Can someone talk to me about Gestational Diabetes

[Hulla]

I am looking for some info really. Apologies if the info that follows is a bit rubbish, I am passing it on as I understand it.

My sister has just been diagnosed at 30 weeks, has been monitoring her blood. Her initial test gave her a reading of 10 which is apparently quite high.

She has had a few readings over 6 this week and now her doctor has decided to put her onn tablets rather than allow her to control through diet.

She has been told that she will have to be induced at 38 weeks because there is a risk of unexplained deaths after this.

Can anyone tell me why this might be? She wants whats best for her dc but doesn't understand (they said they'll explain next time!).

She's had a growth scan and all is fine.

Any info would be much appreciated!

Hi there
I had GD
THe "induced at 38 weeks" stuff is not correct. MOst hospitals do not induce now unless your baby is large. As she has found out early, she should be able to control this through diet.
As for the "unexplained deaths" - maybe refer to a higher propensity for birth complications due to size, but again, this is rare, very rare.
Readings over 6 are fine....again, am confused.
I think your sister has had some bad advice.
XX

Thanks ScaredOfEverything, I wonder if she can get another opinion. I feel so sorry for her, she was so upset yesterday.

Perhaps I'll look for NICE guidelines.

Thanks for replying

Nobody 'has' to be induced, it will simply be the policy of that unit. I know that it is in ours. Babies born to diabetic mothers have a higher chance of being macrosomic i.e. large, and therefore possibly problems at delivery such as shoulder dystocia, obstructed labour or instrumental delivery. So the thinking behind this is that at 38 wks the baby may not be so large. However, it has been my experience that even when scanned it is very difficult to estimate the size of a baby and the literature backs this up. It is true that there is a greater risk of stillbirth and many problems actually arise in early pregnancy when blood sugar levels are uncontrolled. Other complications can be polyhydramnios (excessive water around baby), and problems with baby's blood sugars following birth. Babies born to diabetic mothers can have a variety of problems related to blood glucose control in pregnancy , and diabetes can be a serious complication of pregnancy although it is increasingly common. Ideally, plasma glucose levels should be below 5 before a meal and below 7.8 after a meal.Your sister should be referred to a diabetic specialist midwife asap and they can answer any questions in detail. This does not mean that she cannot have a normal delivery though, get her to talk it all through with midwife and consultant at the joint clinic. Hope that helps (probably tmi!)

I know not relevant in that not mentioned home birth but please check out my story on www.homebirth.org.uk - i "had" GD and was told a lot of different info and it may help to show her that.

Go to the site and under "you cant have hb because you have gestational diabetes" - you will find my story - Rachel

HTH

Not tmi at all, thank you reikizen. It is the specialist that has put her on tablets and said he wants to induce her. If it is her hospitals policy then I doubt she'll rock the boat. She said yesterday she'd never forgive herself if something happened because she didn't want to be induced early. I can understand that.

Its a shame the hospital didn't explain the risks to her like you just have!

Thanks for posting

Hi I've had GD with 2 previous pregnancies and currently have it with this one. The first pregnancy I had with GD I was put on insulin and induced, hell on earth IMO. 2nd GD pregnancy I also had insulin and had an ECS. Neither baby was particularly big (for me) 9lb 5oz and 8lb 14oz. This time I have been put on the tablets which are working really well. scared is right 6 isn't high, they have changed the level to 7 being the maximum, although 10 is quite high, especially if she's on the tablets. If she is adamant she doesn't want to be induced noone can make her. I told the Drs. flat out I was NOT going to be induced with the 2nd GD baby. The reason they want to induce babies is there is an increased risk, I believe, of something going wrong in utero due to an increased sugar level of the baby if it is big, and they don't want you suing them

Thanks mum27. So induction seems to be the best idea (if not a pleasant experience, I was induced with dd).

The recording of 10 was before she started tablets. She has been getting readings between 4-5 (I think) but had about 3 this week which were around 6 so they decided to put her on tablets. She was so determined to do it through diet and was really strict with herself. I think she feels like she failed and thats partly why shes upset.

I suppose it is hard to estimate the size of the baby. If they think his size is ok might they leave her to go naturally or would that be something she'd have to ask for?

Normal readings are between 4-7, so 6 should be ok, if they were high 6's this may be why they started her on the tablets, they work two ways to help your body better use your own insulin. I understand how she feels, I had it with baby 5, not baby 6, got it with baby 7 and was also convinced I was going to manage it with diet this time but at 21 weeks they gave me the bad news, however the tablets I think are still better than giving yourself insulin shots 4 times a day. As for delivery, it's really up to her, I refused ever to be induced again and I think I only was because just before I had mine they lost a baby to a diabetic mother (she was however diabetic all the time)and they were still in panic mode. If she wants to read up on GD and induction I found typing in gestational diabetes and induction and going to a site called bellybelly helpful. it's a site about a study done by the American College Obs and Gyn. Hope this helps

mum27 when you say the tablets work well what do ou mean. I am to go on medication soon. i was on insulin last time but this time i have an option of tablets. i am 29 weeks and not doing so well managing with diet but worried about side effects of tablets. how often did you take them and when. did your readings go down straight away. were you able to eat more? I am starving

BTW i was told induction was the way forward last time but spontaneously went into labour and delivered at 35+5. I have since read that insulin can cause pre-term labour. Has anyone else had experience of this.

forever the tablets worked instantly for me, the next reading I had was perfectly normal and they have suggested I not use the nighttime insulin as well as it might be too much. I so know what you mean by you're starving. I have been trying so hard with my diet that theres nothing left to eat. At 23 weeks I weigh 5kg less than I did before I was pregnant. Apparently there can be side effects of nausea and possible diarreah (can't spell it) I haven't had anything. As for preterm labor...I wish, none of my last 7 have been early even the induced one went over by 4 days and I've been on insulin twice so far

mum27 thanks for posting all of that. I'll send her the link to bellybelly.

One last thing, when they induced you was it via drip? Not a sweep etc?

They did the sweep first, that didn't work so they hooked me up to the drip, then had to continually turn it up for 6 hours. I obviously wasn't near ready to give birth which is probably why it was so bloody painful :-)

Your sister should get a second opinion as there is no need to induce unless baby is overly large or there is some other problem. I had GD and I bought the GI diet book which taught me how to eat properly - dont let her fret the doctors love to scare us mums for no reason.
Kim
www.kiddycat.co.uk