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...

tarka I was having that exact conversation yesterday! It is frustrating how little information is given and how inaccurate some of it is.

mini I just asked for the GTT in my last pg as the MW didn't raise it at booking in so don't know if my area do it normally. But that is only because I looked into the consequences of PCOS a lot myself so knew it was an increased risk factor. So there is definitely a lack of information which is interesting when most literature recommend an early GTT if you have PCOS and if not detected for it to be repeated again at 28 weeks.

Hi, can I join too please? I'm 32 weeks but have been treated for gd since early on (12 weeks) in my pregnancy due to previous "big baby", family history and being borderline gd last time (was 0.1 over the cut off of what's "acceptable" in second hour). I had the gtt at 28 weeks again this time but came in exactly on the cut off of what's "acceptable" for the second hour. My allowance cut off is 5.0 for morning fasting reading and 7.0 one hour after meals, I test 4 times per day. I have an appointment in the gd clinic this week (I dread it every time). My gd is controlled by the miserable diet. I found out recently that the time you test in the morning affects your fasting reading (the hormones rise fasting sugars as it gets later and I was trying to leave 12 hours from bedtime snack before testing). Stress also rises the sugar levels so I'm trying to stay calm. Thanks for the tips on washing hands before testing and about squeezing my fingers changing the reading. I've had no appetite for sweets during either pregnancy but last time fruit juice was my down fall, this time it's carbs and dairy. I have an active 2 year old who helps me cut down on my portion size (mama's food always tastes better even though we're having the same meals)

Interesting reading for those of us who are slim and requiring insulin...

That is really interesting NoRoom. My grandfather developed type 1 in his 40s. They suspected I might have developed type 1 in my second pregnancy but there was never any follow up as I passed my postnatal GTT. I might make an appt with my GP to see if I can have the antibody test before I get pregnant again.

Oh, the irony of ordering jelly beans tonight for a church thing is not lost on me. How I would love to munch through a bag!

Sweets wow your target levels are even tighter than mine! I was told by the midwife to aim for max 5.1 at fasting (though dietician today said that should really be max 5.0...) and max 7.8 one hour post meal (again, dietician says that should really be max 7.7...).

please could everyone share their target levels, especially if diet controlled (no meds)? Thank you

I saw the dietician today... he didn't add much to what I knew already tbh - though did confirm that the standard "choose low fat" advice from the midwife only really applies of you have a high BMI, if not then full fat is better from a GI/GD perspective. He didn't like my fasting readings much, in the past week I've had 2 above 5.1 and 3 at 5.1 exactly and he says 5.1 is too high... I am worried what the midwife will say next week, I really don't want to be induced at 38 weeks if i can help it.

Sweets so does that mean I'm better off testing earlier in the morning to get a lower fasting result... even if I had a late bedtime snack?

Minipie, I was having a late night snack (about 10pm) so wasn't testing until 10.30-11am thinking that it would be better to test after the 12 hours but it turns out that the hormones cause the sugar levels to rise as the time starts to approach 12pm. I've stopped snacking so late and my levels are a lot more manageable since (for now anyway)
I only got one meeting with a dietician and was told to use 'diet' products because they are low in sugar and low in fat. She also said 'dairy is a luxury that I should use sparingly during my pregnancy'. My BMI was within 'normal' range when I got pregnant and I haven't had too much weight gain so far. I had no idea about the carbs/sugars/fats impact on sugar levels and pregnancy before I met the dietician.

What are you having for breakfast? Do you think it is the content or amount that is causing the high readings? I usually have porridge but have to be very careful about how much and eat it as soon as it's ready rather than leaving it stand for a while. I was told I could have a cooked breakfast afterwards such as rashers/egg/mushroom but not to have any toast because it's too many carbs and will raise my sugars too much. Exercise will help bring down your sugar levels too if you're able.
I have the gd clinic every two weeks for the rest of my pregnancy so have to be careful but so far they seem happy enough with me.

Minipie my targets are less than 5.5 fasting and less than 7.8 after a meal. I am on insulin but my targets were the same before I went on the insulin.

My targets are

It's so random how we all seem to have different targets - is it the different trusts we are all under, or is it personalised to our own height/weight/gestation etc? My GTT came back that I was 'borderline' with a high reading after 1 hour, but the fasting and 2 hour readings were within range. I now have to stay between 3.5 and 5.9 before meals and 3.5 and 7.7 1 hour after meals. I test just before eating my 3 daily main meals one day, then the next I test 1 hour post eating the 3 main meals. No other testing required (thus far).

I thought my dietician was quite good, I already had a fair idea about healthy eating but just needed the kick up the backside to cut out the rubbish. She said I should be eating a small portion of carbs at each meal, and go for wholegrain where possible (although she wasn't fussed about pasta, seemed to think I could have white and it would be fine). She said I should continue to eat fruit, but a piece at a time, rather than a fruit salad and space it out throughout the day. Her main recommendation was to look at portion sizes, and visualise the 'healthy plate' - so it should be made up of mainly vegetables, then a small portion of healthy carbs, a portion of meat/fish/protein and then a tiny amount of fat/sugar. She didn't bang on about low fat though, and although I was slim before I fell pregnant I did pile it on a bit in the first trimester!

So far (i'm on day 7 of monitoring my bloods) my results have all been in the recommended ranges. But I have cut out all added sugar other than the odd tsp of jam (eaten with peanut butter on granary toast!) and the odd yoghurt. I cannot say I have cut down on fat! Snacks are pretty boring and I do really miss something sweet after dinner. Sugar free jelly has been my 'vice'!

I have my first growth scan on Friday (at 32+3) and will see the clinic again next week to see how i'm getting on.

Thanks Sweets. I tend to eat dinner pretty late (9.30ish). I then have a snack about 10.30pm, then do the fasting test at 8amish... I wonder if the late dinner is causing the high fasting readings?

My morning fasting reading was 5.5 this morning Really not sure what else I can do to bring the morning fasting ones down. It's hard to eat earlier as I get in from work at 7, put DD to bed at 8.30 and DH gets in about then too.

My post breakfast and other post meal readings are all fine (well since I learned what to avoid anyway).

Different views on dairy it seems - my dietician said dairy was fine for GD if it's full fat (as the fat "offsets" any sugars in the dairy) - and all cheese is fine. It's only skimmed milk and low fat yoghurts which can be high GI as there isn't the fat to offset the natural dairy sugars.

Rusty your dietician's advice sounds very similar to mine. Yes pasta is fairly low GI esp if it's proper durum wheat and cooked "al dente".

Minipie have you tried not having the snack after dinner? It seems so close to your dinner anyway that I wonder if just stopping that snack would mean that you can get away with having your tea so late.

Oh, and if I ate my tea that late I would probably feel that I had gotten away with it having a fasting sugar of 5.5!

noRoom I had one day without a post dinner snack and the reading the next morning was high (5.3 I think) ... I suspect it's the late dinner that's having the biggest effect. last night's dinner was quite high in fat and slow release carbs so guess it will have taken quite a bit of time to convert to blood sugar.

I can't seem to manage to have dinner much earlier. Maybe I should try testing later in the morning - I could do fasting test at 9.45 ish and have breakfast at work... But then that makes breakfast harder as I've found it's more likely to cause a spike if there's been no eating for ages beforehand.

Wonder if the midwives will take my late dinner into account and be lenient about the high fasting results? Suspect not.

I don't think the low fat diet alters the sugar levels but eating food that is not low in fat can contribute towards the baby's birth weight being higher iykwim. I wonder if it depends on the specific hour of the gtt that we failed and how much above the "acceptable" target our results were, that affects what our targets are set as for fasting/post meal reading/how soon after the meal we test? I have a blood test every 4 weeks to check if the readings I give in at the clinic tally with the blood test results for the last month. The consultant said I'm doing "surprisingly well" with the diet (I think he thought I was fudging my readings at the clinic but the blood test results confirmed the overall readings were accurate). It hasn't been easy but hopefully I can keep it up until our baby is born, I've been told it gets harder to control near the end of the pregnancy due to hormones.

Hello,

Can I join you? I got diagnosed with borderline GD last week. I am in quite a lot of denial as I was quite ill when I did the GTT and this can raise blood sugar levels. I am now testing my blood glucose after fasting and each meal and for the most part it is fine with my normal diet unless I am very inactive and then it shoots up. Does anyone else find this and what do they do? I have a target of 6-7.8 @1 hr after meals and it can go as high as 9.6 if I am inactive but if I am busy it has been as low as 4.6. (I can get it to below 7.8 without moving after meals by following their advice and keeping the carbs down but if I then end up getting up and moving it then goes too low.) I am not sure how to keep it between the ranges advised if I do not know how much I will be moving after each meal/each day. Is there any harm from going too low? Does anyone else find it is impacted by how busy they are? Also, does anyone know how they come up with the targets? As it seems that my fasting is ok but my target is 4-6 and I am usually between 4.2-5.5 but that would sometimes be outside of other peoples targets.

Also, I am waiting for another 3 weeks to see the dr and still haven’t got a growth scan. Does anyone know about how flexible they could be about the birth. I was very keen on going straight from the delivery suite home but I understand that may not be an option? (I cannot face staying in hospital for 24 hours.)

Sorry, it is more questions at this stage. I didn't expect to get GD although I do have PCOS as a risk factor but was fine last pregnancy and have no other risk factors. I am still trying to learn as much as I can about this and more importantly what I need to do to get the birth I want! I am still finding it quite ironic as last time, I had a growth scan as my bump was too small and dd arrived naturally weighing 6lb 4oz and it still aged 2.5 very slim. I know 2nd kids are generally bigger and boys are bigger than girls but I would still be very surprised if I have a big baby!!

Mini, I also struggled with late dinners but have now got into the habit of finding a way to have the food ready almost immediately after DS is in bed, or even eating while he's getting ready for bed. I get DH to get cooking, or pop downstairs while DS is in the bath to get things on the go, or just go for very quick basic meals - last night I had beans on toast with a handful of spinach stirred in and topped with feta cheese.

My targets are 5.6 fasting and 7 two hours after meals.

My understanding with low fat is that they're often higher in sugar which is why they're not recommended. I'm just obsessively reading the labels on things like yoghurts etc to try get the lower sugar/carb items. Full fat greek yoghurt is the best ito yoghurts, but requires some fruit to make it less sour.

Agree with pp that some exercise helps. I found lunches very difficult but am trying to get out for even just five minutes after lunch helps a lot and seems to have a very postiive impact on my readings two hours later. If I'm home I make sure I have a post lunch chore - dishwasher to unload, washing to hang up, beds to make etc! :)

LIG I don't think that the 24 hour stay is particularly negotiable even if you are diet controlled and all your readings are fine. I could be wrong though. Ask your midwife as she'll know the local policy.

LIG over 9 is high, active or not regardless of what you have eaten.
To put it in perspective I tested my non diabetic dh an hour after eating a full Christmas dinner last year just to see what his levels would be. They were 6.5. He hadn't left his chair since eating.

With any readings above 9 I think they will want you on medication.

The 24hrs is so they can do several pre-feed tests on your baby's blood sugar. My ds was hypoglycemic at birth even though he was only 7lb and I had kept my blood sugar levels pretty well controlled. It's pretty shit to have to stay in but at least you can psychologically prepare for it.

Sorry - I meant to add, no problem with going low unless you are on insulin. Your body will release sugar into your blood stream if you get too low. It's called the rebound effect - it's why you can end up high in the morning if you "fast" too long at night.

 damn....I was hoping I could get out of 24 hours in hospital as I hated being in there last time. At least this time there will be a purpose rather than them just taking 7 hours to do the paperwork.

Tarka -interesting about going too low causing a rebound effect and I wonder if this impacted my gtt as I was quite ill, had lost quite a bit of weight and not eaten for days. I am not sure 400 ml of lucozade was what my body needed after days of famine and only really eating ice cream and fruit juice.

Really not sure that I understand what is going on and I think eating the same meal can produce very different readings even though the quantity is the same. (Mostly talking about breakfast as I always have the same and take it to work in the same pot.) But the value has gone between 7.0 and 9.6 for the same meal and the only difference I can see is in how busy I have been. However, my other readings are often below target or within range without too much effort. Not sure if I should increase the amount I eat just to avoid any sugar highs from going too low. I normally rely on my body to tell me what/when I need to eat and this blood sugar testing is throwing all this out.Â

Also interesting about babies being hypoglycemic even if normal weight. I sort of thought that if the baby was normal size for what it should be then it would be ok.

So much to learn......Thanks for your help in answering my questions.

Lig, I was told to eat little and often and not leave too long between because they want to keep the sugar levels steady. I was told to have three main meals and small snacks in between each meal and a bedtime snack to avoid your levels dropping too low. 9.6 is very high, if you are stressed, it can cause a spike in your sugars so maybe that is why it went up so much despite you having the same amount of food? If you think you could pass, could you ask to be retested when you're feeling better? I think you have to have raised levels a number of consecutive days to be put on insulin/medicine. It took me a bit of tweaking of food combinations to get within my targets and I still get the odd one above my max target.

I have already asked to be retested because it was borderline (but the mw refused) but thinking of doing the test myself at home to see what I get. Eating little and often is how I normally eat as I am a bit of a grazer but I have actually been eating 3 meals a day and 2 snacks more because of all the testing.

I am just quite unsure what is sending it high on occasions as it doesn't seem to be food related. I have only been testing a week but it was fine for a couple of days with no change in diet and then I had the couple of high reading when I was hurting after my whooping cough vaccine and feeling quite sorry for myself on the sofa because I was still unwell from the infection. Could lack of sleep maybe send it up in the morning? It seems fine again now I am sleeping better again and moving around again.

One thing, I was wondering what do people do about testing after meals. I always try and go to the bathroom but it means that I am always late for meetings etc. because I am too busy to finish eating and wait for an hour and then test. Is it socially acceptable to test at work in a meeting?

Is 9.6 worrying? When I was being taught about diet and testing my blood we tested ours and some of the others were at 10 and one was over 11. The diabetes nurse didn't seem phased by it and thought that when they started eating better it would come down.

Success! I had dinner an hour earlier last night (8.30 instead of 9.30, DH was home early) and this mornings reading was 4.6 so I think the previous high readings were due to the late dinner. Thanks for the help everyone, I will keep trying to get dinner earlier somehow.

I am eating out tonight at an Indian restaurant, any tips on what to choose/avoid? Starters all seem to be deep fried starch

LIG welcome! How many weeks are you? you sound like me a couple of weeks ago post diagnosis. I also have PCOS, no other risk factors, slim, didn't have GD last pregnancy and was borderline this time - was in denial and looking up why the test may be wrong etc. After a couple of weeks of testing I've accepted I must have GD because I do have to be careful with what and and especially when I eat so as to avoid highs... as Tarka says, a non GD person wouldn't get highs regardless.

Different readings after the same meal: I found if I have a proteiny snack then have meal X a couple of hours later, this gives a much better reading than if i have no snack then meal X. Basically I need to have snacks between meals to keep post meal readings low.

Staying in for 24 hours: I tried to negotiate this and failed! (well, the midwife said "of course we can't force you to stay..." with disapproving face) On the plus side I hope it means I will get extra help with BF whilst in postnatal, DD was tongue tied and we struggled a lot and suspect DD2 will be too. the reason is not to do with size of baby, it's because if you have GD the baby may have got sugar "spikes" from your blood during birth (they will want to monitor your blood sugar a lot during the birth for this reason) - so when the cord is cut, the sugar "spike" is withdrawn and the baby may have a hypo, esp if not feeding well.

9.6 reading: I was told to call the midwives if there was any single reading at 10 or above. So you're getting close to that with 9.6...

Lack of sleep can have an effect I've read, but I've had a lot of disturbed/short nights recently (teething toddler!) and my readings have been mostly ok ... but I have been very careful on the diet front.

And yes I would test in a meeting (did yesterday in fact) I have also tested on the tube... I am finding the timing aspect really hard to keep on top of though, I will think "ok I'll test at 2.30" and then a client calls at 2.15 and I forget. and I have to time meals carefully so that an hour later will be a suitable testing time (ie not in the shower/walking to work etc). it's a real pain!