Another gest. diabetes ??- my blood sugar numbers. Help?

[I.Dup.]

I bought a glucometer even though my midwives were not concerned with my 2 hour number last week, it was 132 2 hours after a big meal (with dessert). I was concerned though, so I bought a monitor just to see what my BS is doing. I'm wondering if someone with experience can tell me if these numbers are terrible, or if they could be within the normal range since insulin is *supposed* to be blocked by the placental hormones, anyway????

 

121- 1 hour after a steak/potato dinner

142- 1 hour after ice cream/sweets

100- after 11 hour fast

118- 1 hour after egg breakfast

166- 1 hour after a large candy bar

98- after 10 hour fast

177- 1 hour after dinner of chicken breast and brown rice

132- 2 hours after same dinner.

 

The 177 seems really high to me, esp. since I tested my husband (who is overweight and ate twice as much as I did) and his blood sugar after that dinner was 95 at the hour mark. :001_huh::001_huh:

 

I am confused about whether or not I should be concerned b/c I thought blood sugar was supposed to be higher during the last trimester since the baby is putting on weight and the placenta is supposed to be blocking insulin, anyway? Also, I did not start testing until 30 weeks, is there a reason they have the cut off between 24-28 weeks? Does blood sugar naturally go up a bit higher after that?

 

Thank you for any help. :(

[chanda7]

Your numbers would not be considered "normal." Your fasting numbers are borderline high, 1 hour after meals need to be under 140 and 2 hours after meals need to be under 120. You could probably get your after-meal numbers down by adjusting your carbs, but it is a lot harder to bring fasting numbers down. If the fasting numbers go regularly over 100, most doctors want you on insulin.

 

I'm not "plus-size," but I found some of the best information at this site: http://www.plus-size-pregnancy.org/gd/gd_index.html. A sample diet plan is http://www.plus-size-pregnancy.org/gd/gd_nutrition.htm.

[Leav97]

Those look on the high side. Sometimes having something to eat in the middle of the night will bring down fasting #'s.

[happypamama]

Those sound a little high in general, but you might be able to bring them down. With the fasting numbers, you might examine what you're eating the night before. A friend of mine (full diabetic) said that absolutely, a high sugar evening can affect your next morning's readings, even that many hours later. It's been a little while since I was testing my sugars regularly, but unless I've eaten ice cream/sweets before bed, my fasting numbers are in the low to mid 90s.

 

My 1-hour numbers after eating egg breakfasts are more like 90-110. Otoh, the other day, I ate an egg fried in butter and a muffin for breakfast, and then I was feeling icky a while later (maybe an hour or 1:30 later), so I took my BS, and it was 170! Okay, clearly, carbs for breakfast are not my friend. When my BS is running high, I feel woozy, shaky, dizzy, kind of faint. Not fun. I feel best when I eat mostly protein and good fat for breakfast (veggies, like in an omelet, optional; last I checked, I could also handle a smoothie of plain unsweetened yogurt, banana, and berries too, without my BS going up too high), and when I drink a lot of water early in the day too. My friend said that her doc told her that if she had a few days of high numbers to have a few days of drinking water and peeing as much as she could. Also, she said that taking a walk after high-carb meals helped keep her numbers low, but I'm not generally up and moving early enough to do that before it gets too hot. :)

 

The 177 seems a bit high to me, but I think it would matter more if that was a one-time sort of thing, or if it happened regularly with that sort of meal. My body definitely does better with carbs like brown rice in the afternoon/evening than in the morning, but my midwife says it's really about seeing what works for *you* and that everyone is a little different.

[wapiti]

Yep, they look too high to me too (I had to be under 90 for fasting and under 120 two hours after a meal).

 

No more candy bars. Try a Zone bar instead - I get them at Target (Target also has a slightly cheaper generic version of these bars, and I think they taste better - not as hard).

 

What I had to do for my GD: limit carbs at breakfast to under 30 gms. Balance everything with fat and protein, i.e, no carbs without protein and fat. A bedtime snack, usually something balanced like a Zone bar, will help with your fasting numbers. And do the fasting prick first thing when you get out of bed. Make sure you wash your fingers first.

 

Eat some (healthy) fat with your chicken breast (maybe olive oil or avocado), and only brown rice, not white. (for convenience, there are bowls of cooked brown rice available at Costco - I can never wait long enough for the stove top kind LOL)

 

What was together with the egg breakfast? I'd aim for a balance - lots of protein, a little carbs, and some fat. Don't ignore carbs like jelly on toast (loaded).

 

And benefit from my experience: no pancakes until the pregnancy is over. period. :tongue_smilie:

 

I'd say it is NOT that blood sugar is supposed to be higher in the third trimester, as much as blood sugar is harder to control in the third trimester. And then all heck breaks loose with the blood sugar numbers when labor is imminent (or so it seemed LOL).

 

I would assume a diagnosis of GD at this point, and ask your midwives to recommend a visit to a nutritionist. Keep checking your blood sugar, though I only had to do it 4x per day (fasting and two hours after each meal). ETA: two hours after each meal means you must not eat a snack until the two hour period expires and you do your test first. The timing starts at the start of the meal. This itself kind of forces you to space apart your meals and snacks better. Definitely be sure to eat morning and afternoon snacks, of a balanced variety. I can't stress that enough. Cheese is your friend. Bagels are not your friend, even with butter and cream cheese. Count carbs by looking at boxes and subtracting the dietary fiber from the total carbs, and keep to portion sizes so you know your counting is correct.

 

Anecdotally, fasting and breakfast are often the more difficult times for keeping under the limits, so if you're busting through the limits after dinner, then I think you're going to have to be very careful with your diet here on out.

 

That's my two cents :)

Edited June 24, 2011 by wapiti

[I.Dup.]

Ugh I'm so confused. I met with my midwives who had a midwife visiting from Saudi Arabia. She has cared for over 3,000 patients over there, I just got back from my appt. I showed them my numbers and they said that is totally normal. The guidelines the more experienced midwife has is 155-180 1 hour postprandial, and less than 155 2 hours postprandial. She said the more accurate measurement is to test hourly after eating, to make sure the numbers consistently drop down, and mine do. They said they weren't concerned at all about my numbers and that I def. do not have GD.

 

I am going to try not to worry, but I will be careful and make sure to get lots of protein.

[wapiti]

Ugh I'm so confused. I met with my midwives who had a midwife visiting from Saudi Arabia. She has cared for over 3,000 patients over there, I just got back from my appt. I showed them my numbers and they said that is totally normal. The guidelines the more experienced midwife has is 155-180 1 hour postprandial, and less than 155 2 hours postprandial. She said the more accurate measurement is to test hourly after eating, to make sure the numbers consistently drop down, and mine do. They said they weren't concerned at all about my numbers and that I def. do not have GD.

 

I am going to try not to worry, but I will be careful and make sure to get lots of protein.

 

Hmmm, that's confusing. Definitely get protein, but remember the key isn't just the protein itself, but making sure you don't eat carbs without eating protein and fat at the same meal. That helps smooth out the affect on blood sugar levels. Balance :). And still no candy bars :D

 

If I had those numbers, my OB would have had a cow, so to speak. He likes very tight control.

 

Hope the rest of the road goes smoothly!

[I.Dup.]

Thank you!! I hope so too.

[5Wizards]

 

If I had those numbers, my OB would have had a cow, so to speak. He likes very tight control.

 

Hope the rest of the road goes smoothly!

 

:iagree:

[chanda7]

For what it is worth, I listened to a podcast with a specialist on gestational diabetes. The doctor said anytime your blood sugar goes over 135, your baby is getting "snacks" that it doesn't need. Generally in diabetes, I've read that blood sugar over 140 starts doing damage to your body.

 

There are more dangers to gestational diabetes other than your baby getting too big (or possibly too small). For example, your baby starts making insulin to help you, and then the baby becomes temporarily hypoglycemic after birth.

 

Gestational diabetes isn't necessarily anything to "worry" about, but I wouldn't blow it off either, especially based on the information you have given.

[Heather in WI]

Ugh I'm so confused. I met with my midwives who had a midwife visiting from Saudi Arabia. She has cared for over 3,000 patients over there, I just got back from my appt. I showed them my numbers and they said that is totally normal.

 

I had GD with my last pregnancy. It isn't something to ignore. Have you met with an endocrinologist or nutritionist? I'm sorry, but your numbers are high. I would get a second opinion to your midwife.

[I.Dup.]

For what it is worth, I listened to a podcast with a specialist on gestational diabetes. The doctor said anytime your blood sugar goes over 135, your baby is getting "snacks" that it doesn't need. Generally in diabetes, I've read that blood sugar over 140 starts doing damage to your body.

 

There are more dangers to gestational diabetes other than your baby getting too big (or possibly too small). For example, your baby starts making insulin to help you, and then the baby becomes temporarily hypoglycemic after birth.

 

Gestational diabetes isn't necessarily anything to "worry" about, but I wouldn't blow it off either, especially based on the information you have given.

 

Yeah, and I have heard the exact opposite. That is what is so confusing, no one can agree and the protocols for pregnant women have recently been lowered dramatically, even from non-pregnant diabetics which makes no sense considering our placentas are making hormones specifically to block insulin so the baby has a constant source of blood sugar. I have heard that insulin does not cross the placenta. I have also heard that babies experience blood sugar crashes after birth because of extreme uncontrolled "true" diabetes- swinging from the 300's down to the 50's, etc.

 

Not blowing this off, just trying to get the true information.

 

I totally understand some doctors freaking out about numbers, because of the information they are getting. While there are many, many other doctors who do not freak out because they know the role of insulin during pregnancy, how it is inhibited, and that higher blood sugar levels are common and a normal part of a healthy pregnancy. This is where things get so confusing.

 

I had GD with my last pregnancy. It isn't something to ignore. Have you met with an endocrinologist or nutritionist? I'm sorry, but your numbers are high. I would get a second opinion to your midwife.

 

I have not been referred to either one, however I am meeting with a family practice doctor on Tuesday and will show him my numbers. I'm sure if he is concerned, he will refer me.

 

Your numbers would not be considered "normal." Your fasting numbers are borderline high, 1 hour after meals need to be under 140 and 2 hours after meals need to be under 120. You could probably get your after-meal numbers down by adjusting your carbs, but it is a lot harder to bring fasting numbers down. If the fasting numbers go regularly over 100, most doctors want you on insulin.

 

I'm not "plus-size," but I found some of the best information at this site: http://www.plus-size-pregnancy.org/gd/gd_index.html. A sample diet plan is http://www.plus-size-pregnancy.org/gd/gd_nutrition.htm.

 

The numbers you quoted are the same numbers I've heard as well and find all over the internet, but it's weird because those numbers are LOWER than non-pregnant diabetics...? During pregnancy we have hormones specifically blocking insulin so you'd think they would factor that in to the numbers...? That is the same thing I found in the links you provided, there was no factoring in for pregnancy insulin resistance (normal) and the numbers are even lower for us.

 

I will keep searching and being careful, for sure. THanks for the advice.

[I.Dup.]

Here's an article that agrees more with what my midwives are saying, it's from Tom Brewer of "the Brewer diet". http://www.drbrewerpregnancydiet.com/id33.html

[Heather in OK]

They are a little on the high side. BUT, if you look at the numbers with what you ate before checking, it doesn't surprise me. That highest one you are concerned about, your body may not respond well to the starch in the rice later in the day. You need to improve your diet just a bit. When you do that, you will probably see better numbers.

 

You have some good proteins. But with those proteins are you eating a vegetable? The protein needs a veggie to help break it down.

 

And yes, the sweets are an occasional treat.

 

I'm on the fence about Brewer. My view is a special diet isn't needed. Good nutrition and exercise will, in most cases, prevent a good deal of pregnancy/labor/birth related issues (GD, PreE, placenta health, healthy third stage, etc). When I say "good nutrition" I mean 70-90g protein/day (making sure you have a serving at breakfast and before bed), fresh or frozen vegetables and fruits, whole grains, complex carbs, 1/2 of your body weight in ounces of water each day (water or pregnancy tea; I don't count milk, juice, etc. The body needs water), eating every 2-3 hours, occasional "goodies" (everything in moderation :)), and very little to no processed foods (the placenta will tattle on a woman if she's been eating a diet high in processed foods, among other things).

 

Don't stress about it!! Make small changes each day, don't try to do it all at once. :grouphug:

[chanda7]

Here's an article that agrees more with what my midwives are saying, it's from Tom Brewer of "the Brewer diet". http://www.drbrewerpregnancydiet.com/id33.html

 

For the record, I am a "crunchy" momma that supports natural childbirth, as few interventions as possible, etc. I read every study on pubmed I could find on gestational diabetes when I started headed toward that diagnosis. I've been living with it for the last 5 months.

 

However, most of that information from the article you linked is around 30 years old. I wouldn't discredit it because of the age, but I would consider that when weighing it against other research.

 

Yes, the placental hormones block insulin, but the normal pancreas can make more insulin so it isn't a problem. If someone has gestational diabetes, it is because their pancreas cannot keep up with the increased demand for insulin. Once again, the numbers are lower than for non-pregnant women because normal pregnant women usually have lower blood sugar than when they are not pregnant.

 

Whether taking insulin to control diabetes crosses the placenta and whether the child manufactures insulin to help control your blood sugar are two different issues. I could be wrong, but I don't think there is any question that the baby can make too much insulin if your blood sugar is high. It is one of the reasons natural childbirth supporters recommend against a glucose IV.

 

I do think some doctors go WAY overboard on treatment of gestational diabetes, particularly when it is only a borderline case. Overly strict control of weight/blood sugar does not show positive outcome for the babies, and an abundance of testing and worrying about a "large" baby can lead to unnecessary interventions. I still think the research shows there are real concerns there, though.

 

Good luck with your research and however you decide to proceed. Wishing you a happy and healthy pregnancy. I'm expecting my little one at any time :)

[Pink Fairy]

Personally, I think your numbers look high. I've had GD, and am now considered full on type 2. I have had two miscarriages in the past year, likely related to undiagnosed type 2 diabetes. This is a book that I have found tremendously helpful in explaining what the different numbers mean, before, during, and after pg. Frankly, diabetes and pregnancy is nothing to mess around with, especially for the health and well being of your baby, and I wouldn't be satisfied with your midwives' response to your numbers.

 

Best wishes to you and your little one!

[I.Dup.]

However, most of that information from the article you linked is around 30 years old.

 

Yes, and the funny thing is the standards for pregnant woman's BS levels have just continued to decrease. It's bizarre, considering non-pregnant people do NOT have hormones that specifically block insulin..we do, and yet our levels are supposed to be lower than theirs. :confused:

 

Good luck to you too, and congratulations on the soon birth of your little one! :)

[Guest samsonkc]

This went longer than I expected, but I hope it helps:

 

I am 8 months into my 4th pregnancy, my third with Gestational Diabetes. I can't tell you what to do but I can repeat what I have been told (by the endocrinologist I was referred to at the start of each new pregnancy).

 

If my numbers were the same as yours I would be getting all manner of grief about needing to change my diet or my medication level to get them in control. My doctors' goals are to keep the glucose in tight control and prevent me from having a giant baby who has difficulty controlling his blood glucose level-- and I don't want a c-section so I'm all for these goals. :001_smile:

 

My meal targets are

overnight fasting- minimum 4 hours no food- in the 80's-- never over 95

1 hour after meal- start clock when finished eating- never over 130

 

to maintain this I aim for

breakfast- 10-15 carbs

lunch/dinner- 45-60 carbs

snacks 15-30 carbs

 

I was able to maintain my target numbers until week 28 using only diet. Then I required Glyburide for overnight fasting, now at week 36 I also require glyburide with dinner to maintain my targets.

 

I have several friends who have had GD and each of us had different foods that trigger an abnormal high (as in the carb numbers were right for the meal but we still tested high). My triggers are anything white- white flour, white rice, white sugar, and high fructose corn syrup. Any amount of HFCS will cause my numbers to be off for 1-2 days after. Once I cut that out my numbers stabilized. My friend found she couldn't eat any dairy for breakfast or she would be high. The easiest way to identify problem foods is to keep a food log with your glucose testing and watch for a pattern to develop.

 

I have found, by watching for patterns, that if I have a high fat, high protien, moderate carb snack around midnight my numbers in the morning are in the 70-80 range. But if I skip the snack, don't sleep well, or sleep later than 8:30 I can easily hit 100. I'm not saying that it will be true for you but that by using a log you can identify what is causing a high result and fix it naturally.

 

If you don't want to fight your midwife you can easily just implement the diet and see if your numbers are controlled that way-- that worked for my first pregnancy with GD. You can find carb counts on boxes, bags, and several websites online for natural foods(fruit/veggies...) that don't have labels. Then just measure, keep track, test your blood and go from there. The insuline blocking will continue to increase until around 36-37 weeks. Then it tends to plateau and you should be fine to the end if you maintain what is working at that point. After I delivered my body was back to working normally in 12 hours (but-- if you are borderline gd now or you have gd full force you are at a greater risk for type 2 diabetes later in life, so you need to monitor your health, diabetes can sneak up and cause horrible permenent problems before you realize it if you aren't proactive).

 

I hope this helps-- I was so lost the first time I had GD! I wanted to take care of me and the baby but some things I was told were just wrong --NOT all carbs are equal- my first dietician told me 15 carbs of a snickers bar was the same as 15 carbs of apple and both would effect my body the same way- ya, right. Other things were misleading- you don't need to eat every 2 hours even if your not hungry- you and the baby will not starve. I spent the first 3 months of my next pregnancy practicing controlling my numbers when the baby wasn't influencing me that much, which gave me the confidence to follow some advice and ignore other advice. Now with this pregnancy I finally feel like I understand what I need to do and I know when I need help doing it. I hope you get to that point too!

 

Elizabeth

[sarah1615]

I don't think checking your numbers for one day will tell you the whole story. Glucometers can be off by up to 20% for any given reading, which means that 177 might actually be 141.6 (of course, it could also be 20% higher than you saw too). Also did you make sure your fingers were totally clean before checking your number? That will affect you numbers too!

 

If I were you, I would keep a log of your numbers for a few days and see if you're consistently getting higher numbers. Then bring all of that info with you to your midwife.

 

I had some randomly high numbers with my last pregnancy, but it wasn't really consistent so I just had to watch my diet, do random glucose checks and had a couple extra ultrasounds.

 

Best of luck!

[Susan in TX]

I currently have gestational diabetes and yes, your numbers are high but should be able to be easily controlled with a few changes to your diet.

 

I was told that my numbers need to be under 100 for fasting, and not over 120 two hours after a meal or 140 one hour after a meal. The reason why these numbers are stricter for pregnant women than they are for non-pregnant diabetics is because there is a baby involved. The medical community believes that even slightly elevated blood sugar levels in a pregnant woman can cause bad outcomes for the baby. I think they are erring on the side of caution.

 

Based on what you ate and the numbers you got, I'd say that you should stay away from candy bars and brown rice. For me, I eat about 15g of carb for breakfast (unless it is a Luna bar. For some reason they don't raise my blood sugar levels too high.) and under 40g for lunch and dinner. So just watch your carb intake and remember that even "good" carbs such as brown rice can cause blood sugar levels to spike. I also eat a high protein snack with about 20g of carbs right before bed: 1 cup of 0% Greek yogurt with about half a cup of fruit.

 

Susan in TX