Gestational Diabetes Chatter #6

[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!).

[~mamaspice~]

Hi Girls!

Thanks for your imput on when your Ob's/hospital want bubs to be born.

The Ob I saw at the hospital today re-iterated the 39-40 week limit for me. I also have to have CTG monitoring at each weekly visit from now on. The midwife today said I couldn't have gotten a better CTG reading Also have to have another scan to check bubs size, but fundal measurement wise I am measuring 38 weeks ATM.

Wow Belfie, a sudden jump like that doesn't seem quite right to me. I think there has been an error in there somewhere. Try not to worry and wait and see what it is next week.
Still on 6 units of insulin at night

[blackorchid]

Thanks everyone for the warm welcome! I look forward to learning more about your GD experiences as time goes by

[~mamaspice~]

Hi there everyone!

How is everyone going?

I got a 5.9 fasting reading this morning so up to 8 units for me from tonight.

[belfie]

hey MamaS - sorry to hear your insulin is up, fingers crossed no more increases for you. 36 weeks for you now, wow that's wonderful!

Blackorchid - how are you going? Have you got anywhere with trying to convince them to leave you on metformin?

AFM, have managed to stay steady on 16 units for a few days, but have had a few 7.4's... so I think i'll be up again soon. My folks are currently visiting and Dad has type II, on insulin. It's interesting to compare notes. Tbh it's really quite different the way we both manage it!