Late GDM diagnosis

[Ellerdcc]

I’m 38 + 4 and just found out I’ve been diagnosed with gestational diabetes almost by accident.

I had routine bloods through my GP (for something unrelated) and at my antenatal appointment today they mentioned my glucose came back at 139.1. The cut-off for GD is apparently 139, so they’ve classed it as a diagnosis.

I’ve had no symptoms at all, and a growth scan about a week and a half ago showed baby on the 45th percentile, so well within normal range.

My midwife said it’s ultimately my choice where I give birth after I’ve met with the diabetes specialist team, so a midwife-led centre may still be an option depending on how things look.

Has anyone else been diagnosed this late and still gone on to have a natural birth or a midwife-led centre birth?

Any tips on blood-sugar monitoring or what to expect at the diabetes clinic would also be really helpful.

Thanks so much!

I was diagnosed with my first baby late, at 34 weeks, out of the blue. Protein in my urine was high at 33 weeks, so they sent me for an urgent glucose blood test (that orange drink is foul!) I got given a blood sugar monitor and they offered to put me on meds to stabilise the GDM. I declined the meds and said I would manage it by diet and I did. They were surprised I managed it so well. It can be done! All my scans showed my LG was on the 50% centile for growth, so I was puzzled like you when I was diagnosed.

Cut back on carbs and watch certain fruits (grapes were so bad for me). Check your blood sugar as soon as you wake up and after meals (4 times a day I checked). You will have an app that links to your monitor as well that keeps all your readings, and the readings go to the diabetic clinic as well so they monitor it too. They called me once when I had a bad day. I was always a cereal girl for breakfast or toast, so I had to change. Try and have protein with carbs, it slows digestion and keeps your blood sugar more sustainable

Try not to let it get to you. I felt like a failure until I found out most pregnant women have a sugar spike around 33-38 weeks. It just happened that ours spikes a bit more. Hang in there, and remember it goes when the baby is born and that first slice of toast afterwards was lush! xx

Thank you, lovely, that’s really helpful! Honestly, my diet isn’t too far off a GDM diet anyway—apart from a bit of jam and honey, I mostly eat wholemeal carbs and not many sweets.

I have eaten a lot of fruit, especially exotic ones, which I know can spike sugar a bit, but the diagnosis felt really out of the blue and didn’t seem to follow NICE guidelines.

I’ve started testing my blood sugars today, and they’re fine, I haven’t really changed my diet either. My baby is also below the 50th percentile and growing on target, so nothing else suggests GDM.

From the research I’ve done, HbA1c shouldn’t be used alone to diagnose GDM, as it’s not reliable in pregnancy, and my OGTT at 28 weeks was normal.

I’ll be speaking to the consultant to understand the basis for the diagnosis, because being 0.1 mmol/mol over 39 when that isn’t a standard threshold seems really odd to me.

Definitely speak to the consultant. It's crazy to have a diagnosis on that basis. It makes no sense.

I'm glad I was of some help. Hopefully the consultant will say you don't need to keep testing. I'm not a big sugary treat person, but it was always fruit that pushed me over. But it sounds like you are doing really well. I hope the consultant listens and helps x

I’m kind of the opposite. Known I likely have it since 24 weeks, but no one seems to want to take it seriously or give a diagnosis!

I had some symptoms at 24 weeks so I bought a glucose monitor (from a reputable supplier) and whenever I take readings at home at the recommended times ie fasting or 2 hours post meal - often readings are high and over the threshold.

However my glucose tolerance test at 28 weeks was normal, and a random hospital monitor reading at 33 weeks was also normal. So they say I don’t have it and wouldn’t repeat the GTT.

Had a scan the other day and baby’s abdominal circumference is over 99th percentile so off the chart large, whereas head is 85th and legs 28th! Weight was estimated already 6lb 3oz at 34+4 weeks! My last child was 7lb 4oz at 39 weeks. The large abdomen is a big sign of GD.

Going back tomorrow for appointment due to scan findings so hopefully get some clarity then as it’s making me anxious with the risks of untreated GD. Back on the diet as I haven’t stuck to it since 28 weeks when they told me I definitely didn’t have it. But the odd reading I took in that time still high.

@Ellerdcc Since you have so little time left to go, and your sugars are normal and baby not large, hopefully you’ll be advised it’s fine to give birth at the midwife led centre. Do you have any other children? If it’s your first it you are more likely to go overdue and so probably they’ll keep an eye on sugars etc as could be longer til you go into labour. I have 2 other children, they are much older and were both c sections so I’m due a section at 39 weeks.