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Thread: Gestational Diabetes Chatter #6

  1. #235

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    Didispunk - Sorry to hear your levels have gone up. I don't know how I would have done if I needed to inject myself. I was very lucky I was able to manage mine with diet. Yay for your mum getting there on Tuesday!!!

    Belfie - YAY 6.6 That's a good one, especially out to dinner. I'm crossing everything your levels settle.

    Mamaspice - for you too.

    Sorry I'm crashing your thread. Just wanted to show you all I'm here and know what GD and all that is like. Well, minus the injections part. I don't know how you ladies do it. I think you're strong, amazing people. I'm cheering for you all the way (and hoping I don't seem like a stalker).

    xox


  2. #236

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    Quote Originally Posted by Jewel View Post
    I'm cheering for you all the way (and hoping I don't seem like a stalker).
    Well I can't speak for the others, but if that's stalking, yay bring it on! (and I've been stalking all year in that case ). Thanks for the cheers and support, it's always great to hear!

    Didispunk - omg I'm so happy that your mum is coming on Tues! I hope she is just amazingly wonderful and mega-useful! You so deserve some support and help with everything you're battling

    MamaSpice - how you going?

    Highest BSL today was a 7.5 after lunch. Still haven't hit that "8" but feeling a little more ok about the world... just takes a bit to get through it at first. Am attempting to "go with the flow", we'll see how long it lasts
    Incidentally, my endo says there's no point doing fasting BSL's as if the post-meal BSL's are ok, everything else will look after itself. That seemed a little weird to me, but also explains why I didn't do fasting BSL's last time either.. Do you guys do fasting BSL's?

  3. #237

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    Hi Girls!

    Thanks for the best wishes jewel!

    Didi, glad your mum is arriving soon. And hopefully they'll book in your definate section date for you this week . I can see why you wouldn't want to go on the meds. My insulin is a class A drug.

    Belfie, it's strange how different Endo's can be! Mine has been focusing on my fasting BSL's. All of my ones after meals have been under 7 except for 2, so they weren't concerned at all about those ones. But about half of my fasting BSL's lately had been over 5.5.
    6.2 was my highest fasting BSL. My endo explained that at night is when bub grows so that's why they wanted to put me on insulin at night to make sure my fastings we all under 5.5. I found no correlation between day time readings and my fasting ones. Quite often my reading after dinner would be really good, like 5.6 or something then the next morning my fasting BSL would be over 5.5 which really puzzled me . Then I might have a reading of 6.5 after dinner but my fasting BSl the next morning would be fine.
    It sounds like my endo are a lot more strict on when insaulin needs to start, then a lot of others are.

  4. #238

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    MamaSpice - that is weird. I really don't get why they all do different things . Re your fasting reading, does it make a difference if you have a late evening snack? Actually was this discussed a few pages ago?

    Well I just got a 9.7. I'd been eating slacker and slacker given it wasn't definitely GD yet...so that's the red flag and I'll hop onto a GD diet now. I actually had some frozen fruit yoghurt right after my lunch, but I think it was pretty sweet - so I imagine that's what did it. I feel kinda ok cos it was just hanging over my head. At least now i KNOW there's good reason to monitor my BSL's! I've got an appointment with a dietician on Weds, so I know it's really worthwhile now which is good.

  5. #239

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    Hi belfie, yeah I tried having a dairy snack just before bed as someone had said it might help with my fasting BSL's but it didn't really make any difference.

    sorry to hear you got a 9.7. Did you have to go on insulin with your last pregnancy?

  6. #240

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    Quote Originally Posted by MamaSpice View Post
    sorry to hear you got a 9.7. Did you have to go on insulin with your last pregnancy?
    Yup, but was only up to 18 units by the end, which I didn't think was TOO bad. But really don't want to be induced this time (can't afford to be IYKWIM) so will be doing my utmost to avoid insulin - as that typically does result in induction. Last time the DE wasn't much help with the diet (she just said "oh you know your diet better than me!"), so that's why this time I've asked to see the dietician. I've just been re-reading the NSW diabetes GD meal plan... it has 4 serves of fruit!! Morning tea, lunch, dinner and supper! That seems heaps of fruit to me, and I can normally only tolerate 1 serve a day anyway due to my other dietary restrictions. But really, would you eat that much fruit?

  7. #241

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    Quote Originally Posted by belfie View Post
    Yup, but was only up to 18 units by the end, which I didn't think was TOO bad. But really don't want to be induced this time (can't afford to be IYKWIM) so will be doing my utmost to avoid insulin - as that typically does result in induction. Last time the DE wasn't much help with the diet (she just said "oh you know your diet better than me!"), so that's why this time I've asked to see the dietician. I've just been re-reading the NSW diabetes GD meal plan... it has 4 serves of fruit!! Morning tea, lunch, dinner and supper! That seems heaps of fruit to me, and I can normally only tolerate 1 serve a day anyway due to my other dietary restrictions. But really, would you eat that much fruit?
    I'm not a big fruit eater TBH so no I definately wouldn't eat 4 serves per day. Was Xander a big bub? At what gestation were you induced? And are they just more keen to induce if you're on insulin because they think baby is likely to be bigger? Sorry for all the Q's, I'm just interrested because I cannot be induced, well, apart from them breaking my waters to see if that starts labour.
    I am only on 4 units of insulin ATM but the endo said if I get a fasting reading over 5.5 to increase to 6 units and see how I go. Well this morning my fasting reading was 5.7 So it looks like I'll be doing 6 units tonight.

  8. #242

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    Good questions MamaSpice, and I'm more than happy to answer them. My first thought was "oh why can't you be induced" but then I've seen your sig - vbac :fingerscrossed: so I'm wishing you the best of luck.

    Re my birth, Xander was induced at 39 weeks. It was meant to be about 38+5 but the hossie was busy and then I sat around for a few days with gels, so in the end he was born at 39+1. He was 7lb 7oz, so not big at all.
    Regarding induction, have a read of SeaChange's thread as that explains it really well. In a nutshell, while some drs will suggest induction due to potential size issues (macrosomia), IMO the most crucial issue is around placenta health and the impact of insulin. My endo basically said that GD's can be at higher risk of stillbirth once over 40 weeks in particular - this is why most ppl on insulin are induced. My obs and I negotiated around induction dates. His opinion was that he'd want to induce at 38 weeks if I'd been on high insulin (60-70 units +) but given mine was lower, he was happy to wait. I also had CTG monitoring in the interim. I was happy that they were keeping a good eye on bub. The other issue can be higher risk of breathing problems, and as my endo explained it, if your bubba has had some extra blood sugar and is "big" it's not so much about the size of squeezin' 'em out (not his words ) but the risk around the body being too large for the organ maturity IYKWIM... i.e. immature heart/lungs supporting a big fat boofer body.

    Given your insulin is currently low, you might be able to get away with it. So saying (and I hope this doesn't upset you) given you're 32 weeks, I don't like your chances of staying low and I agree that t his could impact your vbac attempt But on the bright side, maybe they'd just break your waters and if that gets you going (b4 40 weeks) well then that's ok. Plus it's your second which also supports an earlier labour. I tried EVERYTHING to start my labour naturally, but at 38-39 weeks, my body was TOTALLY uninterested.

    Like you, I really can't be induced either this time, so that's my incentive to TRY avoid insulin (pelvic floor nerve damage & prolapse means I can risk suction/forceps - both of which I had last time, which means no epi... which means avoid induction like the plague really). Otherwise it may well be a c-s for me (plus I have a low placenta atm so it also depends on that moving).

    And I'm totally happy to answer any questions you have or we can just chat about it - it's good to think through it all now . Are you also aware that many hossies have a policy to put GD bubs into special care nursery for the first 24 hours to monitor their blood sugars? (they can be low at birth) X went in, but "roomed" with me... i.e. he was in my room a lot, but we were back in the nursery for feeding - so it was less traumatic than I expected. Then he spent 60 hours under lights for jaundice lol so it was good I was mentally prepared to deal with him being in SCN.

    I'm sorry to hear you'll have to go up to 6 units of insulin . FYI, I started on 8 units and ended up on 18. I was also told that at certain times, due to hormone surges & stuff, your BSL's can just creep up & up regardless of what you're eating. It's difficult when you know the impact it can have tho.

  9. #243

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    Wow, thanks for all the info Belfie, I didn't realise that insulin dependant GDM accelerates the maturation of the placenta. A very valid reason for keeping an eye on things. I've also read that because I've had a CS I already have a slightly increased risk of stillbirth post 39 weeks. I think that personally 39 weeks is the limit that I'm comfortable with. If bub decides to come before then, well all and good but I am seriously considering booking a CS for 39 weeks at the latest.

    It will be interresting to see how quickly my insulin requirements ramp up. Hopefully not too quickly How many weeks were you when you were started on 8 units? Were you on Protaphane?

    I have a scan this Friday. I'll be 33+1 weeks so it will be interresting to see what size bub is and what the fluid levels are like etc.

    I'll have to check out what the Hossie's policy is re: bub in SCN etc. Thing is I not 100% certain which hospital I will be having bub. See I'm doing shared care between our local public hospital and a private OB (who is also a senior OB at the public hospital) and the plan was that if I were going to VBAC I'd birth at the public hospital but if I had an elective CS then the Ob would do that for me at the private hospital.
    One of my friends who had GD recently had bub at the private Hossie and bub roomed in with her straight away. She wasn't insulin dependant tho and bub's BSL's were fine. I'm not sure what the public hospitals policy is though. I think they only take them to SCN if they have hypoglycaemia or another complication.

  10. #244

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    yeah it's interesting isn't it. I think the big issue is that insulin doesn't necessarily accelerate the maturation of the placenta but there is an unknown role in the impact on the placenta (maybe that's a nitpicky distinction - but it just intrigued me ). I didn't know that about the increased stillbirth risk from a previous CS either. I'm pretty sure i'll end up being a CS at 38-39 weeks.

    Re my insulin, good question - I had to look it up. I started at 32+5 days.

    Have fun at the scan, great to have another peek at bubba. Just bear in mind all the conflicting literature about baby size, don't let 'em freak you out. I know soooo many ppl who were told bubba was big/small etc and turned out to be quite wrong. I've got a scan at 31.5 weeks for placenta, I can't wait for another peek!!

    Re your hossie, aah that makes it a little tricky to check re SCN policy. Most ppl I seem to remember in this thread, the policy was pretty standard, but of course I don't know how many were public or private. I get the impression that it's very much if you were on insulin. If you're not on insulin they don't seem as fussy, maybe that's why your friend's bub wasn't admitted? I was told that my bub would be admitted regardless of his BSL's (which were fine, first a shade low but still technically "normal"). So saying, I kinda found out that it would happen quite accidentally and then I asked them (hossie and obs) all about it. I don't think I would have been told (grrr) if I hadn't gone asking! Plus I think it also depends on the paed, as a GD bub (insulin-dependant) seems to always get checked (at my hossie) by a paed, so I imagine it's at the paed's discretion a bit too.

    AFM... 9.9 tonight . really way too high, so I'm glad I'm seeing the dietician tomorrow. I actually thought I had an ok dinner too, so clearly I have to tighten up. In general my levels are sitting way too high, with only a few 6's and nearly all 7's. I think my endo thought I'd have a few weeks before it really kicked in... but I think not. So I'll be eating like a saint asap otherwise I think they'll be whacking me on insulin quick smart - eep! I actually found a place that does gluten free fish & chips! I was soooo excited. I had fish, one potato cake, TWO chips, a salad and a gluten free/onion free dim sim (I was soooo excited, I haven't been able to have a dim sim for 8 years!). So ok not very healthy at all, but I really thought the carb load woulda been ok... but the batter probably kicked me over. Plus I had a small oj with my iron in it. So I need to find another way to have my iron (it's a liquid form) and the oj helps absorption, but I think too much sugar! Ah well

    Btw, you know my profile above where it says collecting acronyms... the BBG is the fun bit... that's for Beautiful Baby Girl tehehe just to keep me positive

  11. #245

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    Lol, I was wondering what the BBG was!

    It sounds to me that unfortunately your placental hormones are going to make you insulin resistant regardless of how good you eat, so please don't beat yourself up about it. It sounds like it's outta your control really. It's good that you're onto it though. And just remember that if you DO need insulin it is best for you and Bub. I was doing some research yesterday and in order to effectively limit the effects of macrosomia I read that fastings need to be under 5.5 (preferably under 5.3) and one hour post meal BSL should be less than 8 and 2 hours post meal BSL should be less than 7. SO of course I was *****ing my finger 1 AND 2 hours after breakky and lunch yesterday just to see and 1 hour post meal my readings were 7.6 and 2 hours post they were under 6 so I'm happy with that. I did 6 units of insulin last night and my fasting BSL this morning was 5.2, so under the 5.5 which I'm happy about. I do suspect though that I'm going to havre to keep upping the insulin like you said. HOpefulyl I wont get past about 20 units.

    I will definately have a chat to the OB's about both hospitals policies RE: SCN admission for insulin dependant GDM. You have a point, my friend at the private Hossy wasn't insulin dependant and nor was my friend at the public hossy and they both had their bubs rooming in straight away.

    I must say I AM looking forward to my scan on friday Although I am half expecting them to tell me bub is on the larger side as I'm just feeling really ucomfortable all of a sudden. I cant remember feeling this uncommfortable with my last pregnancy. Plus Charli was born at 38 weeks weighing a healthy 7lb 8oz and I didn't have GD with her, so considering this is a GD pregnancy AND I'm having a boy, which are generally bigger anyway, I thing baby B might be a 9 pounder by 38 weeks.

    Good luck with your upcomming scan. Hopefully the placenta has moved away for you.

  12. #246

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    Hi ladies, sorry to just bardge in on your conversation, but i have a few questions and i though you all might be able to give me some answer's!! I completed my first GTT at 29 weeks and came back all clear measuring 4.2. at 30 weeks i was measuring 33 weeks, due to another complication i had to have an ultasound at 33 weeks so the Dr said we will just check the measurments just to see. So i went for the ultasound at 32weeks and 3 days I measuring 35weeks and 3days. I then went to my appointment on monday to which i was 33 weeks and 4days and my fundal height measured me at 38 weeks. He said maybe i am just having a big baby but he wants to do the 2hr GTT just to be sure. So being naughty and cheeky my sil has a blood test thingy LOL to test the level of sugar in my blood and i did it the ther morining and i had not eated since dinner the night before and it came up at 5.4 does this sound normal or high, i am clueless!!!!
    So my other question is what sort of chance do i have of having GDD seeing that i passed the first one, is there a chance i do have it?????
    I am now 34 weeks tomorrow, what will happen obviously i will need to monitor my diet, but what else happens, this is my fourth pregnancy andI have never had GDD before. Will they induce me early or just monitor me???

    Sorry fo all the questions and thanks in advance for your help.

    NIKKI!!!!!!!

  13. #247

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    Hi Nikki! You are exactly 1 week ahead of me!

    You fasting BSL's are mean't to be under 5.5 so yours seems okay at 5.4. It's hard to know though as it's also your blood sugar levels during the day and after meals that are important. Try not to stress too much about it. Just go and have your GTT and see what happens. Usually GD manifests between 26 and 30 weeks, but I guess it's not impossible to get it later on.
    If you do have it and your bubba is large for gestational age they may want to induce you acouple of weeks early. Did you measure bigger than normal with any of your other pregnancies?
    Good luck with your GTT and let us know how you go.

  14. #248

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    Thanks you Mamaspice for your quick response, I have never measured big with my othe pregnancy and they were 8 pd 2oz 8pd 1oz and my last was 7pd 6oz. I am not a small figured person, i am about a size 16 before pregnancy and i honestly think i won't be much more after i have bubs, the dr said to me that maybe i am having a big baby as i am a fuller figure woman!!!! This annoyed me abit and don't understand as I was this size for ALL of my pregnancy's and why were they not BIG babies??? Thanks for your help and i am going for my test next monday and then my appointment isn't until the following monday!!!! I amnot stressed about having GDD i am only worried about pushing a big baby out!!!!!!!!!!!! I have had vaginal births always and really don't want my last pregnancy to turn out to be a c-section not that there is anything wrong with them i jsut think it will be really hard afterwards with all my children and recovering from a c-section. My kids are 6, 4, and 2. So yes my hands will be full. Anyway enough from me, Hope all goes well with you too and thanks for helping me out !!!!!

  15. #249

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    hey LoveMyKids,

    I agree with what MamaSpice said, and don't feel you're butting in on our convo - the more the merrier... we're just yabbing away as it's pretty quiet in here atm plus it's great picking other ppl's brains!

    I agree that it sounds unlikely you'd have it given your previous history. MamaSpice is the expert on fasting BSL's as for god-knows-what-reason my endo doesn't make me measure mine . I agree that if they think the bubba is large on the scan there could be more pressure for intervention... so saying, those scans are notoriously inaccurate for sizing! As my obs said to me last time, if I knew bubba was big, would I still try to birth vaginally - to which I said yes I would. Have a google around it, it's worth a read. If you do end up having GD and/or being on insulin then there are different reasons for induction (around placenta health). Just so you know, my endo did tell me that GD "can" develop later, it's just that 24-28 weeks is the time it's most likely to develop, and I still don't see why you'd get it after not getting it previously.

    On the plus side, IF they find GD, well then you can control your BSL's with diet which reduces your risk of a big baby - and I think your body would well know what it's doing. My sis vag birthed a 10+lber with no problems (her second), so I think even if bub is a bit bigger, you'll be fine.

    Back to your other question, what happens if you do have it? Ok as far as I know - first you get referred to an endocrinologist and typically you'd also see a diabetes educator (ED) and/or a dietician. Tbh the extra appts can be a nuisance. You'd get all the information about modifying your diet and monitoring your BSL's. Sometimes, even with the best dietary control in the world, your BSL's can still go high in which case you might be put on insulin. Once you're on insulin most hospitals tend to want to induce, and you also get extra CTG monitoring. I know my obs wants to induce earlier (38 wks) if the insulin is greater (60-70 units) and a bit later if insulin is less (I was on 18 units and induced at 39 weeks). I've not heard of anyone being induced before 38 weeks unless there was other stuff going on, and in most cases (that I've seen through here ) a C-S is not considered necessary (unless there's other factors too). I don't know what would happen if they were convinced it was a big baby, that could change things. But that's the typical run of the mill scenario.

    Hope that helps, all the best! Crossing my fingers for you that you don't have it, and bubba is just making like I do in a big bed... arms & legs outspread taking up lotsa room!!

    Belfie

  16. #250

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    On insulin..... feeling ok taking it..

    All insulin so i was told is class A and metformin is Class C.... so the diabetes doc said

  17. #251

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    Quote Originally Posted by didispunk View Post
    On insulin..... feeling ok taking it..

    All insulin so i was told is class A and metformin is Class C.... so the diabetes doc said
    You'll be fine Didi, If i can handle it, anyone can! And I've got a lot further to go than you, Lol

  18. #252

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    Quote Originally Posted by didispunk View Post
    On insulin..... feeling ok taking it..

    All insulin so i was told is class A and metformin is Class C.... so the diabetes doc said
    Oh well done Didi, you're a star . Is it injections? (I don't know if insulin comes in any other form). Is it helping to have your mum there?

    Well I saw the dietitian today and she was GREAT! Don't think she'd expected SO many questions but given I've had GD before, plus my FM for 8 years... it was more about fine-tuning. Interestingly she was more focussed on keeping my weight the same for long term Type 2 risk reduction, and telling me to eat low fat than they did last time. Last time the DE just said don't worry about the fats, concentrate on the sugars. So I had been hoping that with even more vigilance on my food, that'd keep me off insulin, but she said that honestly given I was on it last time, I'm highly likely to be again so that's not great, given I totally don't want to be induced... but we'll see. I feel I've got a better understanding of what to eat, plus even she was groaning at the ridiculous amounts of food restrictions in our household, so that was kinda validating. Plus I found new McCain's Sweet Potato oven fries (new) so I tried them tonight and they weren't bad - we'll see how the BSL's are!

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