Gestational diabetes anxieties

[Shahida1721]

Hi everyone,

I'm a FTM to a beautiful, healthy baby girl.

My pregnancy was great till I got a GD diagnosis around 29 weeks. Although I had moved out the area I decided to remain under UCLH care as I thought I was one of the best in terms of care and service they provide. I regret this now, had a changed to the area I had relocated I would've avoided this whole mess in the first place.

I never knew this but in the UK GD is diagnoses based off a elevated fasting and 2hr BG, both of mine were within normal range. UCLH do an extra blood draw at the 1hr mark which is NOT routine nationally and based off that I was diagnosed with GD as it was 0.3 points above the cut off. I was devastated and confused, I was told word for word 'under UK government NICE guildlines you do not have GD, the consultants at UCLH believe your one hour result signifies a problem and to avoid a big baby at 30weeks you should start tracking your sugars.' The way jt was explained to me was I was simply preventing the potential of a big baby but not neccessarilt have the GD diagnosis. Turns out, my medical files were noted with GDM and I was labelled diabetic for the remainder of my pregnancy.

It caused me a whole load of distress and I ended up needing mental health support from the perinatal team. I feel cheated, a lot of my friends who got a Gd Diagnosis was in line with the nice guildines of a fasting and 2hr reading. No one I know, not a single soul had the additional 1hr reading that caught me out. Had I been at a different hospital I woukdve avoided the diagnosis all together.

I wanted to know if anyone else has had a similar experience to mine (3 draws instead of 2) ??? I worry about my health and constantly panic abojt becoming type 2. I want more babies and worry if this will impede my ability to do so. I also worry about early GD testings in subsequent pregnancies and the likelihood of getting a diagnosis whilst not ever having. If in the first place.

I had a normal GTT at 26 weeks after they brought it forward following some symptoms I was having (drinking and peeing a lot). My readings were 5.0 fasting and 5.7 2 hours after so well within normal limits.
At 28 weeks I had a growth scan which showed extremely high levels of fluid and I had glucose in my urine so my consultant gave me a blood glucose monitor and asked me to eat normally and see what my fasting levels were and 1 hour post breakfast, lunch & dinner. On the first day 3 out of the 4 readings were higher than target so it showed I was spiking my glucose levels 1 hour after eating. If you read NICE guidelines, 1 hour post food blood sugar spikes are associated with worse outcomes and these spikes are missed during the routine 2 hour GTT, which is why I suspect UCLH do the extra draw. In my case, there was doubt as to whether I had gestational diabetes because GTT was normal which is why they gave me the monitor and asked me to test at home when eating normally. Surely you've been given a monitor to record your blood glucose 4 times a day? What are your readings like if you eat normally? By normally I mean not following the GD diet...

So having re-read your post, you've had your baby already? You must've been monitoring your blood glucose in your pregnancy? We're the readings higher than target or normal?

Your argument is because you had extra tests you were caught out? Presumably by monitoring you were able to control it and ultimately do best by baby?

My gtt was clear but I have been advised to do the 4 checks daily including the 1 hour after meals ones as a growth scan indicated the potential for GD. Have I sulked? Yes. But ultimately if it helps baby I will do it. I would never forgive myself if I ignored advice and something happened.

Are you able to feel angry now because you’ve had baby?

@thingymaboob yep I had my baby in May this year, postpartum HBA1C perfectly normal. Whilst pregnant was testing sugars from 29 weeks onwards. I barely spiked and was able to eat foods which I normally ate without spiking too.

@Jonesy88 Since being diagnosed whilst pregnant I still questioned the results and even spoke to the senior consultant who understood why I felt cheated. She said something along the lines of how the government guidelines are insufficient and purposely try to diagnose less people intentionally to save money. The issue I have is whether you agree or disagree with the guidelines is subjective and clearly, nationally most if not all hospitals comply with it.

I just worry about the impact the diagnosis will have on my medical records and the fear of how I'd be treated in subsequent pregnancies. I'm 27 and would love my kids and worry that'll be taken away for me.

[quote Shahida1721]@Jonesy88 Since being diagnosed whilst pregnant I still questioned the results and even spoke to the senior consultant who understood why I felt cheated. She said something along the lines of how the government guidelines are insufficient and purposely try to diagnose less people intentionally to save money. The issue I have is whether you agree or disagree with the guidelines is subjective and clearly, nationally most if not all hospitals comply with it.

I just worry about the impact the diagnosis will have on my medical records and the fear of how I'd be treated in subsequent pregnancies. I'm 27 and would love my kids and worry that'll be taken away for me.

[/quote]
Why would they be taken away because you have GD?

@TH22 sorry I was meant to say 'more' kids not 'my' lol. I fear GD and the long term risks associated it with it (type 2) would limit me from having more kids...

@Shahida1721 many many women have gestational diabetes in all of their pregnancies and some have it in one but not the other.
What exactly are you fearful of? Why does it matter if it's on your medical records? For most women it's only related to hormonal changes in pregnancy. It doesn't affect your ability to have or love your children. I don't understand why you're so angry. Like I said before, I "passed" my GTT but only got diagnosed after monitoring my 1 hour post meal spikes. Had I not been under consultant care (for other reasons), I wouldn't have had a growth scan which found excess fluid and if my consultant hadn't been so vigilant I'd have gone undiagnosed for GD and my sugars been uncontrolled. I think you're lucky to have had an obstetric team who were so vigilant and safe (like mine). You feel cheated because the idea of a perfect pregnancy was taken away from you but all it sounds like you needed to do was monitor your blood sugars for any problems. If you spike 3+ times in a week, they consider that you have GD. The severity of GD varies from person to person and some are very insulin resistant and some are borderline, which it sounds like you were. It was right for them to ask you to monitor your blood sugars.

You'll still be tested in subsequent pregnancies but if you're convinced it was a wrongful diagnosis, they'll come back normal and you can have a normal pregnancy.

So many women with type 1 and type 2 diabetes have children. You didn't even need medication for your GD. I don't mean to diminish your anger and frustration but you're making a mountain out of a mole hill.

Agree.

I had gestational diabetes diagnosed very late and diagnosis was borderline. I mostly controlled it very well until the night before my son was born when I needed insulin. I fully get that it’s a massive pain but I’d rather have known earlier because it did affect my son (by making him fat) and I could have prevented that and the increased risks to me and my son. FWIW I am now pregnant again and do not have GD this time so just because you had it before does not necessarily mean you will have it again.

I have Type 1 Diabetes - my HbA1c was 105 at diagnosis and is now 46 with constant work trying to manage it. I have one baby and another on the way- a GD diagnosis absolutely will not stop you from having more children. Even if you end up with Type 2, it's bloody hard work but is manageable. Stop worrying about your past pregnancy, it's been and gone and you've said your HbA1c is normal now.

Do you have mental health issues?

I dont get the problem.
Your children won't be taken away

My midwife told me a "reassuring" "happy" story that the only stillbirth related relating to GD that she ever knew of at the hospital was a mother who totally ignored all medical guidance ate pizza chocolate and wine etc throughout her pregnancy.
She carried the baby to FT and it was still born but the "good news" is she got pregnant again and paid a bit more attention to blood sugar and the second baby was born alive and healthy earlier this year

I asked if social services had been involved at the midwife was like no why?
And I was like because she basically killed her first child

If this is the NHS approach they really won't give a shiny shit how many kids you have

@Totalwasteofpaper I heard the same story from diabetic midwife at Barnet Hospital. Are you with them also?

😂 Yes!!!

The only consequences are positive as far as I can see.
You will monitor your blood sugars in your future pregnancies and if abnormal will modify your diet; protect your child and yourself.
You will have a yearly blood test for life to check that you haven't developed diabetes and to diagnose it before it causes any harm.
Obviously you may never have high blood sugar in the future but nothing much will have been lost.
There is no reason at all why you should have more children if you want them , I am not sure why you have that idea.