Gestational Diabetes - how many high readings is too many?

[Duv]

I'm 29 weeks and was recently diagnosed with GD. I've been taking my blood sugars for the past week and significantly changing my diet (particularly reducing my carbs) and just had my first follow up appointment to discuss my readings.

I thought I was doing quite well, with only 4 /30+ high readings, mostly only a little over target, and mostly the high readings were in the first couple days I started testing. But the midwife was concerned and suggested this meant I needed to go on Metformin but has agreed to give me another week to continue with diet alone. I was quite surprised by this because, firstly, I was told to expect to get high readings in my first week as I experiment with what foods work for me, and secondly I was told the occasional high wasn't a big deal. I now feel like if I get any high readings in the next week they will say I need drugs, regardless of what my average is. What's the normal threshold - how many high readings is too many?

She also asked me about what I'd eaten and when I mentioned eating peanut butter helped lower my readings she said it was high in sugar and salt (it's not, I buy the 100% peanuts stuff) and high in fat. But I'm supposed to be cutting carbs so I need to increase fat and protein to get enough calories and adding fats seems to be working for lowering my sugar, so I'm confused. I've checked my weight gain and it's dead on track where I am in pregnancy and my starting weight so I don't see what's the problem with high fat food?

How are you doing with diet? Have you found the Gestational Diabetes UK website? They have menu plans and snack ideas, shopping lists and loads of GD friendly recipes. It's worth paying for the membership.
If you've only had 4 readings over and you're not already following this advice then ask your nurse to give you another week and if you stick hard to it, I bet it will bring you right down.

Which readings are over? If they're morning fasting readings that's trickier and you may need metformin.

Also join the GDUK Facebook groups - they're amazing for support

And yes high fat high protein v low carb is the way.

The nhs will tell you that you shouldn't go high fat but this is not a long term approach that could lead to heart disease, it's just to manage your short term insulin resistance

Your midwife sounds a bit odd. Is she a diabetes midwife? At the beginning it was more trial and error to see how much carbs you can tolerate, esp for breakfast. Agreed with a PP that if your morning fasting levels are consistently high, there's not much you can do in diet to control it and meds is probably the best way to go.

I'm now 36w with GD. I noticed that from 32w onward my tolerance for carbs went down quite a bit, and there were quite a few spikes (as many as 5-6 in a week). I explained that to the diabetes team, e.g. I found out I could not have semi-skimmed milk (10g sugar in 200ml) or brown bread for breakfast any more so I swapped to unsweetened soya milk and oatcakes. They were very comfortable with that, saying as long as I found swaps that work and I'm eating healthily, not starving myself, they are happy for me to remain under diet control.