Gestational diabetes (bear with me, it's a long one - sorry)

[MrsAJO2014]

I'm one of the lucky ones who can say that they've had a wonderful pregnancy so far. I've had barely any symptoms at all, just tinnitus in one ear. No aches, no pains, no sickness or nausea, no cravings or aversions.. There have been times (before I started to have a proper bump) that I literally forgot I was pregnant on a busy day because I haven't physically felt any different.

However, before you roll your eyes and think "you've had it so easy, what's to complain about!" it's not all been as plain sailing as it seems.

After the anxious wait we all go through in getting to 12 weeks, we had our scan and blood test and instantly fell in love with our little baby - the unbridled joy and relief is hard to describe, as I'm sure you all know only too well.

We had a few days of excitement, hope and non-stop grinning from ear to ear and then, with one phone call, it felt like our whole world had come grinding to a halt. The blood test results were in and we had come back as high risk for Down's Syndrome: high risk being a 1 in 150 chance of our baby having Down's Syndrome - our result was 1 in 39. So I had to have a CVS procedure a few days later, which carries its own risks, and my husband and I had to have the "what would we do if the result from the CVS show the baby definitely has Down's Syndrome?" conversation. Would we keep the baby or not? Etc. Whatever the answer, we had to be on the same page else our marriage would be in trouble. Some of you may be thinking that "a baby is a gift no matter what" or "why would you even consider abortion, it's your baby that you've been hoping and wishing for, so what if it has Down's Syndrome" and other such comments. Unless you've ever had to have that conversation, please don't judge the fact that the conversation happened or underestimate the amount of stress this period in my pregnancy caused. Thankfully the results came within 48hrs, so we didn't have to wait that long and, thankfully, the baby does not have Down's Syndrome - not because we wouldn't have kept it, but because a clear result means we didn't have to make that decision.

That wasn't the end of our stress, we had another surprise in store for us. The blood test results had also shown a very low PAPP-A reading. So the baby has a protein deficiency, it's not that I'm not eating enough but the protein I am eating is having a hard time getting through to the baby. So I've been put on a daily aspirin to thin my blood in the hope the protein will get to the baby with more ease and I've been put under a consultant and will have fortnightly appointments and growth scans from 28 weeks, to monitor the baby's growth as it may slow down or stop around that time. The potential need for steroid injections for lung development was mentioned. Something else to mull over and stress about.

The following week I had a midwife appointment and she couldn't find the baby's heartbeat. From 9:15am at my midwife appointment until 4:30pm when I finally had a scan at the hospital I literally cannot put into words how I felt, thinking that after all of the stress of the weeks before that it may have been too much for our baby. What if I had now miscarried? Why can't they find the heartbeat? Why is it taking so long to be seen? It was a truly horrendous day and quite frankly not something I'd wish on my worst enemy. Thankfully, the heartbeat was found on the scan - the little mischief-maker had been hiding at the back of my womb and I also discovered that my placenta was at the front, thus obscuring the heartbeat from the doppler. Surely, I thought, that's the end to the drama - not sure my nerves can take much more!

Sadly not. Despite having a diet overhaul the moment I found out I was pregnant and being very careful about my weight gain, (started my pregnancy at BMI 30 and have managed to put on only 8.5lbs in the 27 weeks so far) I have today found out that I have gestational diabetes and low iron levels. Low iron levels can be easily solved with an iron supplement (which can cause constipation - joy!) but gestational diabetes isn't so simple. I have to go to a blood test training clinic in a couple of days time to learn how to do at-home blood tests, followed by fortnightly growth scans and bloodwork clinics - in conjunction with my protein monitoring growth scans and consultant appointments - which seems contradictory because I'm under a consultant to make sure the baby is growing enough but a side effect of gestational diabetes is a big baby?! Fortunately, my result showed that I was quite close to the threshold so the hospital thinks the gestational diabetes can be controlled by diet alone. However, I'm now down to be induced at 38 weeks, if the baby hasn't already arrived (premature birth being another potential side effect of gestational diabetes).

So, despite having (in terms of physical symptoms) a wonderful pregnancy so far, it seems I can't have a clear result from any test I undergo and this is the point that you come in... My quest for advice is two-fold: firstly, I got rather upset today and feel rather like I've failed to provide my baby with the best possible start in life - can anyone relate? How did you change your mindset? Secondly, any mums out there with advice on gestational diabetes? Or who are willing to share their story? I know many women have gestational diabetes but no one I know has, so I'm feeling a bit lonely with it all..

Thank you for bearing with me and reading this far (if you have!) and thank you in advance for your advice and story-sharing - it's gratefully received! Xx

It sounds like you've had a rough time of things and I'm sorry to hear that. Sometimes with pregnancy, that's just the way the cookie crumbles. It isn't your fault at all.

I don't have any experience of GD, although I had the horrible GTT both pregnancies, but I can empathise with much of the rest. With DD2 I had a high risk result for Down's syndrome, a disappearing heartbeat at 16 weeks and serial growth scans from 28 weeks due to high blood pressure. Eventually she arrived at 38 weeks, very small but perfect in every other way.

My honest advice is to just keep on keeping on. Don't catastrophise or dramatise if possible. You will be getting the best possible care and will be monitored carefully. I know this sounds difficult - but the more rational and level headed you are about it all, the better you will feel.

I had GDM in both my pregnancies. First one diet controlled, second time insulin. It wasn't a big deal at all, also had growth scans.

I declined induction until 39 weeks with my second child , went into labour myself and had a six hour labour. My sugars had always been very tightly controlled as I didn't resist insulin and he was a normal weight and had no issues.

First child I had low Papp A due to her trisomy 18 and diet controlled GDM. Survival in trisomy 18 is linked to gestation so declined induction until scans showed placental deterioration. She was born following a 15 min labour at 39 weeks. No low blood sugars despite her size.

There's a really good GD Facebook group if you're on Facebook.

GD is not your fault; you haven't failed your baby. A lot comes down to hormones and it doesn't behave as T1 or even really as T2. It also happens to plenty of us for whom BMI isn't an issue; there are a range of risk factors (mine is PCOS). What's actually terrifying is I'd never have had a clue I have it without the GTT and the test obv isn't routine - makes you wonder how many women without a risk factor are walking around with it, so it's good that you know.

A lot of diet comes down to trial and error (as well as obviously being sensible!). Some of the foods I can tolerate vs some I can't make no sense whatsoever on paper, but that's where an individual's hormones can come into play. I promise taking your readings isn't as bad as it sounds; you get used to it.

It's not actually contradictory re size. Bigger babies is probably the most commonly known complication but the condition can also cause smaller babies due to placenta depreciation as well.

Have a look at www.gestationaldiabetes.co.uk and the FB group for the site - both are super informative and there are some awesome recipes if you sign up on the site even for a month

You've been through the mill and will be under closer care throughout now but take that as a good and reassuring thing

Thanks ladies for the encouragement and the links to further info - having now slept I do feel a bit better about it all, it's still pretty shit though. However, onwards and upwards so they say. At least it's been found and at least the baby's progress will be closely monitored..and it's only another 10/11vweeks which I'm sure will fly by (if the last 6 months is anything to go by!)

God you put a lot of pressure on yourself. I had GD both times and I still had a wonderful pregnancy. Get on the gd facebook page.
I wouldn't obsess over weight gain. With my first I put on 3.5 stone... and 4 weeks after birth I was back to my normal weight. I was only found to have had GD at 32 weeks so not long to adjust.
Seconds time.. diagnosed at 9 weeks. I didn't put on any weight during pregnancy until the last few weeks when I added about 8lbs. the diet controlling can be quite restrictive. 4 weeks after pregnancy and I was 2lbs lighter than my normal.

Mrs I'm in the same boat as you, just been told I have GD.

It has been like others have said trial and error re: carbs. I for instance seem to be able to tolerate bread (even white) but wholewheat pasta sent my levels sky high!

Like others have said it's not your fault.

Oh and I'm one of the gd cases with NO risk factors. Perfectly normal bmi, no pcos, no family history etc etc.

I diet controlled from 9 weeks until 41. If you stay off meds (not always possible no matter how carefully you eat) they will likely let you go a few dates over your date. I got to 40+5 and went naturally thankfully the day before I was booked for induction

THirdeye... you might not be tolerating white bread... it acts more like sugar in that you'll get a spike and crash so by the time you test you'd already had the high level and then a drop. Maybe check every 15 mins for a test and see if your levels are higher earlier

I had almost exactly the same pregnancy as you!

I was diagnosed with GD and went through the same guilt. I was told that I would be induced at 38 weeks. However o controlled my blood sugar through diet and exercise so well in fact that at times it was low and didn't put any weight on all - in fact I lost a few pounds. I also had awful morning sickness that lasted most of my pregnancy.

My NCT leader was great giving me information and the consultant agreed to allowing me to go to full term.

We all talk about the importance of good nutrition but those of us who did suffer morning sickness just had to eat what we could keep down, which in many cases is pretty much beige carbs and jelly sweets

@AnUtterIdiot I had awful morning sickness and for a period just before my GD diagnosis all I could eat was fruit. It wasn't really a surprise that my blood sugar was high as I was living on fruit

I had GD with both of my DC and successfully diet controlled. Can't tell you how much weight I put on or lost as I didn't weigh myself but it probably stopped me gorging on "cream cakes for two"!

You get used to the testing and visits to phlebotomy - it becomes second nature. Before kids I was very needle phobic but now I'm a regular blood donor, so that's a good side effect!

The hardest part, I found, was the initial couple of weeks whilst I worked out what I could and couldn't eat. It seemed very restrictive whilst I got to grips with sugar levels of food. Tea cakes were my friend. In the end it was really just about healthy eating. I was grateful for the extra hospital visits and scans (reassurance that everything was going ok) so that was positive too. I went 40+5 and went into labour naturally. Ended up with an emergency CS, due to my DD stargazing and getting stuck, not related to GD. Due to that and GD with DS they left me til 40+6 to try naturally, nothing happening so had elective CS.

Was eating cake and biscuits again within hours of each birth .

Good luck!

How early did all of you finish work? I was going to leave at wk 37 but I imagine that'll have to change to approx wk 35..

Arghhh how stressful! I'm also in the very low Papp a camp this time, but nobody seems concerned (well except me!) Have also been there with the high trisomy risk last pregnancy, as well as big bleeds and MW thought I was going to develop GD.

None of it's your fault! Unfortunately the crap doesn't stop after birth, my last baby was trouble right up to 12m old! Good luck with the rest of your pregnancy, sometimes you just have to let go and accept what will be will be x

So I've just been to my appointment - got to test at home 4 times a day and hope it can be regulated through diet. We'll see what the next 10 weeks bring!

I'm a week into my GD diagnosis and getting used to it. Like you I was incredibly upset and felt really guilty, my BMI was over 30 and while I haven't gained too much weight during pregnancy so far, I can't hand on heart say I've been as healthy as I could have been either, so I do feel like I've brought it on myself, and knowing the extra risks to the baby makes me feel terrible.

For me it's my fasting levels that were too high, although I wasn't far over their cut off. So I'm testing my blood sugar twice a day and taking metformin, and I'll be honest I'm struggling with seeing any patterns in what I'm eating/time I'm eating/how much exercise I've done. All my post-meal readings are way below the levels they need to be, it's my fasting numbers that have been higher (which makes no sense to me whatsoever). I've been booked in for 3 extra scans and one consultant appointment, providing I can keep all my numbers below the limits.

I'd been hoping to work until 38 weeks (all my financials were worked out practically to the £ based on me starting official maternity leave on my due date) and give birth in the birthing centre at my hospital, both of which are now pretty much impossible. I haven't been given a date I'll be induced but have been told I definitely won't be allowed to go past 40 weeks. I really, really didn't want to be induced, so this is the part I'm feeling quite miffed about, although of course I understand the reasons why it might need to happen.

Yeah they've told me I can go to 40 weeks if I can control it through diet alone but if I have to have medication I'll be induced at 38 weeks at the latest. I'm slightly terrified about the birth altogether to be honest, as I'm on aspirin and just doing one pin prick test at the hospital today made me bleed for several minutes so I'm petrified I'll lose too much blood during birth.

I also haven't been a complete angel so far with my diet in pregnancy (the odd jaffa cake here and there, wine gums have also been a favourite) but I've been much more careful than pre-pregnancy (no fizzy drinks or squash for example, and been far more aware of portion control), but I've got to be even more strict now. I know it'll be worth it in the end though when I get to hold our beautiful baby, it just seems a long way away from now (even though I know it'll fly by!)