Gestational Diabetes Chatter #6

[sloane]

hi seachange. sorry to hear you have GD - although i found it to be more of a PITA than anything else!

i was diagnosed with GD around 22 weeks from memory. i was diet controlled until around 30 weeks then on insulin twice a day. my answers to your questions are....(sorry in advance for being a bit verbose!)

when did you finish work? it was around 32.5 weeks. i was planning to leave at 34 & took my annual leave owing before that. the main impact it had on my work was the number of appts i had to go to. i went public & had fortnightly appts from when i was diagnosed with the obs but sometimes the endo & dr appt wouldn't coincide so i'd go two weeks in a row. i hope that makes sense! my work was quite flexible & i just worked from home on the days i had hospital appts.

Did you have a VB or caesarian? i had a VB - it did end up being an assisted birth (explained more below).

Were you induced? i was. i really, really didn't want to be but in the end i kind of gave in. i also had high BP that was diagnosed at 6 wks PG so i was kind of on their 'hit list'i guess! i had weekly monitoring from about 33 or 34 weeks - CTG & scans to check for movement & also the size of the baby & the amount of fluid around him. i managed to negotiate a 'reprieve' until i was 40 weeks. alot of people are very happy to be induced prior to this & i know there can be medical reasons but i felt that the weekly monitoring (some people also have to go twice a week) really showed that there was no real cause for concern and the BP wasn't causing problems either. i did a lot of reading about being induced & what could happen as a result. i didn't escape completely - i had an epidural & a forceps delivery but whether that matters very much depends on your own personal opinion.

Did it have an effect on the BSL of your baby when he/she was born? DS did have low BSL when he was born & as a result he was given formula as his first feed. i still feel quite conflicted about this & i really wish i'd been more aware of what was going on. they continued to monitor his BSL until he had a certain number of 'good' readings (above 3 i think, or maybe 4).

hope that helps a little - if you have any questions, just let me know!

[ajsmum]

I to have GD I was diagnosed this time at 23 week i'm now 30 weeks. This is my 4th pregnancy and I have had GD with all of them. I was quiet excited to come across this site as I don't no anyone else that has had the GD and noone really knows how hard it is for me to have to monitor my sugars and watch everything that I have to eat. My OB put me on insulin once a day this week so that is pretty hard as my las 3 pregnancy's were just diet controlled and I didn't need insulin my readings are only just enough to for him to worry.

In answer to seachanges questions I was induced with all my pregnancy's and have been told that they will induce me again. With my 2nd son they let me go a week over and he was 9 pound 11 ounces, my 3rd they induced on my due date and he was 8 pound 2 ounces. My 1st i went into labour with him on my due date but still needed to be induced as I didn't dilate with him he was 8 pound.

It's amazing how things have changed over the 4 pregnancy's as when had my 1st they didn't tell me how serious it could be to my baby I had my 1st 11 years ago. But by the time I had my 3rd the procedures and the attention they give you is so different. My 2nd needed to be put in a humidicrib for a few hours and my 3rd needed some oxygon. But otherwise they were born healthy and I have had all 3 VB.

[Caramello]

Hi ajsmum,

Must be hard having 4 pregnancies and not knowing anyone else with GD. Sorry to hear that its moved on to insulin controlled - but hopefully it will start to balance out now.

Thanks everyone for the feedback about your births - I was just wondering how many people went to caesarian after this diagnosis.

[belfie]

Seachange - in answer to your questions:

when did you finish work?
I was due to finish at 36 weeks and I pulled it back to 34.5 (which is tricky to do IMO). I found I was too busy with the extra appointments and trying to organise food for work was a nightmare (but I do have additional dietary restrictions). When I stopped, my BSL's did get better, I can only assume due to the reduction in stress. Both DH and I swore that I'd finish at 30 weeks next time - which is what i'm doing, regardless of whether I get GD or not. I think I can eat better, exercise better to keep BSL's under control this time if I'm at home more. I wished someone had told me it would be better to finish earlier the first time around.

Did you have a VB or caesarian? VB. I was not told that there would be any reason for me to go CS over VB based on having GD. If anything, they said that GD babies can be a bit more prone to breathing difficulties, and the VB process is actually better for babies breathing. My DS was breathing fine when he was born.

Were you induced? Yes, at 39+1 (was gonna be just under but hospital was busy). Negotiated with obs, he would have pushed for 38 weeks had I been on more insulin, say 60-70 units (I was on only 18 units). I struggled to reconcile the literature that says GD is all a load of rubbish versus the medical evidence that shows increased risk of placental deterioration/in-utero death in over-term GD babies. Personally, I wasn't prepared to gamble with the health of my baby and accepted the induction. In it's way it was a blessing as we were far more prepared (with our doula) for all that induction brings. I had an epi, and DS was born with suction (failed) and forceps. I dont mean to scare you, but I wanted to know WHY they like to induce. I also had CTG monitoring every few days prior to induction which actually made me feel more comfortable we were keeping an eye on bubba. Incidentally, both my obs and I were in agreement that we couldn't accurately assess the size of the baby (there's a lot of error in the estimation methods), so that was NOT our reason for induction. And my bub was 7lb 7oz.

Did it have an effect on the BSL of your baby when he/she was born?
His BSL's were low but ok. He was admitted to SCN for 24 hours, but roomed with me - just back in SCN primarily for feeds. I wasn't warned about the typical standard SCN admission for GD babies until quite close (check with your hospital/obs about this). It gave me a big shock initially when I heard it would happen but the reality wasn't as bad as I feared. He then was later re-admitted and spent 60 hours under lights for quite bad jaundice. The mental preparation for the first SCN admission actually really helped me to deal with the second one. There's some literature to suggest if you can express colostrum prior to birth (I had NFI how to do this first-timer aroound) you can provide that if they need help, otherwise GD babies will often be provided with a FF to assist with BSL's. It's worth looking into to prepare yourself. Like Sloane, I don't thinK i was fully prepared for the fact he'd be given FF so early - and at the time for all these so-called "medical" reasons. This time round I will be resisting FF as much as possible.

My Dad has Type II and I think the other thing that threw me is that there are differences in the focus, the cut-off levels and how you manage your diet with GD. Sometimes you can do everything perfectly, but the insulin-resistance is influenced by your placenta and may go up regardless. One day a meal will be fine, the next day it will send your BSL sky high - so above all, don't beat yourself up - just do the best you can.

How are you finding it now? How are your BSL's going?

ajsmum - that's a shame re the insulin, but I hope it makes it easier to manage your BSL's. I found in 3rd tri I was getting some nausea in the evenings that actually settled down once I was on insulin. I imagine you must be really good at the diet now, how is it going?

Cheers,
Belfie

[ajsmum]

The insulin has really brought the sugar levels down. Not just the night ones but my fasting ones as well and the ones after breakfast are really good now. Yeah i'm an expert on what you should be eating and shouldn't be. I'm really over the whole salad thing though but only 9 weeks to go and it is best for bub. I've never heard of giving baby a FF after their born before though. All 3 of my sons were b/f and had their first feed within minutes of being born. So everything is good at the moment.

[Artechim]

Seachange,

when did you finish work?
I finished at 34 weeks. I was going to go until 36 but it as Belfie said, it was a pain doing all the testing and eating at the right times etc so I left early

Did you have a VB or caesarian?
I had a VB. I was on around 120 units of insulin per day by the end and the head high risk Ob didn't see any reason to go CS

Were you induced?
Yes. I didn't want to be and managed to negotiate another week out of them by doing CTG monitoring every second day. By the time I was induced it was 39+3weeks.

Did it have an effect on the BSL of your baby when he/she was born?
My BSL's started going up during labour despite not eating, so I was on an insulin drip to keep my levels normal. I think because of that DS didn't have any troubles - his first BSL was fine, and then the two after that were as well so they left us alone. Some hospitals seem to have a policy of taking all GD bubs to special care but mine didn't. He did go to Special Care for about half an hour, but that was nothing to do with the GD - just a bit of raspy breathing.

Belfie, how are you going?

[belfie]

Belfie, how are you going?

Touch wood so far, I'm fine. My obs doesn't seem to think we need to test until normal time. I recently did a day of BSL's just to check if they were good, and they were. I'm wondering why some drs test it earlier on repeat PG's and others don't - does anyone know?

ajsmum - regarding giving my bub formula, well we were having a lot of trouble feeding so DS hadn't had a first feed (but that's a whole 'nother long story) so that's probably why they weren't going to wait for us to have success feeding and hence he got FF (again, something for me to think about this time).

[Jewel]

Hey everyone!

when did you finish work?
N/a. I was a SAHM.

Did you have a VB or caesarian?
I had a VB. No talk about a csection at all, ever.

Were you induced?
Nope. There wasn't even any talk about induction really either. I had him at 39+4wks. it may have been a different story if I was on insulin. I really don't know.

Did it have an effect on the BSL of your baby when he/she was born?
Nope, he was fine.

Belfie - YAY for no GD so far and that your OB doesn't think you should have the test any earlier. Woohoo! I've got everything crossed you don't get it this time around.

Seachange - Sorry to hear you've got GD. It's all such a kick in the teeth when you first find out, well it was for me. Loads of tears and the "why me" routine. Good luck with it all.

ajsmum - That must have be so hard for you to have GD with all pregnancies and not have anyone around you that knows what you're going through. It's hard enough when people are there to support you and know what's what. Big huge hugs! I hope the last part of your pregnancy flies by.

xox

[Caramello]

Thanks Belfie, Artechim and Jewel for letting me know about your experiences. I wanted to know because my Obstetrician has been pushing a little for a caesarian, and I'm resisting. I want to have a VB if its possible. Also, I had a really big chat with a friend of mine who also had GD through her pregnancy, and works as a teacher. She basically lessed some of my anxieties. I'm going to try for 35 weeks, but I agree that the food and particularly the blood tests are a PITA. Especially when I have sticky beak year 11 students coming to have a look what I was doing (I had to do the test in class and thought I was well hidden) and then hold a discussion about what I was doing.

My Endo and Dietician can't seem to manage to be on time, so I have basically given up working on Fridays - which is the only day that they are available. This is helping a little, although having to wait around for almost 2 hours is frustrating. Even the receptionists were having a giggle about how long it took. And of course they completely stuffed my timing with food and I got a high reading

One of the benefits of this is that my husband is a type 2 diabetic. He's obviously been a little lazy with the food he's been eating, because now he is forced to eat what I do his readings have been so much better

The other good thing is that I had an ultrasound this week and Squishy (bubs) is in the 50th percentile. The Obstetrican was really happy with the results. He's not sending me again until week 36.

I've been put on insulin overnight as my fasting readings would not go down. Had the first lot last night and felt very weird this morning until about lunch time. I hope this feeling is only a once off.

Ajmum - glad your readings came down, I hope this continues.

belfie - no idea about testing. I just know that my Obstetrician wanted it early due to my PCOS and family history.

[Becci]

Hey Possum I probably should read back a bit and see what your story is but I'll comment anyways.

Why are they pushing for a c/s? I've had two GD babies, ended up on insulin for both of them, and while I had to be induced at 38 weeks (a given here once on insulin) I didn't have to have a c/s. Both were born naturally (other than the induction).

[Caramello]

Hi Becci,

IVF baby + donor baby + me over 40 + GD + BP (at one stage, not currently) = Obstetrician that is supportive but slightly nervous.

[Becci]

Well yes I can certainly see how your Obs would be nervous. Do whatever you think is good for you and baby Possum. Glad Ob is supportive, makes all the difference. Goodluck!

[belfie]

Seachange - that is an extra-special bundle you have onboard there, I can see why there's a few considerations. GL with working out what will be best for you and getting the VB you want. I would recommend checking if they'll be putting induction on the cards due to insulin - as Becci said, it becomes quite standard. And obviously induction takes you down that intervention path anyway, but being prepared does help - I found that working with my doula to prepare for the induction was very empowering for me - making the best decisions for me and bubs while still incorporating medical considerations.

Hope the insulin is not still making you feeling yucky. Has it settled down now?

[MrsBump]

Hi all,

I too have been diagnosed with GD but i was wondering could my levels been effected because i was stressed?
My fasting level was 4.0,
1 hour 7.2
2 hours 8.9 (at peak of stress here)

should i ask to be re tested?

[Caramello]

Went and saw the Endocrynologist on Friday with the dietician. I'm now up to 12 units, which is making me feel quite spaced. Unfortunately I got a reading this morning of 6.4. I've decided to try and experiement with supper, as I think I am having too many carbs there and this may be triggering the high overnight readings. The Dietician and Endocrynologist have left me to experiment for 3 weeks to see if I can get the levels down. The other issue is that after lunch I am getting readings of 4.8 etc. So obviously something is not quite right with my carb intake. Shall try again tonight and see if the new supper makes a difference.

My HT Admin should be delighted that I will be available again on Fridays. This will take me up to week 8 of term, and week 32 of the pregnancy. Basically the downhill run until I take maternity leave after week 11 of term (35 of the pregnancy). Given that I will be expected to prepare lessons, mark exams and write reports, I am loathe now to go off any earlier. If I'm working I may as well be paid to do so.

[didispunk]

Can i join you please.... just found out i have it.. did with Ds and not DD..

[didispunk]

Can you tell me what you eat in a day?

I am so stuck for what to eat and what not to eat..

Like Apple juice says LOW GI... welll test after that and VOILA>> HIGH HIGH HIGH

[belfie]

Hi Didi,

Sorry to hear you've got GD this time. Haven't got time for a long reply, but check the link about 1/2 way down this page called "Healthy eating for gestational diabetes Information Sheet" - it's a great little PDF
Gestational diabetes... Diabetes Australia - NSW
I found that gave me some good help and ideas for what to eat, and the main other thing is that what gives one person high BSL's will be fine for another person - it is very individual, so you need to just experiement and you'll learn what sends you high & doesn't. GL will BBL

Belfie