Gestational diabetes baby

[nopun]

I would really love to hear from people who have had GD. How were your babies after birth? For how long did they struggle to adjust their own sugar levels? Did they have any other issues?

I've been recently diagnosed (26 weeks) but think I've had it for weeks, and am freaking out...

I was diagnosed really late at 36 weeks, cos my bump was huge.

Controlled by diet, baby came naturally a week early and was a bit under 9lb. Neither of us had any blood sugar problems afterwards and I breastfed straight away without issue.

Hope it all goes well for you.

You've all been so helpful, can I ask you something else? Something weird has happened with my diagnosis. My first non-fasting glucose test was way over - 9.0!! - so I was then sent to do the fasting one. At the last scan baby was also measuring huge, over 95th percentile, way out of character for me or DP, and very much bigger than my previous DC.

While waiting for the fasting appointment I already started to implement a diabetes diet - and feel a lot better than I did before. Monitoring my sugar levels on this diet suggests they've been ok.

But then this happened: the fasting glucose test had me within the normal limits (fasting 4.0, 11hour 7.6 and 2-hour 6.9). And I'm now not being referred to the diabetes clinic and not being seen by a specialist.

This really doesn't seem right to me - the initial 9.0 was so high - could there be a non-diabetes explanation? I can't think of one (didn't eat anything particularly sugary before the test), and there is other evidence of something being wrong as well. Has anyone come across a similar situation? Would really appreciate any advice!

Mine was just under 7lbs and nobody mentioned GD at all after he was born. I’d really managed the diet very strictly so I think that helped.

These posts have been really helpful to read, I have GD, this is my second pregnancy and I didn't have it with the first. I am currently 27 weeks and on metformin 1-2 tablets a day. I have a growth scan this week and feeling a little nervous as I want everything to be ok.

@nopun so have they said you don't have GD? If your still worried you can continue to test at home an hour after your main meals x

I had severe GD - insulin 4 times a day and was careful about what I ate. I was induced at 38 weeks but it didn't work and I ended up having a c section. DD wasn't big despite what they told me - under 7lb - and sugars were fine. No problems at all x

@Salina2 we're more or less exactly the same time then, my 28 week scan is this week. I saw you have a preemie already (I do too, he was a 27-weeker). How is he doing?

Yeah the GD thing has really unsettled me. I'm pretty sure I have it, and they can't explain why I would have such a high reading unless I had it - but they're still going by the last test when I was within the limits. And won't refer me to the specialist clinic. This seems really unwise to me.

@nopun my DS is doing very well now, he was born at 26+3 days and is now a very cheeky, funny 20 month old. How is your child doing? How old is he/she?

Yes we are pretty much the same amount of weeks, i find it strange that they don't want to refer you to a clinic, have they asked you to monitor your sugar levels for a week after meals to see how they are? I think it would be wise to do that. You could ask for a retest but when I asked for mine to be done they said it wasn't viable.

How are you feeling otherwise? Were you monitored due to having a preemie? I had to have regular internal scans to check my cervix, my cervix started shortening at 20 weeks so I had to have a cervical stitch.

X

@nopun your two hour result merits a GD diagnosis according to NICE guidelines, although your fasting is lovely and low. Trusts vary wildly in their criteria in spite of NICE’s efforts to standardise. It’s only just slightly over though. Your random blood result of 9 is high, and above the point that non-diabetic blood sugar would usually reach. It sounds to me as if you have mild GD which might well be controlled by eating the right things. If you get yourself a blood sugar monitor you can get some idea of what response you get from various foods and where your levels go to.

I had diet-controlled GD, my baby was a healthy weight, straightforward non-induced birth, and no issues regulating sugar. I have annual HBA1Cs as your risk of developing Type 2 diabetes after GD is much higher (annual tests are another NICE recommendation). A trust near me automatically labels all women with GD as Type 2 by default, as they reckon the risk is so high - glad that isn’t the case for me as several years later my HBA1C is still within normal range. Or at least, I’m waiting for this year’s result right now so fingers crossed it stays that way.

Good luck. You sound very vigilant and keeping an eye on what you eat can make all the difference.

@Doubleraspberry that's so useful, thank you so much for your informed reply. My hospital seems to say that 7.8 is the cut-off for the 2-hour result, and says by that measure I'm fine. It's not that I 'want' this diagnosis of GD, far from it, but I just feel that they're choosing to ignore the more worrying evidence that came first... Great to hear that you've managed to keep it in check with diet and that your baby was fine! And fingers crossed for your latest blood test. Have you kept up a very restrictive diet since giving birth or did you get back to eating normally (sensibly)? I will try to keep up my own monitoring for now, especially the sugar issues might get more pronounced when I'm a few weeks further along.

@Salina2 yes I had a cervix length check a while back and they thought no action was required. My first baby is fine now - he's going to school and doing ok, though still tiny & much smaller than his class mates. The NICU ride was rough though (think I'm still traumatised to be honest...) Feels like a tense time now, coming up to the time in the pregnancy when I had him. Great that they caught your shortening cervix, but a stitch sounds scary! Are you feeling ok now? Did they give you a likelihood of going near full term this time?

Glad to be helpful. This is the NICE guidance. 7.8 is the one hour cut off, not two.
www.nice.org.uk/news/article/new-thresholds-for-diagnosis-of-diabetes-in-pregnancy

I have never eaten carbs in the same quantity again, or sugar. I’ve done more exercise on the whole although the amount has varied depending on circumstance. I haven’t eaten the very restrictive diet although I’ve had stints of very low carb. It’s complete habit now to eat most main meals without lots of simple carbs and to limit bread and sugary products, but I have anything and everything as an occasional treat.

@nopun aww that's great news, so glad to hear your DC is doing well and at school now, he will catch up I'm sure, I'm sure your just grateful he is able to live a normal healthy life, my DS has been through a lot and the whole NICU journey is something I will never forget but also something I would never want to relive. But how amazing are the NICU nurses and doctors, they are a god send.

So after my stitches I was told no heavy lifting or physical activity, so I am very much taking it easy which doesn't help with the GD, spending a lot of time at my mums so she can help me with my toddler whilst I get through the crucial few weeks. I have been told my stitches will be removed at 37 weeks so very much looking to go full term (fingers crossed)

I know how you feel about passing the point we're you gave birth to your preemie, i was very nervous coming up to 26 weeks but I'm just taking each day as it comes.

Also the cut of point for hourly reading after meals is 7.8, not two hours. Maybe speak with your diabetic midwife and tell her your concerns but if you haven't got GD and that was just a blip, that's a bonus! x

Well, it seems my hospital is not budging and they are now not referring me to the diabetic clinic, so I have no access to a diabetic midwife. It seems that the NICE guidelines @Doubleraspberry listed were updated at some point - if you check it says there: "4. Diagnosis: Diagnose gestational diabetes if the woman has either: a fasting plasma glucose level of 5.6 mmol/litre or above or a 2-hour plasma glucose level of 7.8 mmol/litre or above." Like some of the pp I also thought I had read that the 2-hour one had to be lower, but they say no. They can't explain the really high reading at the random test or whether it matters.

I agree though that I still clearly currently have some GD, though I seem to be able to manage it with diet at this stage - but by all accounts it may well get worse in the next few weeks. So I guess I'll just keep monitoring myself for now.

I have GD currently 36 weeks and been diagnosed since 28 weeks.
My trust we have to have a fasting reading of 5.3 or below.
7.8 or below after 1 hour
Or 6.4 or below after 2.
My baby is 95th percentile and I have another growth scan today with the appointment Friday to find out about inductions etc x

@nopun I’m sorry about that and sorry to have linked to old advice. I’ve looked at the revised guidance and I am a bit surprised as it goes against the prevailing thinking that GD should be picked up at lower levels than before.

Gosh @Doubleraspberry don't worry - yours and everyone's advice has been so helpful. It's really strange how much variation there seems to be across NHS trusts. And I agree that the upward revision of levels does seem to go against some very sensible advice - I wonder whether it is about cost-cutting (since higher thresholds mean fewer patients to deal with in the specialist clinics). It's not very reassuring either way.

Next big thing for me is the 28-week scan later this week. If baby is still measuring huge I'll talk to them again...

Good luck @splishandsplash!

To be honest, I hated the diabetes clinic and its approach, so would have been quite happy to avoid it! But if this is going to worry you then that’s not good. GD often only kicks in around 26-28 weeks as the demands on the pancreas grow, so you could always request another GTT if concerned about the scan.