Gestational diabetes?

[Kathryn]

What can you tell me? I'm 33 weeks and just failed my second attempt at the one hour test. I'm scheduled for the three hour on Tuesday. What happens if I have it? I can't find anything concrete online about recommended diet. Am I going to have to stick myself a lot?

[Truscifi]

I have blood sugar issues anyway, but they were worse during both pregnancies. The first one I tried the calorie/carb counting and just failed miserably. I always felt deprived and grouchy and hated it. The second I just was low carb in general and didn't eat any starches or sweets at all. It was much easier for me than trying to control portions. It just depends on your personality and how you relate to food which will work for you.

 

As for sticking yourself, yes you probably need to. But it really isn't bad. And it will give you so much more information about how you react to different foods. You may find there are foods that "should" raise your sugar but don't so you can still eat them.

[Loowit]

I had it with my third pregnancy (and undiagnosed in my second).  They referred me to a dietician who went over how to do the testing and gave me a meter.  The dietician also gave me a meal plan and explained how to put meals together and what and how many servings at each meal and snack.  The first few weeks I was struggling to keep my numbers where they needed to be and they were going to add insulin, but the dietician gave me the option of trying to adjust my diet a bit and it helped tremendously so I didn't need the insulin after all.  I also found that there were some foods on the list that I couldn't have at all because they would spike my blood sugars, and some I could have later in the day and be fine.  Milk was something I had to give up, especially for breakfast.

 

I had to test myself in the morning when I got up and 2 hours after each meal.  I got used to it pretty quickly.

 

About 6 weeks after DS was born I went back in for another 3 hour glucose test and passed it just fine.

[Night Elf]

Just to share, I failed the 1-hour test with two of my pregnancies (the first didn't test at all), but passed the 3-hr test. I'm not sure why. So you might be okay! :grouphug:

[PeachyDoodle]

I had it with ds -- bad enough that they didn't even give me the three-hour test. They just sent me straight to the Diabetes Clinic.

 

I was able to control it reasonably well with diet and glucophage (oral meds). I also had to stick myself first thing in the morning and two hours after every meal. You do get used to this pretty quickly and it is not as bad as it sounds. I didn't find it painful at all if I stayed to the side of my finger (you have more nerve endings in the middle of each finger pad). I was already obese when I got pregnant, but following a modified-carb diet, I lost considerable weight in my third trimester. I weighed less the day before I had ds than the day I got pregnant with him. (YMMV -- if you're not overweight to begin with, your doc probably won't want you to lose any.) I learned how to pair carbs with protein and/or fiber in order to slow adsorption and keep my blood sugar from spiking. I've lost about 30 lbs recently using the same technique.

 

One thing to be aware of: Babies born to mothers with GDM can sometimes be hypoglycemic. Nobody bothered to tell me this. When ds was born, his blood sugar was so low that it didn't even register on the glucose monitor. He spent a week in the NICU until his system was able to adjust to not having a steady supply of sugar from me. We were assured that there are no long-term effects from this (he's no more likely to be diabetic than other children, etc.), and once his body adjusted we never had another problem. But they had to keep him on a feeding tube and IV to keep his blood sugar stable until he was able to regulate it himself. I only share all that because I had no idea it could happen, and once we made it through the very difficult pregnancy (lots of other issues besides the GDM), I thought we were in the clear -- only to have him ripped from my arms 5 minutes after he was born and shipped off to the NICU. Just know that, while it's possible, it's also easily treated, usually in 5-10 days.

 

Good luck -- you only have a few weeks to go!

[Kathryn]

So, if I want to be careful for the next week before the test, what can I do? I've read to do moderate exercise after eating. As far as food though, as close as I'm getting to understanding is that lean meats and vegetables are safe and fruits, grains, and even dairy can be problems. So, what do I do with them?

[wapiti]

I passed the 1-hr test but had trouble keeping under blood sugar limits sometimes (I was tracking because I was on metformin for PCOS).  So, my doc basically treated me as GD.

 

That was a long time ago.  FWIW, if I had to do pregnancy all over again, I'd eat a lot more fat.  (Now that I know a lot more, I eat LCHF, though I don't think that's something that can be switched to in the middle of pregnancy).

[umsami]

I've had it for all four pregnancies.

 

With two, I had to inject myself with insulin.  One was managed with glyburide.  One with metformin (I think).

 

You will need to check your blood sugar using a monitor.  They will probably set you up with a diabetes educator.  Whether or not you need insulin depends on management.  They usually want tighter control during pregnancy.  Walking after meals can help.

 

You'll also probably be referred to a Maternal Fetal Medicine specialist.  Expect some scans and monitoring as you near your due date.

 

Worse part was being woken up in the hospital to check my blood sugar. :)

[PeachyDoodle]

So, if I want to be careful for the next week before the test, what can I do? I've read to do moderate exercise after eating. As far as food though, as close as I'm getting to understanding is that lean meats and vegetables are safe and fruits, grains, and even dairy can be problems. So, what do I do with them?

 

**Obligatory disclaimer: My aunt, a Registered Dietician, helped me put together the following, and it worked pretty well for me. But I am not a medical professional! Your RD or diabetes educator will give you more specifics, if they're needed (you may pass the three-hour test and be just fine). IMO, it's never a bad idea to aim for more veggies and water and fewer processed carbs, whether you have GDM or not!**

 

You don't want to completely eliminate carbs. Ketosis (which is the point of diets like Adkins) can cause you to go into preterm labor. Just use moderation. Watch portion sizes (of everything). Spread meals/snacks throughout the day to keep your blood sugar stable -- try to eat every 3 hours or so. Not eating can cause your b/s to drop, prompting a rebound and spike. My go-to meal was about 4oz of lean protein, 1 cup veggies (preferably green/leafy, like broccoli or Brussels sprouts), and 1/2 cup starch. At lunch I could sometimes add in some fruit. For snacks, go for protein or a protein/carb combo. My faves were a small piece of whole fruit (apple, orange) with a mozzarella string cheese stick, 1 T peanut butter with 5-10 crackers, or high-fiber cereal with milk. Healthy fats like nuts and olive oil are good. I loved a piece of sesame Ezekiel bread toasted and dipped in olive oil with a little salt, fresh cracked pepper, and Italian seasoning. Lots of water, obviously ('cause I'm sure you want to pee even more than you already do when you're pregnant! :D ).

 

You can also Google "low GI foods" and get a list of things that are low on the glycemic index. All fruits and veggies are not created equal. Once you get your glucometer, you'll be able to tell what times of day are worse for you and adjust accordingly. I was always much higher in the morning and couldn't have any carbs at all at breakfast or at my bedtime snack.

 

A walk after you eat when possible is a great idea. (I was on bed rest so I just had to be extra strict about diet.)

 

Worse part was being woken up in the hospital to check my blood sugar. :)

 

Amen to that!

[ChristusG]

With my last pregnancy, I failed the 1 hr test. I felt so horrible I knew I . just couldn't go through with the 3 hour test....I honestly felt like I'd puke and then pass out cold on the floor. Going that long without food has always been an issue for me and it's 10x worse during pregnancy. I told the dr that I would just follow the GD diet anyways. I felt SO overwhelmed at first....but it turned out to be pretty easy. I steered clear of high carb foods, avoided sweets, ate plenty of meats and veggies. It worked out well. Dr got on to me for not gaining enough weight LOL. It all went over just fine.

[Heather in OK]

Do some reading on carb loading before the test.  

[happypamama]

Ugh, I am sorry -- I had to take the 3-hour with my first two babies, and it was miserable torture. I refused to do it with any of the others, although I did find it helpful during my fourth pregnancy to check my blood sugar for a couple of weeks before and after meals. I found it helpful to see how my sugar levels corresponded to how I was feeling, to be able to tell what was actually a symptom of low or high blood sugar. I think I found that I couldn't eat bread at breakfast, but I could later in the day.

 

With my first baby, they told me no bananas, no fruit in the morning, and no simple sugars, for the several days before the 3-hour test. Then for my second, they made me eat something like 300 grams of sugars for the three days before the test. Seemed completely opposite advice to me, between the two times. And I passed it both times (and still had large babies -- and my third, fourth, and fifth babies were all exactly in line with the first two for gestational size).

[JessReplanted]

I had GD with my last pregnancy. I ended up taking metformin (oral medicine), and I ate small amounts every 2 hours (and tried to avoid sweets). I had to test my blood 4x a day. It was a pain in the butt, but it was also a blessing in disguise. I didn't gain any extra  weight and I think I learned how to eat healthier.

[Kathryn]

Just needed to vent for a moment. I just got the call that I failed. And that I'll get a call from the place they're referring me to in the next 7 day's.I'm 34 weeks today. So, I'll get a call about an appointment by the time I'm 35 weeks and then have to wait for the appointment. I'm set to be induced at 39 weeks. This doesn't seem very helpful.

[ChristusG]

Honestly, at the point you are at, I'd just eat carefully for the next few weeks. Seems kind of pointless to go through all of that with doctors when you are so close to delivery.

[PeachyDoodle]

Honestly, at the point you are at, I'd just eat carefully for the next few weeks. Seems kind of pointless to go through all of that with doctors when you are so close to delivery.

 

I tend to agree. Have you discussed this with your doctor? (At my OB, all of this happened through the lab, and I didn't even speak to my doc directly about it for a couple of weeks.) I would give your doc a call. Depending on how high your readings were, s/he may be okay with your just restricting sweets and carbs for the next few weeks. Aside from actually giving me a glucometer, the diabetes educators I had were useless. I had to research everything on my own anyway (and I also had to wait two panic-filled weeks for an appointment; thank goodness for my aunt the RD). You can get a cheap glucometer at the drug store if you really need one.

 

Hang in there. Either way, it won't be for long. I was eating Oreos in my hospital room! :D

 

:grouphug: :grouphug: :grouphug:

[Kathryn]

My next appointment with my OB is a week from today, so I'm sure I'll see him before I get an appointment with this other place. I'm just really at a loss here since my diet is basically the exact opposite of what it should be. And exercise is difficult as I also have symphysis pubis dysfunction. And now I've worried myself sick reading about hypoglycemic newborns and the high risk of developing type 2 diabetes.

[Kathryn]

And my doctor just called and wants to see me tomorrow for a biophysical profile.

[G5052]

I had gestational diabetes with both of mine (now teens), but in both cases it was diagnosed much earlier.  Both were full-term, normal-sized babies.  One had a drop in blood sugar right after delivery.  Thankfully a good friend of ours is a very high level lactation specialist (a professor and head of maternal and child health at a large hospital).  She told me to nurse my baby as much as possible in the first 24 hours and to have them call her with the numbers if they disagreed.  The specialist took the same approach, and the problem was resolved without any further concern.

 

I was able to manage it with diet, basically low G.I. food, primarily meats, beans, cheese, and vegetables.  I only had to stick myself during the first few weeks, and then had weekly bloodwork in the office at my weekly appointment.  They also did weekly sonograms to monitor the baby and placenta.

 

And no sign of diabetes, although I still tend to eat low carb.

 

It is scary, but with close monitoring, it doesn't have to be a problem for your baby. 

[PeachyDoodle]

I hope I didn't scare you with the info about hypoglycemia. :sad: It certainly wasn't my intention. Sometimes I talk too much.

 

Just remember that this is a problem, yes, but it's a FIXABLE problem. It can be controlled. Any negative effects can be mitigated. It is better to know so you can take action, even though it is scary. That said, I've been there, I know how scary it is. Is there anyone who can offer you support IRL?

 

I hope all goes well with your BPP tomorrow and that your doc is able to reassure you everything will be okay.

 

(((((Kathryn)))))

[PrincessMommy]

Kathryn, I don't have any diabetes information to share, but I'll be praying for you and your appt. tomorrow.

[Kathryn]

Oh no, it wasn't you specifically, just what I've been reading online. It just seems so overwhelming and complicated. I've dealt with multiple food allergies and elimination diets, and while difficult from a getting used to it standpoint, what needed to be done was fairly straightforward. And this isn't!

 

Thank you for the prayers--they are very appreciated.

 

I go in at 10 tomorrow. He wanted to see me tomorrow instead of waiting until next week because I've been measuring three weeks ahead for the last month and she doesn't move very much. I'm hoping everything looks okay.

[PeachyDoodle]

Hope you got good news today, Kathryn! I'm thinking about you.

 

:grouphug: :grouphug: :grouphug:

[Kathryn]

Thank you! She passed whatever "tests" they had, but she's already measuring six pounds. I feel awful. My boys were just under and just over 7 pounds at 39 weeks, so I'm worried how that's going to play out. The endocrine place did call today and are able to fit me in on Monday afternoon. I'm trying not to stress because I know that can make it worse, but I'm scared to eat since all the things I usually snack on are off limits. I'm fine with meals really, but snacks are my downfall.

[SeaConquest]

I've had it with both pregnancies and both babies were healthy and normal size. I wouldn't worry unless there are issues on your BPPs (mine were always 10/10). I also wouldn't stress about your diet at this point. Insulin resistance actually peaks late in pregnancy and then improves. Just keep things low glycemic index and healthy. Also, weight estimates are notoriously inaccurate in late pregnancy, off by as much as a pound in either direction. So, I wouldn't stress about that either. Try to relax. Your baby will be here soon.

[readinmom]

Had it with my third pregnancy.  I had to monitor diet/blood sugar, and give myself injections.  Dd was born full term with no problems.  I was warned that I might have blood sugar issues later on. 

[PeachyDoodle]

Thank you! She passed whatever "tests" they had, but she's already measuring six pounds. I feel awful. My boys were just under and just over 7 pounds at 39 weeks, so I'm worried how that's going to play out. The endocrine place did call today and are able to fit me in on Monday afternoon. I'm trying not to stress because I know that can make it worse, but I'm scared to eat since all the things I usually snack on are off limits. I'm fine with meals really, but snacks are my downfall.

 

I'm so happy that she is healthy -- that's the best news! Did your OB say anything about her size? I worried and worried about ds's size, and then he turned out almost a full pound smaller than dd -- 6lbs, 4oz. (I was induced at 37 weeks on the dot due to other complications.) You said you are scheduled to deliver at 39 weeks, right? Are you having a C-section? Any chance they would take her a little early if she measures really big?

 

Yes, stress can make the GDM worse, so do try to relax, although I truly realize that this is easier said than done. Is there someone who can help with your boys?

 

I do think you will feel much better once you meet with the Diabetes Educator and have a plan in place for your diet. As much as sticking yourself can be a pain, at least it gives you reassurance that you are on the right track so you don't have to worry as much about every bite you take. You still have to pay attention, of course, but I mean that you know exactly how what you eat is affecting you. Getting your blood sugar under control will probably help the way you feel physically also. It did for me, at least.

 

Only a few weeks and she will be here -- and this will all be worth it! :laugh:

 

[Kathryn]

I'm scheduled for induction at 39 weeks, but he said that might get pushed up to 38 weeks depending on how things go. I do think I'll feel better once I am given an actual plan and can monitor my blood sugar. I suppose the worst thing right now is the not knowing what's going on. I'm not good with that!

 

We have five more days of school after today, and the boys are pretty self-sufficient. They've had to be since I've been so tired recently.

 

As to her size, when I asked my OB about it, he said that's he was "only" 95th percentile and they don't start worrying until 97th percentile. He's pretty laid back, the opposite of me, which is what I need I expect.

[PeachyDoodle]

I am the kind of person who really freaks out when I don't have a plan in place, so I can totally relate. Having a diet plan and a way to monitor yourself will help tremendously, I promise. If your numbers are not where you think they should be after a few days, don't hesitate to call your doctor and see if you need an appointment to discuss further intervention (e.g., meds). Sometimes I think OB's forget that what is routine to them is NOT to the mom-to-be, even veteran moms-to-be. Don't be afraid to ask for what you need, whether that's information, reassurance, or whatever.

 

It's pretty easy to say the baby's *only* in the 95th percentile when you're not the one who has to *have* said baby! But you are early yet. Just because she's measuring on the bigger end now doesn't mean she will 4 or 5 weeks from now, especially if you get the GDM under control. Try to breathe and, as hard as it is, not to jump to any conclusions!

 

I'm glad your boys are so helpful; that's truly a blessing! They are going to make great big brothers to that sweet little girl!

[chanda7]

I had absolutely no risk factors for gestational diabetes, yet I had it with my third pregnancy. I was on a low carb diet for a majority of the pregnancy. My son was just over 7 lbs. at birth, and my blood sugar went back to normal. Two years later, I realized I was having sugar spikes again. My fasting glucose is now at the high end of normal, though it was much lower when I was pregnant. Just a warning that you need to continue to monitor your health post-partum.