Gestational Diabetes Chatter #6

[belfie]

Trac - how much insulin did you get up to last time? I only got up to 18 units, so it didn't matter during labour. That's ick that you had hypos, I was lucky enough to avoid them. GL with your birth too, as you say, we do what has to be done but I hope you get your VB too. Gee Jaylan was a good weight and omg was that a quick labour or what??! Mine was 12 hours, so yours sounds very fast to me. As for Jaylan waking, oooh that's tough. I'm lucky in that my little fellow is sleeping very well so just hoping it will continue through a newborn's arrival! Sorry to hear that you don't get to see Matthew anymore, that must be hard for you all

MamaS - I have my fingers crossed bigtime for your vbac, that's so annoying about your knife-happy ob

AFM well I went back to the dietitian this week... I didn't really want to go cos I felt like a naughty schoogirl who might get told off, but DH thought it was a good idea and convinced me I should (even the endo said don't bother!). So I went and she was lovely. Said I'm doing everything right (YAY ME!) and when I tried to pick her brains for snack ideas/takeaway/out options even she was struggling! She kept thinking of things and having to discard them (due to either my restrictions or DS's), so that was kinda validating!

And so you guys know, our household restrictions (just cos I feel like sharing hte joy!)

• me - no wheat, onion (and all onion relations, chives, leeks etc), some veg (including legume family, radicchio, artichokes, asparagus), honey, coconut and most fruit (plus no dried/concentrated fruit)... PLUS eating for GD & PG
• DS - allergic to eggs, treenuts and sesame
• DH - can't tolerate dairy

I do feel like I'm just eating the same stuff over & over... but I don't have a heap of choice really. She did say that I could try a bit of low fat icecream or frozen yoghurt for supper, so that's what I'm trying tonight, low fat icecream - very exciting! Also I'd only gained .2kg in a fortnight so she said that was great too. So I'm sooo happy now that I feel i really DID do everything to avoid insulin and now I don't have to keep a stupid food diary anymore either, yay. I'm back at the endo on Monday and see what he thinks of my numbers. have only had 1 fasting under 5.5 in a week, but as I've said before he doesn't care about that. Have had 4 post-meal BSL's over 7.5, but I was "trying" some foods that I now know to avoid... but I imagine he'll still up the insulin with that.

Hope you're all having a good week. Pantha, how are you going?

[~mamaspice~]

Hi Girls!

Trac73, yep I'm on insulin but only a small amount. My main issue was having fasting BSL's over 5.5 so I'm on an intermediate acting insulin called Protaphane in the evenings. The duration is 24 hours but It peaks from 4- 12 hours after injecting it so has corrected my fasting BSL's quite well so far. I'm on 6 units in the evening. I see the one youre on a more rapid acting one that peaks 1-4 hours after taking it. Hence why you need the 2 doses a day I guess.

belfie, wow, all those food restrictions must make things tough! Can you have custard? I have that as a treat in the evenings and it's low GI. Lower than Ice-cream i believe. I've been a bit naughty today. I've had a few lindt balls

[PanthaLily]

yeah I'm going alright.
Had my appt with the Dietician yesterday... who was suprised that I hadn't seen a Dr yet. Mentioned it to the midwife in my appt straight after and I'm seeing the Dr on the 3rd.
The dietician was really happy with my results and told me I didn't have to keep the damn food diary anymore (YAY!) and that I should only really worry if I get 3 high results in a week and not to be alarmed if my results go a bit haywire in a couple of weeks.

Came home and I got a 7 after dinner last night... and a 7.6 after breakky this morning *rolls eyes*
I'm thinking my after breakfast one today might have been a mis read or something though, because after lunch I was back down to 5.8.

I've got a horrid cold at the moment too. And of course, because it's a cold, you can't take antibiotics for it and all the cold & flu stuff says consult a Dr before taking. At one stage today I coughed so hard I think I strained a muscle in my belly :-(

Have a physio class tomorrow night, so I'm hoping that'll loosen up some of the junk sitting on my chest.

Sorry for the whingy post... guess I'm having a downer day... I'm not a good sick person lol

[~mamaspice~]

Sorry to hear you're not feeling well pantha. When you are sick it can mess with your BSL's so the high after brekky reading could be becasue of that.

[PanthaLily]

thanks MamaSpice... that was my next theory lol

If I get another 7 this week though I'll be ringing the dietician ... just to be safe.

[belfie]

Came home and I got a 7 after dinner last night... and a 7.6 after breakky this morning *rolls eyes*
I'm thinking my after breakfast one today might have been a mis read or something though, because after lunch I was back down to 5.8.

So sorry to hear you're feeling crappy, and don't apologise for the whingey post, I think it's all I ever do! As for the high BSL... firstly, yeah, what MamaS said, colds can play havoc.. and secondly, if your BSL's do start to go up, it isn't like they all go up together IYKWIM... it can be all over the place. That's definitely what mine are doing. The other thing is that if you're ever unsure about the read, you can always re-wash your hands and try doing a different finger. I've done that when it was "the" BSL that would trigger me going on insulin or not... I always double check it lol!!

MamaS - I can have custard yay. But I must admit, my little serve of LF icecream tonight was YUMMO! Re insulin, I'm on Protaphane too, but in the morning (pre-brekkie).

[Trac73]

Belfie- i cannot remember how much insulin i got to last time but for some reason i think it was about 80units a day, i do remember it just kept getting increased . Wow so many restrictions that you have to deal with, it is hard enough finding food that you are able to eat without raising your BSL's but to add other restrictions would be harder again. Goodluck

PanthaLily - Take care of yourself there is nothing worse than having a cold when your pregnant as like you said there is nothing you can do for it. How many children do you have? I know what you mean about the straining muscle pain i do it all the time and it just takes your breathe away. Try and take it easy

MamaSpice - how were your BSL;'s afer your Lindt balls? Hope you are doing well

Well AFM i handed in my maternity leave form today and i will be taking maternity leave from the 27th of Sept ( i think this will be the week i will be induced 38wks) but prior to that i am taking 2 weeks annual leave. I cannot belive that i only have 6 weeks of work to go thank goodness. Other than that things are good here, since being on the insulin my BSL seem to have stayed stable so hopefully they wont need to increase it at my next appointment in 2 weeks.....fingers crossed anyway. I bought my insulin today and i couldn't believe the price of it $33, i probably shouldn't whinge about it but it is the fact that they give you 5 boxes of 5 pens and i wil probably only use one box so it seems such a waste....
Take Care and Chat soon

[belfie]

I bought my insulin today and i couldn't believe the price of it $33, i probably shouldn't whinge about it but it is the fact that they give you 5 boxes of 5 pens and i wil probably only use one box so it seems such a waste....

Gosh I must be lucky then, my endo's office always just give it to me! So saying, I do have an NDSS form updated for insulin, but he just commented that I needed that to get more needles. That's so exciting about your mat leave, woo hoo!

Well my BSL's have been a bit better the last few days (yaaay) so that's been good. Hope everyone has a good weekend planned

[Caramello]

Hi everyone!

Just thought I would let you all know that I gave birth to my son, Thomas Edward, last Wednesday the 21st of July. I'd really like to thank those that gave me all their wonderful adivice about GD - it really made a difference in terms of how and when my little son was born. He is thriving now and DH, myself and I are enjoying every minute!

Good luck to you all!

[~mamaspice~]

Aww, congrats Seachange on the arrival of your beautiful baby boy! Enjoy every minute

Belfie, yay for good BSL's lately!
I have been lucky so far too in that the hospital supplied me with my first lot of protaphane. Looks like I'll be up for more in a week or two so it will be interresting to see how much it costs.

Wow trac, you are better than me, working right up to 38 weeks! I'm on mat leave already and I couldn't imagine still being at work. I've just got to the point now where I'm really not getting much sleep at night so the nana naps are a godsend.

Panthalilly, hope you're feeling better!

AFM well I'm traveling pretty well. Although tonight I got a 7.6. I guess that's what I get for scoffing a couple of pikelets after dinner. . .

[belfie]

Ooooh Seachange - congratulations on the arrival of Thomas Edward! that's just wonderful news. I'm thrilled to hear he's thriving and glad that the how and when's of your son being born worked out well - you have done an amazing job! Have a wonderful babymoon, I'm thinking of you all and sending your little man a BIG hug!


MamaS - I'm back at the endo tomorrow which is probably timely. I tried a homemade pizza and got 9.9 yesterday then tonight some fish, few dim sims (they're gluten free and onion free!!!!!) and a salad... 9.1. Eeep my guess is insulin up by 4... as for mat leave.... lol I ended up finishing at 27 weeks!!! But admittedly there was a lot of reasons at the time.

[blackorchid]

Hi there Ladies,

I was diagnosed with GD last weekend, so I hope it's ok if I join your group.

I have a question regarding endos as I'm in a bit of a flap about whether to continue my metformin use. Well, actually I want to continue using it, but the diabetes team at RPAH don't want me to. I'm thinking that's just a tad insane, as I've been insulin resistant for many years (non PCOS) and have been on metformin for years also. It just seems crazy to me that I should go off a drug that is giving me insulin sensitivity so I can flood my body with even more insulin, which it can't use properly.

I've done a fair bit of research and know that the latest data is that metformin use is safe during pregnancy. It's been used in South Africa as a treatment for GD for 30 years, and is currently being used in the UK. I believe it's safety for use in GD is being reviewed at the end of this year in Australia.

So the reason for my long winded post, is that I would like to visit an endo in Sydney who prescribes Metformin for GD and discuss the issue with them. I'm particularly interested in the outcomes of the Mig trials, which were held in Australia and NZ starting in 2005. Initial outcomes were that it is safe but interested to what the follow up with the children has been.

If any of you know of an endo in the Sydney area, particularly inner city, who uses Metformin for GD would you mind passing on their details so I can arrange a visit?

TIA!

Yas

[belfie]

hi blackorchid, welcome to the thread sorry to hear you've got GD. In regards to your question about metformin I'm sorry I don't know much about metformin use at all - I think you know more than I do! I've only ever used insulin with my GD (this PG and last PG). I'd suggest it might be worth posting a general question in the medical section (i.e. the section this thread is in) and seeing if someone else can shed some light?

I do remember hearing of some others in here a while ago using metformin, but certainly it doesn't seem to be part of the standard treatment in Aus. From my experience I also think there's great variation in how GD IS treated in Aus which I'm sure doesn't help. GL with getting some answers.

hi everyone else, hope you're all going well. AFM visit to endo today exactly as expected, insulin upped to 14 units and for every reading over 7.5, I'm to add another 2 units on... with a review in 2 weeks. So i'm kinda pleased cos I was getting sick of going in there every week lol. Even the endo commented oh you're only 32 weeks, that's going slow which cracked me up. I know I need more insulin tho cos a simple chicken salad sandwich which SHOULD be fine (and was a week or so ago) still sent me too high today. Interestingly I'm tracking about 2 weeks ahead of my last PG in terms of insulin dose, so I imagine I will get to a higher dose before bubba arrives. Oh and they gave me more insulin today, woo hoo.

[~mamaspice~]

Hi Blackorchid, sorry but I have no info on the use of metformin either. Although on the Diabetes australia website there is a story about a mum who had GD who was on tablets to control it (so I'm assuming metformin?) so it must be done for sure.

Hi belfie, Bummer about the higher BSL's good to hear you only need to see the endo fortnightly though. I had a 7.5 last night but I know why. I tried my luck with a jacket potato. I haven't had one for a couple of months and boy was it Yummy. I also had it with crumbed veal so the potato along with the crumbs on the veal would not have done my BSL any favours

Just want to add a quick question for those who are medically managed (ie: on insulin) what gestation does your health care provider feel happy with you going to? Are they keen to let you go over or do they want bub delivered early? The hospital aren't too keen for me to go past 40 weeks. Especially because of combining the GDM with a possible VBAC. In fact the Ob said in a perfect world they'd like to see me go into spontaneous labour before 39 weeks with a bub measuring under 4 kg.

Just curious to know that everyone elses care provider thinks about when you GD bub will be better off out than in IYKWIM?

[sloane]

hi mamaspice, i'm no longer PG but i still pop into this thread every so often to see how the ladies with GD are going

my dr offered me an induction at 38 weeks but i refused. i held out to 40 weeks but had once or twice weekly monitoring (which i had from about 35 weeks i think? can't remember now!). i think if i was to have GD again, i would feel more confident in pushing for 40+ weeks (assuming no other medical concerns) because in hindisght, my DS wasn't ready to make his entrance just yet & the induction put him under what i think was unnecessary stress (i ended up with an assisted delivery as his heartrate dropped when it came to the pushing stage). he was 3.99kg so a big boy, but not huge.

[belfie]

Just want to add a quick question for those who are medically managed (ie: on insulin) what gestation does your health care provider feel happy with you going to? Are they keen to let you go over or do they want bub delivered early? The hospital aren't too keen for me to go past 40 weeks. Especially because of combining the GDM with a possible VBAC. In fact the Ob said in a perfect world they'd like to see me go into spontaneous labour before 39 weeks with a bub measuring under 4 kg.

Just curious to know that everyone elses care provider thinks about when you GD bub will be better off out than in IYKWIM?

Aah good question. I had that convo with my obs a fortnight ago (once I was on insulin. He was flagging induction at 38.5 weeks for me. I teased him and said you let me go to 39 last time. We both agreed that induction increases the risk of instrumentation (which I need to avoid at all costs) but he said the risk of birthing a bigger baby post 40 weeks (plus placenta maturation risk) is the flip side of the coin. In my case there are also some additional reasons (vaginal prolapse and pelvic floor nerve damage) for wanting a smaller bub... so his logic is second bub, could be bigger + insulin, so I think he'll never want to let me past 40 weeks at the absolute most. Plus he's optomistic that having laboured before I've got a better chance of either a) earlier labour on my own and b) much less induction activity (so to speak!) - if I could get started prior or with just gels/water breaking that would be much better than the drip. Further to that, we're also waiting on a placenta check (marginal placenta praevia) in a few week's time, plus I think HOW much insulin might influence as well (I'm tracking to be on more than last time)... so there's a few variables yet to be fully considered. FYI X's birth was induced at 38+6 (sitting around with gels for a few days) then he was born at 39+1, 3.4kg (7lb 7oz) and his APGAR's were great, no trouble breathing and his BSL's were ok (but on the low end). If we get around that size/gestation I'm not against it... but obviously am hoping for a instrumentation-free vag birth!

Incidentally I also talked to my endo about this, and he did seem less pro-induction, but agreed loosely with the 40 week thing... I got the impression that he didn't think placenta maturation was nearly such a big issue. So saying, he made the caveat that he's not an obs so doesn't have all the other elements in consideration - he's purely thinking about the insulin/placenta component.

Your hossie/obs sounds to have a very similiar perspective. Are you going to be trying all the natural induction methods? I did most, but not all last time. I'll be trying ALL (assuming that placenta moves) this time.

[Trac73]

Hi Ladies

Seachange - Congrats on the birth of your son Thomas, enjoy every moment with him.

BlackOrchid - Welcome and i am looking forward to getting to know you, there is alot of woman in here that have a bucket of knowledge, make sure ask plenty of questions to get your head around GD.

MammaSpice - my last bub was induced at 38+4 days and he was born at 38+5 days and he was insulin, so i think this one will be the same being induced at around that 38week mark, i know that they don't like you to go far over 40 weeks because of the placenta at our hospital but if you are insulin and bub is large (heading towards over 9 pd) they will induce. We will have a scan at 34 weeks to see the progress but i am seriously thining 38 weeks is where i will make it.

Belfie - sorry to hear that they have increased your insulin, so what amount of insulin are you up to now? Hope you are well

AFM - they have increased my night insulin by another 8 units making me have 24units at night and 16 units in the morning. My fasting levels just will not stable, and my day BSL's are seriously all over the place one minute they are 4.4 the next 7.1 so completely confused. Have a feeling that the insulin will just keep getting more and more like it did last time. Other than that health wise i am feeling pretty good. Having a few troubles at work and counting the days until i go on maternity leave and annual leave. I am 30 weeks today so time sure is ticking by fast and guess what i have done nothing, no sorting out clothes, no cradle set up. It is so funny that when we had our son it probably was slowly getting sorted by now funny what happens when it is 3rd child lol

Take Care Everyone and i look forward to Chatting Soon

[belfie]

Trac - do you think your insulin dose is heading up quicker this time? And also, is over 7.0 your trigger? I'm told to just stay under 7.5. I'm only on 14 units (morning only) but copped another 9.1 for dinner tonight and no way should it have been that high (brekkie & lunch were great)... so it's up to 16 units tomorrow for me. Glad you're feeling mostly ok and hopefully mat leave comes around nice & quick!

I had a check-up today and suddenly my measurements are 4 weeks ahead even though they were spot on a fortnight ago. I'm hoping it was just measurement error. On the bright side, she's head down and still definitely a girl (I was getting a bit paranoid!).