoRoom. What you describe is what I was told for my first pregnancy but the reality of it was much nicer than expected. Yes I had to be monitored throughout labour and I was on a insulin drop during labour, I also had to stay in hospital for 24 hrs after birth so they could monitor baby's sugar. My dd had low blood sugar at birth but the rose quickly and levelled beautifully within 12 hrs, so no real issue there. The induction took about 42 from first arriving in hospital for pessary to baby in my arms but the reality of the labour was a day in half in hospital, I was given my own room, wasting time on internet and playing cards with dh followed by a six hour active labour stage. Unfortunately I had to be monitored through those six hours but because I was 'high' risk because of gd I had a midwife at my constant disposal, she was nice too so we had some nice chats. After birth I really wanted to go home and at the time I was quite aggravated at having to stay but in reality dd was born in the early hours of the morning in 27th and I was home late in the day on the 28th so I really wasn't in hospital that long. It felt longer at the time but looking back it really wasn't.

Not sure if my experience is helping you at all but it didn't put me off another 'gd' birth, I would of course love to experience going in labour naturally but if I don't before I have to be induced this time around (assuming I am induced) the. It won't be the end of the world for me. The induction was well organised and controlled and that aspect of it was really nice and reassuring for both me and dh. I'm not scared about the prospect of another induction birth. I think they make it sound a bit worst than it actually is. Just keep an open mind about your birth plan an you'll be fine.

As for growth scans, they told me dd would be near 11lbs by the time she was born at 38 weeks, she was in fact an ounce short of 8lbs. Perfect in every way. So I think you are doing well to keep an open mind there too, growth scan are just estimates and are very inaccurate in my experience.

Build that's the silver lining I'm focusing on - being "high risk" although it rules out the MLU, does at least mean I will have a midwife around a lot (I hope) - some of the birth horror stories I've heard have been seemingly "low risk" women who've been left to get on with it a lot and only too late does someone check and realise they are not progressing.

I was told by the diabetes midwife that she knew of one woman who had managed to persuade the MLU to accept her - she was diet controlled and had very good records. So that's also in the back of my head as a possibility though might have been scuppered by the last few days of not being able to test

oh and yy to the scans being inaccurate. I know lots of women who've been told they are having a giant only to end up with a 7-8.5lber!

Build did you have an epidural?

NoRoom your description of the labour/birth you've been told to expect is exactly how both of mine were and both were positive experiences - one with epidural and one without. Neither was longer than 8hrs in labour (although the process took a few boring days), neither delivery needed any further intervention. In both cases I was showing no signs of imminent labour when they started. I do remember how hard it was to let go of how you had expected to labour but on the positive side at least you have a while to process it. That's what I told myself anyway.

As for the 24hr stay, can you book/request a side room? I paid £100/£120 for mine and it was well worth it.

Minnie I did have an epidural but I was a real wuss about labour even before I knew I had gd. This time I want to try without and see how I go. Looking back on my labour with dd I reckon I would have been fine without the epidural. In a bizarrew way, I'm kind of looking forward to it, just out of morbid curiosity to see how it will all go.

Tarka how did you go about booking a side room and what did it involve? That was the only though bit for me, being on a really busy ward with dd after the birth, I just wanted a bit of quiet. I would love that option this time.

I've given birth four times with nothing more than gas and air but I've never been induced so I don't know how I'd cope with that. I've also had very fast births (4 hours, 2 hours, 1 hour 15 mins and 25 mins) so I'm a bit bothered about how induction will be. I've been told that they'll just try and break my waters to get me going but that seems to go against the NICE guidelines for induction. My biggest worry (other than another shoulder dystocia) is what the first few hours will be like post-birth. I want to breastfeed again and would like a physiological third stage but am bothered that they are going to be trying to whip baby to one side for 'checks'. I guess that I remember what it was like giving birth to DD1 at 34+6. It was not a great experience and was more about what the doctors wanted than what I felt comfortable with.

My major concern about the growth scans is actually that they are saying baby is smaller than it actually is. All of our babies have been relatively short in the legs compared to their overall size. If you calculate the estimated weight of this baby just using abdominal and head circumference then it is much heavier compared to using the femur length as well. Plus the graphs show that this baby isn't following a 'normal' curve but is cutting across centimes and growing more rapidly than expected. I've been here before. I told the obstetrician last time that DD3 was going to be huge but was told 'no' and that she was average sized. I was right. I want to be listened to this time but am being talked over and ignored

Tarka at my hospital there are hardly any private rooms and they give them to those with greatest need ie those who've had a traumatic birth, sick baby etc. If nobody needs them they are available but chances are slim as its a very busy hospital!

noroom I had dd at 34 weeks so I know what you mean. I don't think the checks on a GD term baby would be anything like the ones on a prem - from what the midwife said it would just be heel prick blood tests before/after feeds and otherwise it's like any other baby?

re breastfeeding, I want to breastfeed too but suspect if the baby has low blood sugar they will press formula. And DD had tongue tie so if this one does too, BF may not be effective till that's sorted. I'm going to try to express colostrum antenatallly from about 38 weeks so they can use that instead of formula, hopefully that should help get my supply going too and maybe even bring on a natural labour...

noroom Would you want an ELCS given large baby/shoulder fears? if so I'm sure you could ask for one.

I understand your concerns better now noRoom, for me being induced is the only birth I know and I didn't find it bad at all but I guess if you've had other none induced labours to compare with then I can be a bit daunting. To reassure you about test and such directly after birth, I held dd right after birth and then her dad fed her her first bottle (we chose not to breast feed but had we decided to I would have been given time to do so) then dd was dressed in her sleepsuit, that took a a while because dh and mil who were in delivery room with me offered to dress her while I got cleaned up a bit but they couldn't figure out how the clothes went so they had to dress and undress dd a couple of times. The midwife was laughing gently at them and she didn't rush them, she let them get on. After this though she did do a heel prick to check dd bloods sugar. I was later told that that was actually her second heel prick but I didn't notice the first one so they must have done it very quickly, maybe when she was being weighed. Dd was back with me very quickly and she didn't leave me again until I went home.

One tip I would say to make the heel pricks easier is to put one or even two pairs of socks on baby's feet to keep them warm an to make the blood flow easier. The first help prick dd had on the post natal ward (so her third I think) the midwife struggled to get enough blood out for the test and had to spend a bit a time rubbing dd's feet before trying again. It was late November though but I think newborns to tend to have cold feet and hands though. Well dd did anyway.

On a different note, I've just had a look at the post natal ward of my hospital and found that the facilities are so much nicer then where I was three ago with dd so I'm thinking my post natal stay may be much more pleasant this time. Like minnie I don't think they have many side rooms! the website says 6 so I reckon I should just make the most of the postnatal ward facilities as I hope to only be thre 24 hrs or so anyway.

What going on with my bloods????

Last night we had a pork casserole type dish, tomato based with whole grain rice. I had a small portion of the whole grain rice and more of the meat and veg (no root veg: broccoli, green beans and spinach) and only a bit of the sauce. I was a bit worried about my result because of the rice but I'd had a busy day and was super hungry, results 2hrs after meal were 5.7. Super happy.

Today, as I was really busy and didn't have much time to stop for lunch, I had a small portion of yesterday's leftover (as results had been so good), 2hrs after my bloods were 8.9? Was is that all about?

noroom I've no experience of the post birth GD tests on baby but DD1 kept going blue when she was born and they did need to rush her off to nicu. But I was still able to have delayed cord clamping (something I wanted but seemed to be standard at my hospital anyway) and a physiological third stage. My MW stayed with me to deliver placenta (which only took 20 mins anyway) and a second MW dealt with DD. So hopefully the heel picks required shouldn't interfere with your wishes. I just sent DH with DD1 to nicu whilst I was still getting cleaned up and he came back and got me when I was ready so this may also be an option for you. I also wasn't allowed to bf straight away as DD1 was nil by mouth but nicu offered donor milk and we started at the end of day 2 and had no problems (I had just been hand expressing and passing anything I expressed to nicu as and when). It will probably put your mind at ease if you speak to mw or consultant to find out your options.

The postnatal ward at my hospital only has a 6 bed ward and the rest are private rooms so worth checking your hospitals maternity ward arrangements.

build I've found the same meal gives me different results too. I think in both cases the higher reading was when I hadn't eaten for a long time prior to the meal (so once was a post dinner reading when I'd had no afternoon snack, and once was a post breakfast reading when I didn't have breakfast till 11am). Seems little and often is the key for me.

good tip on the heel pricks build, I remember DD really didn't like them when she was in SCBU.

Humph, my morning fasting readings are creeping up - all in the 4s last week then 5.1 yesterday (right on the limit) and 5.4 today Any ideas how I can get them down? would a bedtime snack help?

It may be a bit of trial and error, Minipie or it may simply not be something that you can influence. Anecdotally I've heard people saying to eat a very slow release carb+protein snack at bedtime, my diabetes nurse wanted to know if mine was any better if I ate my tea earlier and I've read that there is not a lot you can do about fasting numbers by diet control. What are your post-meal numbers like? FWIW, you have a low target for fasting levels compared to mine (5.5) and I've only ever had one reading under 5 even with insulin. My fasting levels pre-insulin were 5.8-6.4 even though my post-meal levels were all fine.

Oh, and my diabetes nurse says that you need 3 days of high levels in a row before worrying/doing something so maybe see what tomorrow brings then ring your diabetes nurse specialist?