Can you control gestational diabetes without medication?

[NooNooHead]

I’m 32w1d and my blood glucose fasting levels have been slowly getting higher over the past few days - it was up to 6.3 this morning and I spoke to the diabetes midwife yesterday who advised me to start on metformin this weekend if I feel that I can tolerate it.

I’m due for another scan and consultant appointment on Wed and my consultants will be deciding whether I should have my c-section date moved to 36 weeks if I can’t tolerate taking insulin or metformin.

The last time I tried to take insulin, I had a very odd reaction to it where I felt all tingly and had prickling feeling in my arms and legs. I have a drug induced movement disorder and am always worried about whether any new medication will affect me adversely...

I’m not sure if I take metformin whether I will have another reaction to the drug... my body/central nervous system seems so sensitive to things that I am always going to think the worst about any potential side effects that could happen.

I’m wondering whether to wait and see what the consultant says on Wed after my scan and whether they will decide to bring forward my c-section date... has anyone ever had gestational diabetes and had their ELCS date brought forward due to similar reasons?

I'm currently 39 weeks and have been diet controlled for the majority of the last 16 weeks. My fasting numbers were high from 29-35 weeks and I was taking metformin after dinner for most of that time. Despite an ok start I started being sick every single night, I raised it with my GD nurse who said I could stop taking medication as my numbers had come down well and there would be enough in my system to give me a break.

Thankfully my fasting numbers have continued to stay low so there's no need for me to back on the metformin, and yesterday the consultant signed me off to try and start labour naturally with a sweep booked in for 40+4 if nothing happened by then!

GD is notoriously hardest to control between 30-36 weeks so perhaps I was just lucky, but I think if you were to try the metformin you may find that you won't progress to insulin anyway, and if you get some of the nasty side effects you might be able to take a break like me.

How are the rest of your numbers?

Thank you Thunderwing for your reply... interesting to see what others have experienced and are advised.

My other numbers are getting higher - today after breakfast of scrambled eggs on a slice of toast they were 8.2 (!) and yesterday I had similar levels after breakfast but luckily they were in the acceptable range after dinner and before bed.

When I spoke to my diabetes midwife she said it would probably be likely I would have to take some form of medication but as I am SO bloody intolerant of lots of things since my stupid movement disorder, no-one an predict what reaction I get to anything, it is just a case of trial and error. 🙄😖

You were lucky that you managed on metformin for a bit and came off it - I just hope if I manage to take it, I will have a similar experience. 😳

If I can’t control my levels med-free or through diet and exercise alone, I’m sure my consultants will look at my levels on Wed and then decide to bring my c-section forward... which is good in some ways, but it will be a fortnight of worry about the effect the diabetes will have on the baby.

My last pregnancy with my DD was most likely to have been undiagnosed gestational diabetes as she was 11lb5oz (!!) via EMCS and I really don’t want that again which is why they are probably going to push for an earlier c-section this time.🤔

Have you looked at gestationaldiabetes.co.uk? There's also a Facebook support group which has been absolutely invaluable to me, lots of information and advice about food pairing to manage numbers.

I can't even look at a carb in the morning, but I can tolerate them better in the early evening!

I'm sure your consultant will have some good advice after your scan, just remember that you DO have a say in what you want/don't want, do don't be afraid to speak up

Yes, you can control it without medication, been there, done it.
You need to drastically reduce your total carbohydrate intake. Nothing made of any kind of refined starch/flours - so no bread/cake/cereals, no potato, rice etc, and no sweetened drinks.

Replace rice, potato, pasta etc in meals with green leafy stuff and lower carb veg, and add in some natural fats (butter, avocado, olive oil). Eat some lower carb fruits, especially berries but watch your portion size. Snack on olives, cheese, seeds and nuts (but again, be aware of portion sizes).

MarksdailyApple blog and dietdoctor.com LCHF blog are both sensible and accessible, easy to read info and full of lower carb, starchy food free recipes, if you are interested in finding out a bit more about low carb for diabetes prevention/treatment/reversal, these blogs are a good starting point

I did, I tried metformin and the stomach pain were whose than labour!

I found that that different carbs had different effect, white pasta could sent me to 12-14 by whole meal to only 8ish for example. I had smaller amounts of whole meal carbs, zero white carbs and I also introduced a small late night snack alongside slightly smaller portions. I read for some people this helped with the morning peak and it did for me. Generally I add nuts before bed. I also found I could eat more at lunchtime and reduced dinner portions, a reverse of my normal habits

I was though induced at 37/38 weeks and I’d suddenly hit a point where I couldn’t seem to control it. I was induced as for some reason I’d lost nearly all my waters, dd was a healthy 7lb 7

Anutteridiot,

With all due respect, 150-200g carbs per day is utter madness for anyone whose blood sugar is out of control, I cut right down to around 40g total carbs per day during pregnancy, which is fairly moderate low carb (very low carb/ketosis would be under 20g a day), with the support and approval of my DH (a dr who advises the same to many of his patients - this is within an NHS settling BTW!).

www.dietdoctor.com/low-carb/gestational-diabetes-pregnancy

The other thing tho, about lower glycemic index foods (ie seeded bread, real porridge etc not spiking blood sugar so high, is that blood testing isn’t being done often enough to get a real picture of what’s going on.
I’ve done this, experimentally, tested blood sugar every 30min until it returns to baseline levels. The simple carbs spike blood sugar much higher, but levels return to baseline quickly, within two or 3 hours. With the complex carbs, the spike is lower so that is regarded as being “safe”, but it takes much much longer, many hours, to return to baseline (and actually that’s very damaging). If you are eating 60 or 70g of complex carb at every meal, blood sugar can be chronically elevated (even if still within “safe” levels on random testing), because it takes so long to digest the sugars in the complex carbs.