Gestational Diabetes

[clarebear1983]

So I've just had a call from the hospital to let me know I failed my GTT with a score of 10.5. I had a bad feeling I would even though this is my second pregnancy and didn't have it the first time.

I've got an appointment for a weeks time for a scan and consultant appointment. Right now I'm in full scale panic mode, all previously well managed anxiety issues have resurfaced and I'm struggling!

I've left a voicemail for the diabetic nurses as instructed and I'm waiting on them calling me back. I guess they will talk to me and teach me how to monitor my blood sugar.

I'm worried all the sugar I ate in the 6 months prior has caused issues (I've had a really sweet tooth since getting pregnant). I had my last midwife app at 24 weeks (I'm 28 weeks now) and she obviously tested my urine for sugar etc. and it was fine, so I assume this has 'developed' since then and now.

I need talking down a bit, give me your positive stories and advice on how I can manage this. Particularly in the short term i.e. the next couple of days before I see any professionals as I'm currently terrified to eat anything incase I already have a growth restricted 10lb baby in my belly.

I had gd in my second pregnancy but not in my first. It was honestly fine and actually made me eat more healthily and get fitter. I managed it with diet and it was basically just healthy eating with an eye kept on carbs (not too much but not too little). A happy side effect was I finished that pregnancy at a really healthy weight and felt really fit and well. They encouraged me to walk after each meal if possible to help with regulating blood sugar and that helped with my fitness. I began the pregancy with a bmi of 22 and it was the same within a few weeks after the birth. I now have glucose tolerance tests every 2 years, as it does put you at higher risk of type 2 diabetes later in life, but that has been the only negative of the whole experience. My baby was around 3.5kg, so not huge. He needed a formula top up a couple of hours after birth as his blood sugar level was too low (sometimes happens with babies after a t'd pregnancy) but after that he was fine, breastfed easily and gained weight as expected.

Hi Clare
I am really sorry you are worried but just wanted to clear two things with you to ease your worries slightly. Eating sugar doesn't cause GD. It's caused by a hormone secreted by your placenta. Basically it interferes with your body's ability to use or produce insulin efficiently.

Secondly, the midwife couldn't have checked your blood sugar level via your urine at 24 weeks as that has to be done via a blood test.

I had GD in my last pregnancy and I got lots of info on the UK diabetes forum. Plus I met with a nutritionist at the hospital who went through my food diary. You will get a lot of support so don't worry too much.

First don't worry. You've had regular checks this far and they would have flagged anything too worrying. You really have to be high all the time in the first trimester for there to be a significant issue. The good news is, now you know, so you can manage it for a fitter, healthier you and baby!

Be prepared for it to be frustrating. There is no logic to why doing the same thing sometimes works and sometimes doesn't. Hormones are unpredictable beasts.

And be prepared for it to be boring. The restrictions are just that - boring. Try to think in terms of what you can eat, not what you can't.

Eat to your meter, when you get it - i.e. you'll learn how much you can tolerate. Eg I am not so bad with chips but can't have any mash; can cope with a bit of pasta but no rice. Every body is different.

Breakfast will be hard. Grab and go carb free breakfasts are virtually impossible. If you like meat it's all much easier - e.g. you can have steak and eggs for breakfast. As a fussy vegetarian it nearly killed me!!!

There's a GD page on Facebook where people swap good recipes and also there is a gestational diabetes uk website.

Mostly it's a warning call - for whatever reason your body's initial insulin response isn't working as it ought to do. For me, i found it ok to control by diet but I wasn't so careful after DD was born and sadly now think I am at least prediabetic 2 years later :( I should have stuck to low carb and the gym!

Elizee - sort of - the urine test would have shown sugar if it got above a certain amount because that's when the kidneys can't cope and spill glucose into the urine. So fact that there was no glucose in her urine at 24 weeks doesn't mean that the blood sugar was or wasn't too high, but it does mean that the OP wasn't cruising around at 10.0 or something, which is a comfort!

Gumbubble - thanks for the info. It's really good to know that it didn't effect you too much. Were you induced? The midwife did mention it's likely I'd not go past 38 weeks due to the babies size.

Elizee - Thank you, that definitely helps. I think the midwife checks for excess sugar in urine as I recall in my last pregnancy eating a doughnut (might have been 2!) not long before giving a urine sample and it tested positive for sugar which can apparently be an indicator of GD but in that instance it was just an indicator of me being a greedy pig luckily.

I'm glad I'll get a lot of support, I don't deal with these things very well at all.

Rebeccaslicker - yes that's it, but explained much better than I did! Thank you.

Rebeccaslicker - Unfortunately I don't eat meat either, I do eat fish though so hopefully that will help a bit with the diet. I think eggs are likely to feature heavily though going forward by the sounds of it.

I'm selfishly even more upset that it's over xmas too though, it's bad enough not being able to partake in the prosecco, now I'll have to forgo all the other fun stuff too!

I'm getting married a few months after my due date so I'm all for continuing a healthy diet and gym, I'm went into this pregnancy still carrying the 'baby weight' from my almost 2 year old so definitely have a good chunk to lose.

What happens in terms of appointments and scans now? I know I have one next week but how often will the baby be scanned from then on?

Is induction definite? Is there any chance if the babies size is ok they would let me go into labour naturally?

Sorry....so many questions!

I had GD when I was pregnant with my daughter (first child) in 2016. I was induced at 39+1 because my waters went and I didn't go into labour, but I had an agreed induction date of 39+6. The consultant was prepared to let me go to 40 weeks but no later.

I was diagnosed at 28 weeks and after that I had a diabetic clinic appointment every week. From 36 weeks on I was scanned every week as well. There was a lot of focus on the idea that the baby would be massive but actually she was 5lb 15oz so 9th centile. She's settled at around the 25th centile since, so I don't know if she was on the small side because of the GD or if she was just going to be small anyway.

I really recommend the Gestational Diabetes UK Facebook group - it was a lifesaver for support.

You'll get lots of extra support and extra scans which should be comforting. My diabetic consultant is a huge proponent of natural labour but the induction just didn't work for me - DD was far too cosy in there! She was born at 37+1 at 7lbs4, when we'd been told she was huge so the scans aren't that accurate! I guess if I'd gone to 42 weeks she might have been huge though 😉

YouAndMeAreGoingToFallOut - thank you, I'm joining that facebook group now. It's good to know that an induction might not be the only way. I'm glad I'd already decided to do away with a birth plan this time though and accept that pregnancy and labour is just not predictable enough to have a plan!

Definitely the baby being really big or having growth restrictions seemed to be what the midwife kept mentioning in terms of risks. It's hard not to sit here whilst babies kicking away worrying that he or she is already too big or something.

Apparently my hospital has a really good GD specialist so that's good to know I'd be in good hands, a week suddenly seems a long time to wait to see him though, apparently they would like some BS readings though to work from hence the delay.

I'd love to go into labour naturally again, last time it only lasted 1.5 hours so was hoping I might get similar luck this time. I guess I can still be optimistic and it will be extra incentive to manage the GD as well as I can.

I had GD and was induced at 38.5 weeks even though baby was not measuring big - there is a risk of the placenta deteriorating with GD, so you will not be allowed to go to your due date and into labour naturally - at least that was the case at my hospital last year. In terms of the suggested NHS diet, don’t blindly follow it - work out what works for you. Anything with gluten in sent my readings skyrocketing, but I could have ice cream with no problems. So the advice to have whole wheat bread for example was disastrous for me. I managed to control it with diet until right towards the end when I had to have a shot of insulin over night. I was determined not to go on the metformin as although it is deemed safe during pregnancy, I couldn’t find any long term studies confirming this. All the best for the rest of your pregnancy.

Thank you Kintan, it sounds like it's a lot of trial and error in terms of blood glucose. I've got an appointment now for tomorrow with the diabetes clinic so I think I'll feel calmer when I can see actual numbers on a screen etc.

I'm currently mostly feeling hideous about all the other 'bad' things I've eaten without knowing over the last few weeks but I guess I wasn't to know and I can't undo that now.

You won't have eaten anything as terrible or as fat acting as 75g of pure glucose - and that took you to 10.5. So anything else may be a bit high and need controlling but it shouldn't be an issue. They will do an H1BAC test which is your average blood sugar over 3 months (it basically tests how much sugar has stuck to your red blood cells) and hopefully that will reassure you.

Fast acting, not fat acting!