Gestational diabetes - tests high in the morning

[Vanikanth]

Hi,
I am expecting my first child. I'm 29 weeks into my pregnancy. Everything was going normal until I did the Gestational diabetes test, 2 weeks back, where the fasting is 6.1 and after taking glucose 7.9. I'm feeling terrible about the test results and really worried about the risks for my baby. The doctors advised me to have a balanced diet and exercise regularly, also asked me to do tests 3 times every day. I started doing everything, from diet to exercise. The tests show certain decrease during the day but my morning tests is still at border, fasting is 5.1 and after breakfast is 7.8. During the day, it is little better- after lunch and dinner, it is between 4.7 to 5.
I'm really worried about the risks as the tests show very border level results, mainly in the mornings.
I'm planning to increase my walk from 1 hr to 2 hrs a day. I have an appointment with dietitian today but I'm sure I'm eating very low carbs food and completely avoiding any sugar. So, I don't think the dietitian will ask me to change much.

Can you please share your experiences and knowledge.

Thanks.

I was diagnosed about 6 weeks ago, am now 34 weeks and managed to survive Christmas!

What are you having for breakfast? I have either low carb toast with bacon and tinned tomatoes and mushrooms or banana pancakes with whipped cream and getting high 5s/low 6s.

You still need to eat some carbs, but pair them with protein as well. In terms of fasting, the things that made the biggest difference to me were increasing my water intake during the day and having a high protein snack before bed.

I had this with dc1, all readings fine but post breakfast were higher. It took a while to find something to eat that didn't give high readings. Weetabix or cereals were a no. Porridge was good with water or skimmed milk, berries or bacon, eggs, tomatoes. Can you do a quick blast of exercise post breakfast? If fasting on waking is high, try and have a snack before bed, I used to have an oatcake with cheese and a camomile tea. I reduced carbs and they were only in whole grain form unless I could burn them off swimming, gym or walking and really upped my protein intake. The dietitian advice I received from hospital was poor, with many foods giving me high sugar readings (like weetabix). I found advice from the diabetes website much more helpful. I am currently 24 weeks with Dc4 and following a similar diet again in case of another GD diagnosis.

I was also diagnosed around this time (for me 28 weeks). Tried to control it with diet but couldn't. I ended up eating no carbs at all as ANY kind of carb sent my sugars too high, so after a week of trying diet control, they put me on long-acting insulin overnight. This brought my fasting reading under 5.3.

However, I continued to struggle with meals and after finding ketones 3+ in my urine a couple of times at clinic, they put me on fast-acting insulin before meals as well. Since then it has been much better. I can control my sugars and can eat sensible carbs. Before, I was losing weight as couldn't have carbs at all, and also had a GD-related problem of excess amniotic fluid, which has gone away since I got the sugars under control.

How long have you been trying to diet-control? Are you keeping a record of what you eat before each meal, as well as the blood sugar reading afterwards? I would screenshot these and email to your diabetes midwife/nurse and ask for guidance. They will probably ask you to go in and discuss Metformin or insulin. For me they went straight to insulin and I was glad as have heard Metformin can have some unfortunate side effects (upset tummy).

I was diagnosed last week (I'm 26+4 now ) and as much as I have been monitoring my food intake, making sure I exercise regularly and I've been following the midwifes notes like a bible, mine just doesn't seem to be anywhere close to the what it should be.

I saw the midwife again yesterday and basically have been told that I'll be referred to a consultant tomorrow and if by tomorrows appointment, it hasn't changed I'll most likely be put on metformin.

Prior to falling pregnant I was on metformin to help balance out my hormones and to help me conceive. Metformin is usually taken by people with diabetes so she isnt sure if this is causing a spike. I was fine when I took it before so if it helps me control my sugar then I'm happy to take it. At the end of the day if you are doing everything you can, there is nothing more you can do. I'm very fortunate that my diabetes midwife is so supportive and doesn't make me feel like a failure.