Pregnancy / Gestational Diabetes

[madgirl]

Can anyone share their experiences with me? I have suspected gestational diabetes, and I am 35 wks pregnant. They caught up with high sugar levels in bloods taken at 30 weeks. I self pricked 3 times a day for a week and now have to continue for another week as the sister felt it was on the high side, with one after dinner one night at 9.5 I have to say I feel quite anxious about it all, and have got myself into a bit of a state about whether the baby could have been harmed- ie before they picked it up? I am quite big (bump wise) but all my maternity notes record a normal size. The diabetes sister did not say to cut out all sugar, just to eat little and often and not to have more than 2 pieces of fruit a day, but looking at various old threads here on mumsnet, it seems that other people have been told different things. The other thing I was wondering was looking at the score on the little machine thing they gave me to test my blood on what is considered high enough to be GD and what is just rather high glucose levels?? thank you, anyone

Hello madgirl, no experience of gestational diabetes but my dh has Type II diabetes and I have just had a look in one of his books on diabetes. It suggests that pregnant women should aim for blood glucose levels of 4-6 mmol/l before meals and no higher than 10 mmol/l 2 hours after a meal. TBH, the suggested level after a meal surprises me a bit as it seems quite high - normal blood glucose level is taken as 4-7 mmol/l and even after a meal it shouldn't rise to more than 9 mmol/l for any length of time, so I would have thought that should be the aim. But it gives you some figures to discuss with your diabetes nurse. I'm not sure how high the results would have to be for a definite diagnosis of GD.

TBH, I'm a bit surprised about the dietary advice you have been given. My dh's dietitian said fruit was OK because it is digested slowly so the sugar is not all released straight away. The advice is usually to base your meals around carbohydrate and to eat plenty of fruit and veg, i.e. a healthy eating regime. There is a lot of interest in the glycaemic index of foods at the moment as well - this is a measure of how quickly food is digested. The slower the digestive process the better, because slow digestion means gradual release of sugars into the blood and therefore blood sugar levels do not suddenly peak. As you can see from the list, some foods you might consider to be `healthy' e.g. baked potatoes, actually have quite a high glycaemic index.

One important piece of dietary advice is to avoid eating sweet things unless they are part of a main meal (for instance, you should avoid snacking on cakes and biscuits but you can have a pudding after your dinner) and don't drink sweet drinks unless with a meal (this includes fruit juice). That should help to keep your blood glucose levels down.

HTH and that the rest of the pregnancy goes well. Try not to feel too anxious, GD can be well controlled.

Hi Madgirl,
I had gestational diabetes 2.5 years ago with my first pregnancy. Like you, I self pricked for about 12 weeks and was scanned every fortnight to monitor the size of the baby. I basically cut out all unnecessary sugar, but found other stuff that I ate was also really high in sugar...although I thought I was being healthy by eating it! For example, most cereals are high in sugar (although Weetabix is low), soy sauce was another one, I think, and also orange juice. I think my rule of thumb was to stay below 5g of sugar per 100g of foodstuff - that value is usually quoted on the side of packets.
I agree with gingernut about the glycaemix index. I think if you are having a baked potato, for example, which has a high GI, the sugar release can be slowed down if you eat protein alongside it. So baked potato and tuna, or baked beans, would give a slower sugar release than baked potato and a side salad.
Another thing I found was that sometimes I got a high blood reading which I objected to because I had tried really hard to monitor my food intake! Sounds daft, but if I washed my hands thoroughly and pricked again, I would often get a lower reading which may have been something on my hands affecting the blood reading.
I found the diabetes consultant at the hospital quite patronising, he would say things like "been eating too many choccie biccies, have we" which was no help at all! I had questions I tried to get answered by him but he was very vague and unless you basically gorged on sweets and biscuits, which he could then tell you to cut out, he didn't really seem to have much more information.
Anyway, my DD was born perfectly healthily by emergency caesarean (not as a result of the diabetes) at 8lb 10oz. Luckily I went into labour on my due date, as the consultant had said that I could not go overdue as I was very big. I was retested 6 weeks after her birth and all traces of diabetes had gone. I gave birth to a son 3 weeks ago, NOT a diabetic pregnancy (which is quite unusual if the first one is) .....and he was 11lb 5oz!
Please don't worry about your baby, the doctors have picked up on your condition and will take special care with you. Eat sensibly and healthily and you will also be fine. Good luck with the rest of your pregnancy!

Madgirl, I was thinking about this again and thought you might find this link to a page on the Diabetes UK website useful.

Sorry, haven't had a moment to reply properly to you guys, very much appreciate your taking the time. Gingernut, I found what you said really really useful and have since done some more surfing- all reflects what you said. My levels have been not tooooo bad, but had one tonight of 7.7 - that may be tho that it was a rice based meal. i also have cut out sweet things aside from with meals. judd, thanks to you also for such a long useful post. blimey you're right about cereal. you merrily go along eating your disgusting bran flakes thinking that this way you'll avoid getting constipated, and the sugar content is indeed higher than weetabix! I am going to ask to see the dietician on thursday for some practical advice, the diabetes sister who i have been seeing just seems to raise eyebrows at the level and not much else. so i feel empowered with this information. i am having a scan in a week (wk 36) because of a low lying placenta at 20 weeks so i suppose i can ask them to check that the baby isn't massive, actually hopefully this will happen anyway? thanks again ladies MGx

mad girl - just spotted this. I had gestational diabetes and ds was fine. I had a natural birth (he was 8lb 4oz). I like you took my blood sugars and just kept to a sensible diet.
I was like you when I had it - I worried and worried - having a baby is stressful enough!!
Just use this as an excuse to have lots of scans and see your baby!! They predicted my ds would be a lot bigger than he actually was.

I had my blood sugars checked after ds was born and I was fine - the diabetes had gone.
If you want to chat about this let me know and I will forward you my e-mail address. I know how stressful it can be. It is quite common now - I know 3 other people who have had it too.
Good luck mate x

Just to invade your thread (sorry). How soon after your GTT did you find out your results?
Bron

I found out the same day. The hospital rang me at home.

carlyb thanks for this. can i ask you (or can you remember!) what kind of level readings you were getting?

sorry that i didnt reply sooner - only just spotted your message. I am going to try and find my book with my readings tonight. They were never high, I remember a couple of times I went over the 'correct' range and I realised what foods made it go over. will try and find my book.

Hi Madgirl - sorry this is long!

I had Gestational Diabetes with my DD (6 months old this week). I had to self test 5 times a day and keep a VERY strict diet - but then I am living in the US where health care is all a bit mental. My numbers were measured differently so I can't help you with that part of it however I can give you a little diet advice, a bit similar to Judd's.

Whenever you have ANY carbs you need to balance it with protein. Carbs include: all wheat, all rice, all vegetables (even beans and pulses), all fruits, all sugars, milk & dairy products....basically everything that isn't a protein (Meat, Fish, Cheese, Nuts, Eggs)...so a typical day for me went like this....

Breakfast: 1 slice of toast with a fried egg, 1 cup (8 fl oz) of milk - NO CEREAL (I was banned!)
Mid morning snack: 1 small apple and a handful of nuts
Lunch: Pasta (no more than fits in the palm of your hand, once cooked), 1 grilled chicken breast, SMALL salad, 1 glass milk, 1 small orange/half a banana
afternoon snack: 6 small crackers (or 3 jacobs cream crackes) with either cottage cheese or cheddar
Supper: baked potato with tuna mayonnaise, steamed green beans, 1 glass milk, 5 strawberries.

It was quite hard to get the hang of it but after a couple of weeks I was really into it. My DD was born at 7lb 14oz so a good weight, and I only gained 2lb the last 8 weeks of pregnancy - my bump got bigger but I got smaller if you see what I mean. The key to the diet I was put on was to never eat more carbs than can fit in the palm of your hand at the 2 main meals of the day. I could also 'exchange' carbs if I was out to dinner, ie. I could skip the milk and fruit if I fancied a larger salad or a sensible size bowl of pasta. When I get preggie with next baby I've been advised to go back onto the diet asap - to help minimise the chances of getting GD again. I was banned from all sugary drinks - did you know that a regular coke has up to 8tsps of sugar in it?, no orange juice (it's very high in sugar), as few simple carbohydrates as possible, my DH and I are now totally onto brown rice/pasta/bread which can only be a good thing.

One last thing - stress can make your readings go up enormously.....when ever DH and I argued my numbers were absurdly high - even if I had eated the EXACT same thing as the evening before....weird!

Wishing you lots of luck - it's not that bad I promise!