GD diagnosis and immediate problems - HELP!

My sister found out 2 days ago she has GD. Straight away we both did some research on foods and portions and made some plans.

Today she had her first Diabetic Clinic (I was supposed to go but had to pull out at the last minute, so she went alone), and everything they told her contradicted the info we got from Diabetes Australia. The rest of the women were given new appointments, but C was told she has no new appointments, because she has until Monday to fix her BSL or they'll put her on insulin.

Now...that sounds completely ridiculous to me! She's going to be testing 4 times per day, so she'll be learning what sets her off. I think it's unreasonable to FIX it in 4 days. She's making changes, she's doing more exercise, and so far she's complied with everything they've asked of her. PLUS, her baby is smack bang on average for growth.

So I guess I'm asking for opinions, ideas, whatever....she IS making changes, and she is definitely serious about it. We just both think 4 days is far too quick to be a proper judge!

It is way to soon, she should be given a bit longer to adjust and to see what her levels are. I was rushed onto insulin when I didn't need to be and ended up with an allergic reaction so my gp fought my ob snd dietician and it was managed by diet. Hopefully your sister can be given more time to manage it by diet and exercise before being put on insulin.

Very strange to hear that. A first appt at Diabetic clinic generally involves seeing Dietician and Diabetic educator, OB, and endocrinologist. FRom there will have regular appts with all as needed and a wee test and CTG at every appt or just before.

She needs time to figure out her diet and see what her sugars do first and if not being diet controlled then insulin.

Unless off course her GTT was very dangerously high.

They didn't tell her what the GTT came back at, but they did a ***** test this morning and it was 6.1.

Can we find out what her test came back with?

so she has previously done the OGCT and now OGTT. clearly they were high readings for them to say she may need insulin.

you will see some changes in 4 days, and it is likely she will feel a bit crappy initially from changing to a diabetic diet.

On Monday she must be having an appointment if they want her on insulin so try and get to that ask lots of questions and hopefully you will get lots of information too :)

She should be told what her results are. Whether Someone's results come back normal or not I will still explain to then the cut odds for each figure and what there's is.

Make sure she writes down all questions for Monday as often in appts people forget what they want or need to ask.

When the bsl was taken today was it 2 hrs pre or post food or just random.

Did they happen to do an A1C test when they took blood? That test shows elevation in BSL over the previous several months. If that was raised then it could indicate that she already had Type 2 diabetes prior to the pregnancy and she is unlikely to be able to control it with diet alone.

The other thing that comes to mind would be that hospitals are big 'patch 'em up' factories and not the loving GP that has known you for your whole life. The Dr's make snapshot judgements. When I went to the GD clinic and saw the specialist after being diagnosed I recall her saying to me "..of all the people that I see today, you are probably the only one that will understand what I am saying to you..". I thought she was a bit judgemental, but then I attended the clinic every couple of weeks and sat in the waiting room with other GD mums and watched as they ate pies and drank coke. Clearly they didn't understand the whole GI thing. Presumably for those people that have absolutely no idea nor any inclination to learn about diabetes and GI, there would be a fast track to insulin because that is the only option left if people are unwilling to change lifestyle habits. I am not saying that your sister is in that category of course, just that the Drs see a lot of people come and go and take an educated guess on who will make an effort. If she rocks up to the appointment with a food and exercise diary and her 4x daily BSL, then an appropriate plan can be worked out. They will be more inclined to trial lifestyle changes if she can show that she is working on it (provided the changes are actually lowering the BSL's). But if insulin is needed, it isn't the end of the world.

Sorry havent read the rest of the replies but she does not have to take the insulin straight away they cant force her and should give her an option to have a good go at changing her lifestyle.

I had GD and the doc "suggested" I go on insulin and i negotiated that i will change my diet and give me a few weeks.

Towards the end, even diet didnt help so i had to take insulin.

All the best to your sister.

She should try not to stress, I found that I could manage my GD with just a small walk ever day and following the diet advice they game me. If I did go out for dinner or indulge in a small treat I just made sure I walked right after or before so that. 4 days may see quick but hopefully they are just trying to help the baby as soon as possible to make sure it's not effected. The first week after being diagnosed was the hardest for me, I think I cried every day for the first week until I realized I could manage it. Good luck.

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so she has previously done the OGCT and now OGTT. clearly they were high readings for them to say she may need insulin.

you will see some changes in 4 days, and it is likely she will feel a bit crappy initially from changing to a diabetic diet.

On Monday she must be having an appointment if they want her on insulin so try and get to that ask lots of questions and hopefully you will get lots of information too :)

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I'm not sure what OGCT and OGTT are, but she did the fasting 2 hour GTT almost 2 weeks ago, and then they did a normal ***** test this morning, although they said to her that it's more involved than the normal machines? Whatever it was, she said it was done just like a normal ***** test.

She definitely doesn't have an appointment, they told her to ring them on Monday to give them her levels; they also said that if she didn't ring, they would ring her. Obviously I wasn't there, but I know how she came home - upset and defensive. She's ready to work with them, she told them that, but it very much feels like they aren't willing to budge. I guess we'll find out what happens Monday.

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She should be told what her results are. Whether Someone's results come back normal or not I will still explain to then the cut odds for each figure and what there's is.

Make sure she writes down all questions for Monday as often in appts people forget what they want or need to ask.

When the bsl was taken today was it 2 hrs pre or post food or just random.

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Just random, she wasn't told to fast or anything. They just rang her yesterday, told her she has GD, and she has to go to the clinic (today).

The 'appointment' is just over the phone, but we're definitely gonna write down a bunch of things, put the phone on loudspeaker, and ask away!

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Did they happen to do an A1C test when they took blood? That test shows elevation in BSL over the previous several months. If that was raised then it could indicate that she already had Type 2 diabetes prior to the pregnancy and she is unlikely to be able to control it with diet alone.

The other thing that comes to mind would be that hospitals are big 'patch 'em up' factories and not the loving GP that has known you for your whole life. The Dr's make snapshot judgements. When I went to the GD clinic and saw the specialist after being diagnosed I recall her saying to me "..of all the people that I see today, you are probably the only one that will understand what I am saying to you..". I thought she was a bit judgemental, but then I attended the clinic every couple of weeks and sat in the waiting room with other GD mums and watched as they ate pies and drank coke. Clearly they didn't understand the whole GI thing. Presumably for those people that have absolutely no idea nor any inclination to learn about diabetes and GI, there would be a fast track to insulin because that is the only option left if people are unwilling to change lifestyle habits. I am not saying that your sister is in that category of course, just that the Drs see a lot of people come and go and take an educated guess on who will make an effort. If she rocks up to the appointment with a food and exercise diary and her 4x daily BSL, then an appropriate plan can be worked out. They will be more inclined to trial lifestyle changes if she can show that she is working on it (provided the changes are actually lowering the BSL's). But if insulin is needed, it isn't the end of the world.

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That's a great point Artechim, I'll hafta ask about the A1C test. With a strong family history of both Type 1 and 2, as well as PCOS, it's entirely possible she already had Type 2.

I understand the snapshot judgement, it's sad but true. However, she told me she was the only one in the class asking questions - she asked how they treat the baby after birth, and if it would be an idea to store up some colostrum beforehand so they don't give the baby formula. The other women asked her what colostrum was. And then she asked if they would be induced if they needed insulin, and the other women asked what inducing was :o So I would've thought that whatever judgements they'd made before then, they would've realised that she's researching and intelligent and willing to work. I guess we'll just have to prove it to them!

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Sorry havent read the rest of the replies but she does not have to take the insulin straight away they cant force her and should give her an option to have a good go at changing her lifestyle.

I had GD and the doc "suggested" I go on insulin and i negotiated that i will change my diet and give me a few weeks.

Towards the end, even diet didnt help so i had to take insulin.

All the best to your sister.

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Did you need to be induced because you were on insulin? They've mentioned it a couple of times now, but at the moment bub is smack bang on average growth wise. If bub isn't big, why induce?!

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She should try not to stress, I found that I could manage my GD with just a small walk ever day and following the diet advice they game me. If I did go out for dinner or indulge in a small treat I just made sure I walked right after or before so that. 4 days may see quick but hopefully they are just trying to help the baby as soon as possible to make sure it's not effected. The first week after being diagnosed was the hardest for me, I think I cried every day for the first week until I realized I could manage it. Good luck.

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Yep I think that's gonna be the biggest change that'll help her - she does hardly anything through the day now that she's not working. She only moved in a little while ago, and for the last few years has been living a very hard life, so I think she's been having a bit of a holiday :) We can go for walks together, it'd do me good as well.

Thanks for your answers everyone :)

Yes I got induced at 38w4d but there were other factors. I had alot of amniotic fluids, bub was measuring big (im small 155cm tall) and traumatic first birth with 3 to 4 degree tearing.

I had GD with DD1. levels were 9 after the 2hr test. i met with a diabetic nurse specialist and endocrinologist and was given 3 weeks to control it with diet and exercise. unfortunately it got to the point that i was practically starving myself to get "safe" levels so i went on insulin at 31 weeks and was induced at 39 weeks (gels only) and DD1 weighed in at 7pd 14oz and 50cm long - so not massive but she went into scn due to low blood sugars.

DD2 the jury was still out on whether or not i had GD. even though my test after 2hr came back at 7 (normal range) i continued to do the ***** tests and was getting levels at 9 and even 11. i did the 2hr test again at 32 weeks and it still came back at 7 but i had heaps of amniotic fluid and Bub was measuring big which concerned me and my ob so i opted for induction at 38 week 1 day (arom only). DD2 weighed in and 9pd 4oz and 54cm long.

eta : she was also admitted to scn for blood sugar issues. so even though according to the two tests i did with her i didn't have GD, my ob and i think i did...