Gestational diabetes and potential delivery date

[dannd]

Hi everyone,
I’m looking for some advice from Glasgow mums — especially those who have given birth at the Princess Royal Maternity or are currently planning to.

I am 35 weeks pregnant, and at my 32-week scan, baby was estimated to weigh 4lb 7oz. I was diagnosed with gestational diabetes at 16 weeks and have been on 24 units of insulin at bedtime, which keeps increasing as I still can’t get my fasting levels under control. I’m also on 2000mg of metformin daily. Within the past week the diabetic team have also introduce fast acting insulin with my dinner only as I seem to be more insulin resistant at the end of the day.

Honestly, I’m feeling really worn out with it all just now. At my last appointment, I asked roughly when they might consider induction because of the insulin and metformin, but I was told it would depend on baby’s next growth scan. So far, they seem happy with her growth, which is good — but I thought being on medication would mean they wouldn’t let me go to full term?

Just wondering what others’ experiences have been — especially if you were also on insulin or metformin. Did they induce you early? How was your care at Princess Royal Maternity?

Thanks in advance 💕

Hey I'm at a nearby hospital and was told I would be looking at 38ish weeks. For induction or section. Mine was weighing estimsted 5lb at 32 weeks. I have other risk factors too though. I'm diet controlled and sugars have been OK.

Are you seeing a consultant too?

Just to add I'm 34weeks.

Sorry not in the right area of the U.K., but they should also be considering placenta condition with GD, i was induced at 37.5 weeks as growth scans showed she was big and I was advised they prefer not to go over due date with GD as there is an increased risk of the placenta failing which gets higher towards the end of pregnancy.

No Glasgow but GD.

Congratulations on your baby.

getting straight to business... 2 key things.

You
What are you eating and are you doing 15/20 min walks post meals? I basically went to meat and veg no cards and no refined sugar with my first. It was grim and I was told I was over the top so With my 2nd I wasnt as militant at all and regret it as we did a spell in NICU plans while it could have happened anyway I blamed myself for a long time.

Be aware of this because they often dont spell it out to you - your child may well have hypoglycemia and need to go into nicu. I didnt consider it as a real potential outcome with my 1st and assumed id be fine woth my 2nd.. and was pretty distressed / shocked / traumatised when it happened. It also meant I couldnt properly advocate in nicu because I wasnt prepared ahead of time.

Your birth
Are you sure you would take induction over elcs?
Studies lump emcs in with elcs so the stats you see are skewed elcs has excellent outcomes and if you need to move up delivery i would be inclined to go for that.

You also need to know/ask what % of inductions in first time mothers ultimately lead to emcs in your hospital

As you can tell im not pro induction (i know 1 person who came out of it okay and more than i can count that didnt) but everyone does what's best for them. Make sure you ask all the questions so you can make an informed choice

Yeah I’ve been seeing the diabetic consultant and obstetric consultant. I’m 36 weeks on Tuesday and got my last growth scan then too, so hoping to finally get a confirmed date of what’s happening. I suffer from anxiety as well so think I just mentally need a clear plan in my head 🙈. Also querying to myself if induction is the right way forward as I’ve read than so many early inductions end up with emergency caesareans anyway. What are you going to opt for?

Yeah I’ve also read about the deterioration of the placenta with GD. I think at this point my anxiety is just running wild and I need a clear plan in my head.

The diabetic team seem happy with my diet and what I’ve been eating. Majorly reduced carbs as well and not a snacker outwith my meals. It’s just all so draining, especially when you know you’ve eaten well but then get a high reading.

I am at this point extremely unsure about how I would like to deliver. Part of me is like right request a caesarean due to the amount of failed early inductions etc and the fact these can take days before they even eventually decide to offer a caesarean as well . But then all I know is normal birth and the thought of the recovery after the C-section scares me 🙈. I am really unsure what to do for the best.

We are off to pram centre to collect pram..I'll come on and reply later as feeling so similar to you. I think we have same team I know people from your hosp were on my education call thing.

Sounds like there isnt much you can do about the diet / you are doing all you can.

My recovery with both my elcs was very good tbh. There was music, we all have a nice chat, very calm all round....
I was going out to the shops /for a walk after a week...
It's really personal so do some research yourself but also ask to speak to the consultants if you want. Its very different if you have been labouring for a day or 2 and then have one.

I have absolutely nothing helpful to add to this post but I am in the same position right now.
I was diagnosed with GD at 26 weeks with very borderline levels.
Ive been diet controlled since with alot of pushback from the diabetic team, who havent seen me in person, just phone calls.
They keep maintaining I need to start Metformin as my fasting levels are high, except, ive never had a single high reading in the morning, just the occasional one due to eating late and not exercising.
Im now 34 weeks pregnant. Baby is about 4lb 12oz so within normal range.

Ive been consultant led since the beginning due to complications with pregnancy 1 and so far nobody has discussed delivery with me.
Fetal medicine have suggested a section from 37 weeks as its term and with all the issues in this pregnancy, they want baby out.
But still waiting on a consultant.

The thought of a section terrifies me.
I had an induction with my 1st and it was a disaster for a number of reasons so i dont know what to do right now.

With my first I was booked in for a C-section at 38w2d (also breach until the end) although she decided to come at 38 weeks anyway. I only had metformin but was over 40 which might have contributed to the decision.

Hi op, I had gestational diabetes with 2 put of 3 pregnancies.

First one baby was 'huge' on growth scans so opted for c section, weighed 8lb 1oz. Hated my section especially the recovery

2nd baby was back with induction, the most pain I have ever experienced (1st child was normal vaginal no GD).

If I were in your shoes I would opt for a section, of course it's your choice but I genuinely felt I was dying.

Just to add a story from the other side my induction was fine. A bit long and boring but not awful. I had the pessary inserted on the Wednesday morning then it was just a waiting game till the next morning with bouts of being on monitors to check mine and DDs vitals. Checked in the morning and cervix was dilated enough that they decided they could break my waters, had to wait for someone to be free to do that so it was around 1pm when it was done. Contractions kicked in pretty much immediately, I was pacing around till I needed gas n air then I stood leant over the bed. DD was born about 5 hours after my waters were broken and we stayed overnight. So 2 nights in hospital and most of the time was waiting for something to start and then waiting for someone to tell me I could leave.

Just a wee update as I had my 36 week growth scan today. Baby is still tracking perfectly at 6ibs 9oz. I’ve decided to opt for the induction and atleast give my body a chance to respond to it. I am booked in for the pessary at 38+2 weeks and also been told that at anytime during the induction process (if I’m not progressing) I can still request a c-section. I do feel so much better now there’s a plan in place. Thank you for all the advice ❤️

Hi @dannd Sorry I'm in England but I had borderline GD which was diet controlled. Just to add a positive experience that I had an induction with my 3rd baby. 1st was an emcs, 2nd vbac, 3rd was 1st induction and another vbac, and on the whole the induction was a positive experience. I was really worried and anxious beforehand but it ended up being good. It's great that you're happy with the plan so wishing you all the best x

Hi OP. How are you? I’m in a similar position as you trying to choose between elective CS or induction at 39 weeks due to newly diagnosed gestational diabetes. May I ask how your induction went if you don’t mind?