Support and help with Gestational Diabetes?

[Crapweasel]

Failed the "Lucozade test" last week, I've now been told that my GTT has also come back high and have therefore been diagnosed with Gestational Diabetes.

Having failed the Lucozade test but passed GTT during my last pregancy I was really hoping to dodge that particular bullet again. Oh well....

Did some searching in the archives and found this fab old thread with lots of support and tips on diet etc. Any current sufferers (or experienced old timers) fancy joining a similar thread for 2010?

I have a diabetic clinic appt on Tues (where I understand I'll get a finger prick testing kit and see a dietician) so I'll report back then.

I'm 29 weeks by the way.

[nessmay]

Just wanted to say as a type 1 diabetic (for 18 yrs) who is now pregnant with DD1, please try not to get too stressed about not having perfect readings all the time. Diabetics have a test called a HbA1c (not sure if this is done with GD) and it gives you your average reading for the last 3 months. My last one was 5.6, despite the fact that if you look at my book you'll see the odd 10-12 reading and even a few over 15! However careful you are your blood sugars can go up due to things out of your control (if you have a cold/flu for example your body creates more gluclose or readings can flutuate due to a change in temperature).

I know GD is treated differently, but this is probably because its likely that it'll go after you give birth so the docs/nurses/mw's are either really strict or don't care. If you were diagnosed with type 1 or type 2 you'd get a lot more care and advice cause your stuck with it for life!

Think of the positives, you get more scans, you're probably now eating a much healthier diet, you'll probably be booked in at 38 weeks so no scary surprises and in most cases, it will disappear after your bundle of joy is born. Please don't get scared of the large baby stories either, all the large babies I know of in the last few years (over 9lb) were born to mum's who were not diabetic.

[Crapweasel]

Hi Lou. Per my notes, risk factors for GD include family history and a high BMI. I think it would be very early days for you to be developing GD however it might be worth mentioning your symptoms to your GP as, if you have an underlying issue it would be best picked up early. Testing for GD usually isn't until 28 weeks. Congratulations BTW

Ness, thanks for your message. I know that we (I!) may appear to be moaning about what is hopefully a short term issue for us. What you say re averages makes perfect sense to me. I wish my clinic team would agree with you! When I pointed out that my readings may not stabalise immediately after birth as I'm on steroids which muck things up a bit they pretty much said "well we won't care so much once the baby's out" Charming , but perhaps re-assuring also

[nessmay]

Oh no cw, don't think anyone is moaning at all! I'd be exactly the same, in fact ask my dh, I moan a lot! I've probs become a bit blase about diabetes over the years though! I find you end up knowing more about how to control it than the experts do!

Now where did I put my family sized tin of celebrations?

[RubyReins]

Evening all.

So, update on today with the consultant! We (DH dutifully attended too) saw the midwives first who were very positive and kind. They said the heartbeat etc is fine and they didn't really talk about LO's size. I'm 31 weeks and measuring 33cm so I think that's big... Google will be my friend later no doubt. One midwife did tell me which bit of the baby is which - I found that really nice actually as up until now I've just been prodded and the resultant writhing mass is all a bit indistinguishable! I have another community midwife appointment next week and they told me to keep that as my midwife will want to be appraised and she'll be the one coming round to see me once LO is here.

So, then on to the consultant. She was what my granny would have called a "nippy sweetie"... I think she was miffed as I refused to allow her students to be in attendance. The thing is, I am reliant on hearing aids and if there are other noises in a room (rustling of paper, shuffling etc) then I get terrible interference on the old aids. DH is used to translating for me when I can't see someone's face etc. She knew that I can't hear well but spent most of the time talking to her screen. She's now worried that the baby is deaf too. Not something that has concerned me in the slightest and there are no indications that that will be the case either. We'll cross that bridge should we need to. Upshot is that I am on Metformin now and I need to see her weekly. I'll get more scans etc too.

What was interesting is that she said "there's no need to see a midwife now as you're seeing me now". I'm keeping my appointment though as even if I do have to be induced (which is her plan) I doubt she'll be the one mopping my brow or checking on me a few weeks later to see how things are! She did say that she won't "let" me go to term. I said that we'll take it on a week by week basis and I'll listen to her (provided she lets me hear her! ) and take on what she has to say but that the decision is mine.

I'm not really sure how I feel now. I definitely don't want to be induced - I have my reasons - but she seemed pretty insistent that that was how it was going to go. We'll see how the metformin goes. Hopefully that will control my bonkers readings and I'll be trooping up to the labour ward under my own steam!

I guess we'll see!

Hope you're all well.

[ChocolateCalculator]

Ruby, sorry to hear that your consultant wasn't great. Although hopefully the metformin will help your sugars calm down a bit.

I think you probably start to get your head around the possibility of induction as although by no means inevitable it's probably pretty likely for all of us.

Ness, thanks for putting it all into perspective. I do feel fortunate that this is just a temporary restriction, although the prospect of future type II does loom large.

[RubyReins]

Ach it'll be fine!

I am getting my head round induction and I know I have to keep my options open. It's really just my hope that it won't be inevitable.

She was a bit on the nippy side but then I will see her six times or so between now and D-Day so hopefully a rapport can be built.

I don't mean to complain; I am a staunch supporter of the NHS having been in and out for various things over the years. I was diagnosed on a Wednesday, seen at the clinic on the following Monday and am now under consultant care a week on. Can't fault them, I just wish it was all slightly more human and sympathetic...!

[MammyG]

Hello All
Just a query for now. Am 19 weeks and had sugar in urine and reading of 5.5 Wont have glucose tolerance test until may 13th. How likely is it that I will actually have GD? Is there anything I can do at this stage to prevent it? All advice appreciated. I already have a gallbladder problem to contend with so am worried about developing GD too.

[ChocolateCalculator]

MammyG, I'm afraid I have no idea how likely it is that your GTT will show up GD. Obviously sugar in your urine isn't ideal, but it could have been caused by whatever you had last eaten.

Unfortunately there is nothing you can do to stave off GD, but try not too worry too much. If you do have it then it's a pain in the neck, but it's really not the end of the world.

Good luck with the GTT, and remember to come back and join us if the results don't go your way!

[MammyG]

Thanks Chocolate
Will keep following whats going on and let you know after 13th.

[RubyReins]

Hiya.

Just writing with an update. Been on metformin for almost a fortnight now and my levels were all over the place for a few days (ranging from 4.5 - 12.8 ), but it's all calmed down now. I had a before dinner reading of 3.7 tonight which had me jumping about like an idiot. Had to have a sit down after that!

Hopefully things will stay that way for the next 7 weeks.

Hope you're all well.

[ChocolateCalculator]

Ruby, I was only thinking yesterday that this thread had gone a bit quiet! Glad to hear metformin is working out for you, gives me hope that I will be able to stay off insulin even if I don't manage on diet alone. I'm less confident about being able to manage on diet as I had an odd day last week where my sugars went haywire for seemingly no reason, spiking up to 9 when I hadn't eaten then an hour later down to 2.8! I'm 23 weeks now, so still a long way to go if things like that are going on. Got my next appointment with the midwife a week on Tuesday so planning to mention it then.

How much longer has everyone else got left?

[burmesegrumbler]

Hi Ruby,

Good luck, sounds like you have been put on a bit of a roller coaster! They do seem to like to make us feel like we are going to damage our babies.

I was diagnosed with gestational diabetes at 36 weeks with a OGTT result of just 8.2 - on a day when I was very stressed (I have since read that anxiety increases blood glucose). I have also read there is no mandate for diagnosis of GD beyond 28 weeks, as there is simply no data to compare 'normal' results and 'GD' results this late on (which even the diabetic consultant I have seen admitted). I have been reading articles by Michel Odent and Henci Goer which have really helped to put my mind at rest about the health of my baby. Suggest you google them for some alternative views on GD and birth.

I am currently 38 weeks and despite the OGTT result, my home birth was approved by the senior consultant obstetrician at 37 weeks. I have been self monitoring my blood glucose four times daily since the diagnosis (no medication required) and all have been absolutely normal without any diet changes, asides breakfast (when your body is naturally less sensitive to insulin - as stated by my diabetes consultant at my appointment). So, my usual breakfast of yoghurt and lots of fresh fruit is out (even though the highest reading is 8.1) and I have switched to eggs or honey on seedy brown toast (any cereal, low GI or not sends me over - which I think is due to the lactose in the milk).

The diabetic consultant reviewed my self monitoring two days ago and seemed really happy, said I was very much a borderline case and did not fit the GD profile, but said as I wanted a home birth, best to keep up the self monitoring so that even during labour everyone can be confident the baby will not be affected by either a surge or drop in blood glucose. I was advised on the best snacks during labour to keep my blood glucose constant (nuts, oatcakes, cheese and small pieces of fruit chopped to be taken in moderation).

Despite it being an irritation to continue self monitoring when all is well under control, and given my baby is not large and no other health issues are present, I thought best they stick needles in me on the run up, rather than in my baby when she so chooses to arrive.

Immediately after that appointment I saw the obstetrician who's opening line was, 'as you have gestational diabetes and so we will need to induce you next week, as we will be inducing you you will not be able to have a home birth, your birth will be on the labour ward, we will use a gel (since read this gel is made of pig semen - nice) to induce and if nothing happens within 8 hours your waters will be broken and we may have to put you on a drip of pitocin and then oxytocin'. You can imagine my response given the senior obstetrician had approved my home birth the week before and the diabetic consultant was happy and my growth scan was absolutely normal - right on the centre curve. Through my tears I raised my concerns on induction leading to more intervention (forceps, ventouse and ultimately C- section) he agreed that yes induction did have a higher risk of intervention, but also said allowing a woman with GD to go full term has an increased risk of still birth. Research I have read says only pre existing diabetes and GD along with several other health issues can cause this increased risk, but not GD alone. If anyone knows of any recent research (the only research I have found is 2004 or older) which states otherwise, I would be happy to have a read, so please post links.

DH told him 'well that is simply not going to happen' and we walked out of the appointment. We bumped into the consultant midwife who saw our distress and took notes on what had happened.

30 mins later my midwife rang to say they had just taken an emergency meeting and my home birth plan was still approved by the senior obstetrician in charge of the entire anti-natal department and that she would arrange for me to meet her at full term to discuss options if I go overdue - but that in the meantime, nobody should be talking to me about induction (she also mentioned even if that was the advise I was given at full term, sweeps should be offered first, so a home birth or birth centre option would still be viable) and she would now attend my remaining anti natal appointments.

The NHS is full if 'routine' and box ticking, those of us that fall outside of boxes make life tricky for obstetricians. My advise is always ask for a second opinion, always ask for the name of medication they want to use on you, always ask for the titles of the publications the research their advice is based on. The advice on offer may still be right for you, but at least they know you will not be dictated to and you will make an informed decision that is right for you and your baby, as nobody wants a healthy baby in their arms more than you. We are mothers to be, not ticking bombs and should be treated as humans, not breeding cattle.

[RubyReins]

Wow - what a treat your obstetrician sounds... Mine is a bit of a cow too - very much into the box ticking exercises as you say.

There does seem to be a lot of conflicting information whirling about with respect to GD. My ob was of the view that she would induce me at 38 weeks and went on about "not letting" me go to term. She didn't go into the details but I am pretty up on the induction process - I had to be well briefed on it for my old job. My midwife certainly does not share her concerns and neither do the diabetes consultant or the diabetes nurse who I speak to regularly. The midwife sees no reason why I shouldn't go to term and as my levels are all ok now albeit with the help of medication, neither do the other health professionals I see.

I too have worries about induction. The ob rolled her eyes when I mentioned the "cascade of intervention" but my midwife told me that I was within my rights to be concerned. The midwife, who apparently once almost cam to blows with this doctor has had my next appointment rescheduled with another ob. She said that she's not what I need which is interesting.

I do agree that we are seen as ticking time bombs frought with latent danger. My cousin is a doctor and she whittered on about having ELCS for both of hers as it is her belief that birth is too dangerous. I think she had witnessed very high risk births during her training which had tainted her view. Midwives are experts in normality and with the exception of this whole sugar thing my pregnancy has been absolutely fine.

I do like the idea of asking for the research they are basing their opinions on. That's a very powerful question to have in your armoury. I'm a (reasonably!) bright lass, although my brains seem to be leaching out of my ears of late, and I am perfectly capable of understanding such research - the ob did treat me as though I was very stupid.

The very best of luck with your home birth! And in the meantime tell them to keep the pig spunk to themselves

[burmesegrumbler]

Thanks Ruby, had a 'clearout' and a I think a 'show' yesterday, not sure though...hoping this means DD1 is on her way soon, with luck before my next anti-natal appointment so I can just get on with labour without any more stressful meetings with obstetricians!

[RubyReins]

Fingers crossed!

[Crapweasel]

Hello all . Good to see we're all hanging in there.

Well, I met my first arrogant bully consultant a couple of weeks. Do I get some sort of badge? . He waltzed in whilst I was finishing up with one of the registrars "Yes, I know it's protocol to induce c. 38 weeks. Yes, I'll wait until the 36 week scan before making any decisions. No I don't have any questions...." and proceeded to go on about my increased insulin units (which are now completely controlling my blood sugars thank you); my being hypothyroid (also completely controlled) and insisting I see an aneasthetist ref. steroid cover in labour (I'm on steroids due to arthritis and it's probably these that have caused/aggravated the GD). So now I'll probably have to have a canula for that too .

He was happy to throw about the risk of still birth but wouldn't give me any actual facts/figures.

On a positive note, I had my 36 week scan yesterday and baby is growing perfectly along the 50th centile line and is on target to be a good 1lb lighter than his (non-GD) sister so that's one thing on my side.

Back to the clinic on Thurs so should get some decisions then I expect. I don't expect to be "allowed" to go to term but I do want to explore options re monitoring/possible sweep etc before going straight for the pigs semen

Good luck burmesagrumbler - labour vibes coming your way.....

[burmesegrumbler]

Still waiting.....on the raspberry leaf tea........

Had an anti natal appointment with the diabetic consultant and the consultant obstetrician yesterday and had a tour of the labour ward so I know what to expect if that's where I end up.

Diabetes, fine, haven't had a single high reading (without having to change my usual diet at all,other than not eating lots of fruit and yoghurt in the morning, but spacing it out during the day and having toast for breakfast). Still continuing to monitor so they don't need to test my baby blood glucose levels after she is born, if my levels are fine, there is no reason why hers wouldn't be.
My six week overview blood test showed no increase blood glucose overall. I still believe a GD diagnosis at 36 weeks is ridiculous, all women suffer from lack of insulin sensitivity in the last few weeks due the pressures of pregnancy and the fact I have it under control effortlessly seems to tell me I don't actually have a problem.

Told the obstetrician I did not even want to discuss induction until I reach my due date (22nd May), she seemed Ok with this but outlined the risks again and suggested I read the NICE guidelines www.nice.org.uk/nicemedia/live/11946/41320/41320.pdf
I have read them in detail and concluded there is still no evidence that my case shows any increased risk as my baby is not large and I do not have insulin dependent diabetes. The biggest risk for me it would seem is an early delivery and the possibility of respiratory problems associated with early births, so in my view she is defo better in than out at this stage.

I have requested a growth scan and fluid check at 40 weeks, if everything is still going well, I will continue to decline induction, if not I will agree to a sweep and then still try to give birth naturally at home, if that fails, I will think again.....I just want to give her the chance to arrive wen she is ready, rather than force her out.

It's been a very emotional journey for me as my sister in law had a still birth nine months ago (nothing to do with diabetes - it was an umbilical cord issue that nobody could have foreseen), so every time a consultant plays the risk of still birth card, I am left in pieces, doubting my own gut feeling, that my baby is fine, I am fine and I can do this without intervention.

I do strongly feel that the best thing for any woman at this late stage is to be feeling happy and confident with her choices, not anxious, thank goodness for my midwife, she always puts me back on track when I am having doubts and thinking, let's just do a CS and get her out safely now.

Hope you are all coping Ok and have sterling support from your MW?

[Crapweasel]

Any sign of labour yet burmesegrumbler? I know I'm not an expert but I'd have to agree that if you can control your levels and still eat toast (my personal nemesis!) in the AM then your diagnosis seems a bit severe.

Well, I had my consultant appt on Thurs which didn't get off to the best start when her opening remark was "I suppose we will just book you in for your 38 week induction". To cut a long story short, we have compromised with requesting the community midwife to do a sweep at 37 weeks (my appt will actually be at 38+1) and then for me to have another scan and consultant appt during that 38th week (with a view to booking in for an induction then if I haven't requested it by then via my midwife ).

I'm not radically against induction at some point before term but I'd like to see if we can get things moving a bit more "naturally" first. I am on insulin but baby is growing well and the risks that were thrown around on Thursday were more around shoulder ddystosia (which doesn't ring true to me with a projected term weight of under 8lb when I've previously successfully delivered a baby of 9lb 2oz). It goes without saying that anything is better than stillbirth but I do still feel that my physical and mental experience of labour should carry some weight even though the baby will always come first.

How are the rest of you doing? Ruby? Chocoloate? You still round?

[ChocolateCalculator]

I'm still here and getting very jealous of all this talk of babies actually being born! I'm at that annoying stage of pregnancy where it seems like I have been pregnant forever, but still have forever to go. Also been craving sweet stuff for the first time this pregnancy, am so looking forward to being able to eat normally again.

Burmesegrumbler, I have to agree that what you're describing doesn't sound that much like GD to me. I've also heard that insulin resistance is a problem for most pregnant women towards the end. Sending you lots of labour vibes!

[RubyReins]

Hi there

Yup still here. I had another appointment with the consultant today - a different one from last time thank god! She noted that the other doctor had said that I should be induced at 38 weeks but she disagreed. She said that there is no point in inducing before you at least have a chance at being ready. She said that she would not even consider it until my due date so that's positive. The baby is "normal" sized and my sugar levels are all within range now so she's not worried. I will have to have continuous foetal monitoring which is a bit disappointing but they have a few "remote" ones that mean you are not tied to the bed and its immediate environs.

Feel a lot more positive about it all. I do agree that the mental aspect is very important too and I think that the doctors don't see it as being as crucial as the midwives do. I am brewing lots of aromatherapy oil blends to assist on that front.

Operation Get Baby Out will start in earnest in four weeks! Crates of pineapple, vats of curries and DH on a nightly promise.

Glad we're all hanging in there.

[burmesegrumbler]

I have been pregnant FOREVER! It's official!

At least the weather is nicer now and there are loads of lovely salads to be made that won't send levels up!

Ruby, really glad to hear your new consultant is happy about you going to term!

Watch out for the pineapple -it is sugar loaded! I cut it up into chunks and eat one an hour, along with my raspberry leaf tea......still waiting, even after a curry fest overt the weekend (freezer is now full of tasty homemade curries!).

I have bad lower back pain and pain across my pelvis and period like cramps, please tell me these are all signs she will be making an appearance soon?

[negrilbaby]

Need some help here. After a slow start it looks like my GD is hitting fast and I'm running out of ideas about what to eat. What can I eat for breakfast? I had boiled eggs this morning and one pitta bread. I thought I'd be fine because I'm usually very active in the morning - getting 2 year old up and to nursery and then on to work myself. My sugars were way up though an hour after eating.
Can't really cope with pasta, bread, rice or potatoes so my evening meals are getting rather boring - lots of salads.

I looking for some inspiration - 7 weeks to go and need all the help I can get!

[Crapweasel]

I've been a bit naughty and cancelled my clinic appt for today. No change to my sugar levels, no clear plan for an induction - it just didn't seem worth it.

Have the midwife booked in to give me a sweep a week today (sadly have a funeral on the Monday and don't want to be worried about things happening during that) so am keeping my fingers crossed that I might get my spontaneous labour after all. The thought of sugar in pineapple had occurred to me too - the last thing I want is to go into labour and then be shoved full of insulin because I've overdone the fruit! Curry and raspberry leaf tea both definitely on the list though.

Chocolate, I do feel for you. At least a diagnosis at 29 weeks means I "only" have 10 or so weeks of these restrictions. Hang on in there.

Ruby, yey for your consultant. CFM does seem to be fairly non-negotiable doesn't it . If my labour is anything like my last (ie v. fast and intense) then I'm not so worried about moving far from the bed but I would hate not be able to move around the bed as last time I just HAD to be on my hands and knees during a contraction (although I actually delivered on my back). I used the pool for pain relief last time which was fab but that's out of the water (no pun intended )

Burmese, yes those all sound like VERY promising signs. In fact, you could be in labour at the moment I suppose....

Negril, are your levels up all the time or are you struggling with breakfast in particular? Mornings are my very worst time. By the evening I can tolerate rice/pasta/new pots in reasonable, though not large quantities.

My diabetic nurse would have loved me to have stuck with bacon and eggs every morning but that just isn't me (in fact I don't eat meat so a double no). I've found pitta very "carby" - even the food doctor seed one. You might find one slice of wholemeal bread or one of the vogel/Bergen soya and linseed breads keeps you under the radar. Otherwise, the tip I had on here for Lizi's granola is currently working for me. I have 1/2 grapefruit, 35g granola with a couple of spoonfulls of greek yoghurt (oh, and about 14 units of insulin ) most mornings and am generally fine. It's amazing how different the readings can be though. And on an "active" morning they can sometimes be higher - really frustrating.

Take care all.

[negrilbaby]

Thanks for the advice. I have tried the granola but I have problems limiting myself and have ended up getting through two packets in a week - and its not cheap!!!
I'd quite happily have bacon and eggs in the morning but it seems a bit mean when DS is having his weetabix!
I think part of the problem is that I'm feeling really hungry most of the tme - so am not good at limiting portion size. I've managed to cut out all sugary snacks and cakes - so I have actually started losing weight, although with an ever increasing bump.
I have a growth scan booked for 36 weeks and need to make a decision about an elcs after that. DS was emergency cs - mainly because of his size and my ftp. At the moment I am leaning towards asking for one. My birth experience was horrible last time round, very medicalised with constant monitoring and flat on my back. No reason to believe it would be any different this time. They keep mentioning the danger of still birth given my age (43) and I find my ability to express my opinion flies out the window when they play that card.

[Crapweasel]

at the granola consumption. When I said 35g I meant just that - I have to weigh the damn stuff out in advance or I'd be just the same.

The single dietician I've seen was very scournful of all types of "pouring cereal" for that very reason. I think she'd have had a heart attack if she'd seen my actual bowlful of cereal pre-diabetes . You might find that you can tolerate weetabix? I could for a while though had to go down from 2 to 1 1/2 before I gave up.

I've lost weight too and, unless you had a high BMI to begin with "they" don't tend to like this.

Don't forget that you can/should eat between meals. Good snacks for me have been cheese, nuts and a fab chilli seed mix that I've found in Tesco. 1-2 Oatcakes are also apparantly OK. I've also been eating a mid morning snack which is generally a banana.

I see what you are saying about a cs. Personally I'm desperate to avoid one but my first labour was very different to yours. You have time to decide though. And there are very definite advantages - especially second time around.