Gestational Diabetes

[lemontop]

Hi

Just had results of my GTT come back high and have an appointment to see two doctors next week. I think one might be a consultant and the other a dietician. Has anyone had any experience of GD in pregnancy? If so what's likely to happen at my appointment?

I'm a bit concerned that I'll be 31 weeks when I have my appointment which seems a bit late.

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Hi there - this thread is a little old. [[https://www.mumsnet.com/pregnancy/gestational-diabetes
If you want to read more about gestational diabetes, we’ve got some information here]]. MNHQ

hi, i was diagnosed with GD at 31 weeks too and my appointment didnt conme through til i was about 34 weeks, i only saw a consultant because my bloody sugars are all under control despite not being advised to change my diet (i think i was having a bad day when i had my GTT), all i have to do now is see the consultant every two weeks and the diabetes nurse who just looks over my results and thats it really, my consultant apoointments are pretty much the same as seeing the midwife. Im 38+1 and have been told im being induced at 39+4 because 'its common practice to induce women with GD around their due date'

I haven't seen a dietician so cant help you there but good luck with everything! Be prepared for them to mention induction though. Also are yuo measuring big? Im measuring two weeks ahead of what i am but i had a growth scan and baby and fluid are perfect size so they r stumped as to why im measuring big (i think its a fat layer as i was 3 stone heavier before 21 weeks, i havent gained any weight in this pregnancy just lost it which is why i was sent for a GTT in the first place)

anyway i will stop rambling now, good luck with everything

haha meant blood sugars not bloody sugars!

I think bloody sugars is a much more appropriate name!

You lost three stone?!

Do they grill you on your weight and weigh you etc each time? I'm paranoid they're going to have a go at me for being fat. I was sent for GTT due to 'raised BMI' and have tried to stick to a fairly healthy diet but have gained about 16lbs so far.

Do you have to see midwife as well as or instead of consultant? All measurements have been fine so far as I know but haven't been for a few weeks. Keeping everything crossed.

Do they induce rather than offer a c section then?

so many questions!

No, they shouldn't grill you or have a go at you about your weight, but if a raised BMI is an issue they may address it (hopefully sensitively!) as it is the 'big thing' in the NHS and maternity at the moment. It is (as you will be aware) linked to poor health and poor obstetric outcomes but those are statistics, they are not you personally.
You may be able to control the diabetes with diet alone or they may prescribe tablets or insulin injections. GD does put you at greater risk of diabetes in later life, as does a raised BMI so it might be as well to try to make those changes now anyway.
With regard to c section, a vaginal birth is always the preferred option because of the potential problems of major surgery both for you and baby. Particularly if this is your first it can have a significant impact on future pregnancies.
In our trust the consultant and midwife do a joint clinic and that is generally seen as good practice to minimise the amount of time you spend schlepping to the hospital.

they didnt grill me on my weight and i have a high bmi, well its not as high now! yeah i lost 3 stone which is apparently down to the GD which is one reason i got sent for a GTT! They did mention my weight but it wasn't nasty or anything infact my diabetes nurse said 'ppl with high bmi's which yours isnt really' so that didnt bother me.

I dont see the midwife at all now just the consultant bvut there was a midwife present at my last appointment who did all the fundal height etc (appointment before was just consultant and she didnt do my fundal height which i think is pretty bad considering they r supposed to be keeping an eye on babys growth)

A c-section hasn't been offered unless im not in established labour after 24 hours after im induced (dc1 was induced and it took 12 hours from drip to birth) so i dont think i will be needing one, quite glad cos i would much prefer a normal birth than a cs. although im quite disappointed im being induced because i wanted to start naturally this time and not be induced again!

I developed Gestational diabetes at 26 weeks.

I saw a dietician and consultant. Had to check my blood sugars after every meal and watch my diet. Bloods were still high so had to start injecting insulin 3 times a day.

I have had a growth scan every 4 weeks and have been told baby is measuring big for dates. Thye said they will prob induce me at 38 weeks although baby has now turned breech so might be CS.

I have also got a lot of fluid around the baby which is common with GD. This means that waters may rupture early or might go into early labour.

The consultant has also said that when in labour my bloods will be checked at regular intervals and glucose or insulin given as neccessary.

There is also a chance that the baby may have high blood sugars after being born and so there is a small chance she will have to spend a short time in scbu to be monitored.

I was diagnosed at 28 weeks in my first pregnancy and then had it again in my second. There was a weekly diabetic clinic but I only needed to go every two or three weeks as my blood sugars were well controlled through diet - we just decided at each session when they would need to see me next. At each session they weighed me, took my bp, sometimes took bloods and I had a consultation with a diabetic specialist and the midwife, sometimes my consultant looked in too. The consultation was usually just a quick look at my blood sugar levels diary and sometimes the midwife would have a wee feel of my bump. I had a couple of growth scans at 32 and 36 weeks I think and so we would discuss those too but they were mostly normal (both dcs were 7lb-ers so not huge).

On my first clinic I also had to have a chat with a dietician who did not nag me about my weight (BMI of 30 I think? - me not the dietician!) but just talked me through good nutrition etc.

Finally, I was induced at term both times and it was fine. Obviously I have no 'normal' birth to compare them to, but it was not terrible, it was completely manageable. I live quite a way away from the hospital so to be honest, I was happy for it all to be started as I had been dreading a late night (or, even worse, rush hour) dash along the motorway whilst in labour. I know I would not have handled that well!

If there's anything else you want to know, just ask.

Thanks very much for replies. I'm starting to feel a bit better! Can I ask those of you with GD how you found out. Was it the results of the GTT or was there anything else like did anything show up in your urine samples? I only ask because other than a urine infection in very early pregnancy all my tests and measurements have been spot on.

I'm worried about the BMI thing as had actually been trying very hard to eat a healthy, balanced diet and do lots of exercise. I was going to the gym up until about 25 weeks but then I just started to find it too much. I didn't gain much weight for a while but then got married and went on an all inclusive honeymoon so it went a bit pear shaped!

DH wants to come to appointment so I don't want to be embarrassed if they're going to have a go at me about my weight. Silly I know!

I was sent for a GTT because of a previous large baby, DD was 9lb5. I never had glucose in my urine or any other indicators, In fact I was really stunned when the results came back positive for GD.

I have put on over 3 stone, i'm 36 weeks, but nobody has ever had a go at me about my weight

Lemontop,

I had no symptoms, it was just picked up in the standard blood test at 28 weeks. All my measurements were fine, bloods were fine - nothing else was out of the ordinary. I did tick all the boxes for it though, overweight and at the older end of the scale!

It's a lot to take in when you've just been diagnosed isn't it? I was absolutely frantic in the week between getting my diagnosis and going to the clinic - terrified that I had done something wrong that was going to affect the baby (huge consumption of minstrels/dairy milk for example). However, they were all absolutely lovely at the clinic and I was secretly very pleased to see very small and thin pregnant people there too!

And I found two really positive things came out of it (over and above dcs obviously). The first was that monitoring my blood sugars meant I ate super healthily so I was a couple of pounds lighter at the end of my pregnancy when I started - before the baby was born! Secondly, I was always convinced something was going to go badly wrong (even before the GD was diagnosed - I'm a total pessimist) so the extra clinic visits and scans helped me feel less worried.

Lemontop I was also diagnosed this week - I'm 34 weeks. Had no other symptoms, urine etc clear the whole way, and it was only when I saw the consultant at 32 wks that she decided to have me tested (due to high BMI/Dad with late onset diabetes/fairly large first baby of 9lb 6)

Saw my new consultant this week (GD specialist) who mentioned that he "aims to deliver women with GD by 39 weeks" and have another appt with him a week monday to discuss further - He indicated that he'd likely be taking the route of induction but depending on size of baby at 36 week scan may discuss C-Section. (Am currently trying to decide which I am less scared of - Was induced with DS1 and narrowly escaped an emergency c-section - wasn't pretty though!)

Saw diabetes nurse this week too who gave me a bloods monitor and showed me how to use it - am now monitoring bloods before/after meals. Couldn't see dietitian as she was on leave so will also be seeing her in 10 days too. Nurse wasn't hugely informative on what to eat so I've kind of experimenting at the moment. Most annoying thing is not knowing whether I can snack/what to snack on - Nurse said 3 meals a day, avoiding snacks, but elsewhere I've read snacks are fine

They shouldn't have a go about your weight, but even if they do I think it would be worth being a little embarressed in front of DH as it's alot to take in and will be helpful for him to be there.

Hope all goes well for you - I've been in a bit of a panic and feeling sorry for myself for the past few days, but am starting to get my head round things... Would love some more inspiring ideas for meals though!

piffpaffpoff I must admit I was getting a bit of an addiction to bags of minstrels ( and not the little ones either!)

It is a lot to take in and obviously I've been imagining the worst case scenario without properly understanding what that is. I'm also worried about having further blood tests as each time I go it takes them lots of attempts to get anything out of me because of my tiny veins apparently. I realise this will probably seem ridiculous when I experience childbirth!

I was also told a few weeks ago that I'd tested +ive for group b strep and would have to have iv antibiotics and there'd be little chance of me using the birth centre. I think my chances of a nice short stay in hospital and waterbirth are fast flying out of the window. I guess none of it matters as long as baby is delivered safely.

I've tried to stick to a very healthy diet for the last few days. mrskitty I've heard a GI diet is good for GD so I've been using some recipes from Rosemary Conley's GI diet (don't laugh!) which I was loosely following anyway. She says you should have two 'power snacks' in the morning and afternoon. I've also heard (not from Rosemary) that it's a good idea to have a snack before bed. I'll ask when I have my appointment on Thurs.

Thanks again for your advice.

Lemontop/Mrs Kitty

On the food front, it is basically a low GI diets that you should be following. Cut back on the sugar and refined carbs and you will be heading in the right direction. I used to eat the following...

Breakfast was either weetabix or porridge or eggs. A lot of cereals are shockingly high in sugar. Also I had to wave goodbye to fruit juice and toast.

Lunch - veg soup was my saviour. Or an omlette, or a baked potato with beans and cheese if I was really hungry.

Evening meal - chilli con carne with a teeny bit of rice, pasta bake, veg&chicken with cous cous, soup, shepherds pie with very little mash topping, grilled chicken and veg, chicken/beef and veg stirfry with teeny bit of noodles

For snacks, I had cheese and oatcakes, an occasional apple, raw carrots and my dietician said if I had to have biscuits then to have rich tea.

The main thing for me was portion control, I ate little and often and that kept my blood sugars stable. I also found exercise was good - I tried to get out for a walk every day as well. Plus I did also have occasional blow-outs - nothing as marvellous as a bucket sized bag of Minstrels, but an occasional ice lolly or a kit kat!

hi there. just to add to the food frontI was diagnosed at 14 weeks! at the first set of standard pregnancy tests. They don't know if GD or lifelong yet, till they test me 6 weeks after birth am 31weeks now) that a low GI diet is exactly right to follow, you will feel alot more stable on it as whenever I fall off the wagon I feel terrible all day, extreme high or low blood sugars both feel awful!

Porridge is actually NOT good for diabetics as its incredibly starchy (my dietician told me this after I had 2 mornings of porridge that sent me to over 11!) and you mustn't have too concentrated carbs, its different from normal 'healthy eating' standards where porridge is normally good for you. same goes for oatcakes believe it or not!! weetabix, all bran, eggs, granary toast, no-sugar muesli, fruit (but NEVER fruit juice, this is practically banned!) or yoghurts (low fat only) especially orange juice) - these have all been good for me for breakfasts. most other cereals have sugar in them, surprisingly so. **A good tip is that if 'sugar' (or its other names - fructose, for example, anything with -ose at the end!!) is listed in the ingredients of anything in the top 3 of the ingredients then its not going to be kind to you...

of the tinned soups, thinking about lunches, I like the Baxters range especially their vegetarian soups (carrot & butterbean, wow, really , really, the king of canned soups) - other makes like Heinz actually have sugar in them, making them dangerous for us diabetics...
am talking from my trial and error standpoint over the last 12 weeks or so! and my dietician has been quite helpful.

dinner and snacks, I cook from scratch mostly, you kind of have to: you can't go wrong with chicken, steak, tuna, salmon, loads of fresh veggies, a little soy sauce or lemon juice, unsalted nuts, chickpeas, lentils, kidney beans, with a small amounts of brown rice or a baked sweet potato (miles better for you than 'ordinary' tatties!and they don't make your levels go up, normal tatties will. they also make nice oven-baked chunky wedges). I make stirfries, casseroles using lots of herbs & veg, grilled meats with big salads, that kind of thing. Its been restrictive but I can see its very good for me - plus am nearly 32 weeks and have only gained 9.5lbs...!! (Baby is a huge 4lbs of that!)

I'm having to inject 4 times a day (with each meal and bedtime, but i don't have to inject if i have a carb-free meal so its more like 2-3 times daily most of the time) & am really really hoping its GD not lifelong... although have been diagnosed rather early. fingers crossed! have learnt alot anyway

PiffPaff / BrightonBleach Thanks for food advice - I had recently read that a low GI diet was a good idea. Have been monitoring for 4 days now and appear to be doing quite well at sticking within my limits, although made an error at lunchtime today by having a couple of slices of watermelon after my macaroni, only to discover that watermelon has an astonishingly high GI! Put me up to 8.8 an hour after testing, but hopefully my consultant will recognise that I am aware of the mistake I made & treat it as a blip rather than a reason to put me on medication (and also consider the fact that they didn't exactly give me any guidance to follow - and won't until a week tomorrow!)

Have also discovered through experimenting that I need to say bye-bye to my morning weetabix and decent toast - Looks like eggs or fruit/yogurt for the foreseeable future for me! Re: potatoes, I've found that I can't have 'old' potatoes but new potatoes seem fine. Basmati rice works well for me too (Love my carbs so am glad they don't all send me sky high!)

MrsKitty no worries its all trial and error and your obstet.should definately know that anyway - my aunt is diabetic and she said obviously with GD you need to get within the limits fast as poss because of dangers to baby, but that normally it takes quite a while to work out which foods are ok for you and which aren't so good! it will vary person to person as well - i.e., weetabix is fine for me, not so for you. you should be able to eat bread in moderation, especially seeded and granary - it seems to me the key to all of it is 'moderation', boringly so , especially with carbs; a portion of carbs is 2tbspns brown rice for example, or 3 new potatoes or one good sized sweet potato or 3 tbspns pasta (I get on quite well with pasta as well, as long as I have a small bowl, maybe with tomato arabiata type home made sauce and a salad)

I know what you mean, I wasn't given guidance straight away, had to wait 2 weeks and get stuff off the internet and try out different things. annoying isn't it! I keep a food diary as well as my blood glucose diary, so the diabetic nurse and obs at my fortnightly appointments will always be able to look at a reported high or low and check it against the date in my food diary and advise me if they need to (and they always do like to read the food diary, so its good to keep one - good for you as well as then you can notice what foods might be good/bad).

don't forget that sometimes you will get a high or low for no reason seemingly, as pregnancy hormones can send your body mad...

just to add, even if they put you on meds its not the end of the world believe me (& I've had to inject from day 1 of diagnosis at 14 weeks), you get used to it and the fact that its helping your pregnancy be 'normal' will help your mindset...as would the fact that you will be able to stop any meds they give you the minute you've had the baby!

in terms of delivery, all they are telling me so far is that they won't let me get quite to the due date and certainly I won't be allowed to be over. Baby is in 75th centile of growth, which is large but not abnormally so apparently. he's been breech and cephalic so i don't know whether I'll be induced or c-section yet, going into labour naturally seems unlikely - unless he decides to arrive on his own several weeks early EEK

lemontop & MrsKitty also to add for your info that I've been told that if I have a natural delivery it will be quite a 'medicalised' birth with me on an insulin drip throughout, so no birthing centres/midwife-led centres for me!

Brighton I've been consultant led from the start - never had a hope of seeing an MLC - same as last time they have already warned that even if I manage through diet I may still need an insulin drip for the birth as well as constant monitoring...I'm hoping that I will still be able to remain reasonably mobile/upright even with monitoring, as I was able to last time (had consistent monitoring due to early waters breaking with Meconium) but was still allowed to sit on my birth ball & stand/move around within a limited space. May yet end up as a C-section though as baby turned from Cephalic to Breech presentation last week too!

Lemontop give us an update on how your appointment goes next week

MrsKitty I'm consultant-led hospital-led pregnancy too, I see some midwifes there too but not really getting to know them as such, usually different ones take my BP etc and then I wait for the diabetic medi-ops team and sonographer. No idea what its like to have a 'community' pregnancy as this is my first!

we'll get there won't we - don't know whether to be more scared of induction or c-section either. any tips from your 1st diabetic-led delivery gratefully recieved...

heres some additional meal ideas from my food diary this month if of any use to anyone:

pork loin steak baked in cider vinegar (& a little real cider!), stock, herbs, large sliced apple, sliced leek and onions with a baked sweet potato & green beans.

home-made pizza - the smallest fresh base bought in morrisons, we had half each, covered in paste made from tomato puree, garlic, chillies & dash worcester sauce; grated cheese, 1 slice of thin ham chopped up and fresh tomatoes & a red pepper.

sliced baked chicken breast in a tortilla/wrap with mashed up advocado & 1 chilli, grated carrot & cucumber & half a tin of sweetcorn, tspn low fat mayo.

spagetti (small amount) with home-made meatballs (drained lean mince, chlli, 1 slice bread grated, diced spring onion, 1 egg, pat into balls -chill for an hour before frying lightly & spicy arrabiata sauce - tinned tomatoes, chillies, mushrooms, olive oil, tomato puree etc, simmered with the meatballs) bit of cheese on top

baked salmon, corn on the cob with a knob butter, massive salad, roasted cherry tomatoes.

chicken and brown rice risotto stuffed with loads of diced veggies & kidney beans and simmered.

fresh haddock fillet pan-fried lightly with small bowl oven chips & green beans & peas.

I like the skinny cow low fat icecream lollies as well!!!!

brighton Funnily enough I didn't have GD in my first pregnancy - I was consultant led due to having a BMI "Just over our cut-off point" for midwife led care, and a predicted large baby (and if that was without GD imagine the size this one might be ).

I was induced last time due to my waters breaking with meconium but no contractions - I can't say it was an enjoyable experience, but I don't know how much the actual induction contributed to that.

DS was eventually delivered after apprx 29 hours in the hospital with forceps after a failed ventouse. Thinking back on it now, I think it was more to do with the fact that the midwives changed shift just as I moved into the pushing stage that I got myself worked up as the previous midwife had been very supportive of my hopes for labour/delivery then when the new one came on she just wanted me strapped to the bed and even when I agree wasn't then what you'd call helpful or supportive with anything! The thing I think I really missed about my experience was that I didn't get the chance to labour at home for any amount of time - I was kept in (unexpectedly) when I went in to have my waters checked, then induced, then on the ward. I guess at least this time whether I'm induced or have a section I will be ready for it. I'm also at a different hospital this time as my time spent after delivery on the ward was rather grim and I just couldn't face going back.

Like you say - we will get there! and there will be a lovely baby at the end of it!

One concern I do have re: the GD is breastfeeding afterwards - I've read some stories on here where mums have been forced into giving formula to raise blood sugar in the baby - I have no problem with people choosing to formula feed but I resent the fact that some hospital staff see it as an easy option in situations like this to get a box ticked IYSWIM. I'm hoping my hospital will not be this way inclined as my consultant mentioned that he would send me up to see the breastfeeding councellor at my next appointment which sounds quite promising & pro-active in providing the right support - fingers crossed anyway.

Thanks for the additional meal tips - unfortunately I'm not much of a meat eater - chicken or beef a couple of times a week but thats about it - think I'll be making alot of currys & chillis over the next few weeks (but forego the Naan or garlic bread )

Seems like we all have fairly similar due dates (all within a month of each other at least) We should keep each other updated with this thread on how things are going - I think the old GD support thread dwindled out a few months ago so it's about time there was a new up to date one

good idea MrsKitty , I will keep in touch on this thread - be interesting to compare notes along the way!

they haven't mentioned breast feeding to me yet, be interesting to see what they say about that...

your last birth sounds a little traumatic, I will have fingers crossed for simple and straightforward for you this time!

best wishes

Just on the breastfeeding front, I bf-d both DCs for a year no problem. No-one mentioned anything about this not being possible but I live in an area where they are so pro-breastfeeding it's not true! The only thing that happened to the babies immediately post-birth was that they had their blood sugars taken once and they were both fine so there was absolutely no further intervention. Interestingly, on my notes the consultant put that it was to be treated as a normal non-diabetic birth. Whether this was because I was diet-controlled I don't know.

One thing I have since learned (after reading a lot about individual's GD experiences on here) is that the treatment protocols are very different depending on what area you are in, from what is deemed 'acceptable' blood sugar levels through to what happens at the birth! I think the main piece of advice I would give is to go to your consultant meetings armed with all your questions and preferences so that at least they know what you want to achieve, and hopefully they will factor that into the care they give you.

The diet advice is great. Sounds like I'm on the right track with the GI thing. I guess I'll just have to be more careful with portion control (my eternal problem!), substitute veg for large portions of rice etc and kiss goodbye to my beloved minstrels! One thing I've noticed, even in the short space of time I've been trying to follow this, is that I've hardly needed any heartburn medication. I reckon cutting out junk might save me a bit of money too.

brightonbleach do you eat snacks between meals? I was wondering how eating fruit would affect blood sugar.

If anyone has any tips re suitable exercise that would be appreciated. I find walking for a long time tends to give me a stitch under the bump so don't like to feel I'm overdoing it. I might take up aquanatal again.

Would be very good to compare notes on this along the way. Hope you're all having a nice bank holiday weekend.

lemontop I've noticed the drastic reduction in heartburn too which is great!

Have been testing really well (I think) and keeping within my limits since I started on Thurs but then yesterday after lunch and dinner I went way up (was 10.3 after dinner yesterday ) What was bizarre was that I had pretty much exactly the same meal as I'd had on Thursday lunchtime and only scored an 8 then. Have been keeping a food diary since I started to help me to understand what works and what doesn't.

Bit annoyed - the diabetic nurse when she gave me the monitor on Thursday gave me a pot of strips and a load of lancets, and told me that as I came to the end of them I would need to contact my doctor and get a prescription for more...What she didn't take into account was the bank holiday weekend! My surgerys policy for prescriptions is tha tyou have to GO IN (can't telephone) to request, then go and collect 48 hours later, so the earliest I can get a prescription for more is Thursday...Noticed on Saturday that I'm going to run out of strips by my next meal today, and out of lancets by tomorrow, so I'm going to have to go out and buy some to last until I can get a prescription - at a cost of £25