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2010 Gestational Diabetes Support Thread - Page 3

post #41 of 201
Can I join you all? My name is Nicki and I am 21 weeks pregnant with my 2nd child.

I was diagnosed at 29 weeks with my son, we tried diet control but I was on insulin within a short period of time.

This time I am 30 pounds lighter, have been doing some light exercise and eating pretty well- though way too much fruit and honestly that's the only thing I have wanted since I got pregnant so it's a bummer. I see an endocrinologist normally since I have insulin resistance, and she has had me testing 4x a day for weeks now. My numbers have been great (I have to be under 120 2 hours post meal and under 95 fasting) with just a few highs here and there when I ate something I shouldn't. But in the past week my fastings have been high. ranging from 90-106. I have tried a protein snack before bed and that only got me to 95, i don't know what the problem is, but I am not having a hard time controlling my after meal sugars. I have gotten my past couple of days just under the wire but...

My biggest fear is getting the official diagnosis and having to go on insulin again. I know it's not the end of the world but I am sure you understand what I am trying to say. My endo has me emailing her my numbers ever week, and I am so nervous that tomorrow she will email me with bad news. I really on't think my numbers are all that out of control but she is way over cautious.

My OB won't let me go past my due date, and last time I was induced at 38.5. It sucked. They said my son was HUGE, yeah he was 7lb 4 ounces and 19.5 inches when he was born, with perfect perfect glucose levels. The other thing that sucks is I KNOW my due date is August 26th, making me 21 weeks today, but my OB refuses to aknowledge that I have 33 day cycles and insists on using her own due date which is 5 days earlier, well when facing induction those 5 days mean a lot to me. So I am still fighting her on it. I don't want to give up on those 5 days. But she keeps telling me that 5 days doesn't matter.... I wonder if she will fee that way come baby time???

Edited to add- does anyone have ANY clue on how to lower my fasting? I just need it a couple points lower, though the 80s would make me much happier... Here is my numbers for this week so far (fasting and 2 hour post meal)...
I missed some tests in here because our evenings were crazy it was my birthday and my son was gone to my mom's and I would remember like 3 hours after meal instead of 2 I am back to setting my watch alarm.

Friday 4/9-- 89 90 79 96
Saturday 4/10-- 106 103 127 not tested
Sunday 4/11 --98 96 110 not tested (we actually didn't eat dinner because of a late lunch)
Monday 4/12-- 95 98 99 not tested I fell asleep
Tuesday 4/13-- 96 105 101 99
Wednesday 4/14-- 94 110 92 110
Thursday 4/15-- 90 96 haven't done post lunch yet, just ate a few minutes ago
post #42 of 201
Thread Starter 
welcome, nicki!

no real time to talk, but what helps my fasting numbers best, besides a good bedtime snack is a late afternoon walk, like 15 minutes brisk. Movement really is the key to my numbers, personally.
post #43 of 201
Hello all, hope everyone is doing well!

I'm doing a bit better, they raised my insulin dosage just a tiny bit a few days ago, and that is helping. Some of my fasting numbers are still a bit higher than they want but mostly they are under.

I am still measuring way ahead(on Tuesday I was 35 weeks 4 days, measured 43) but baby isn't that big, it's mostly excess fluid. My blood pressure was up though and I'm spilling protein in my urine-so with that, combined with the GD and my past history of shoulder dystocia and all the pain I'm in due to SPD, we are inducing labor in a little over a week(we haven't set the date, but right at/just over 37 weeks). I've been having some contractions off and on, and I'm dilated to 3. So yeah, baby will be here soon. I'll be so glad to stop all the needles! LOL
post #44 of 201
Welcome Nicki!

You've done a great job setting yourself up for a better go round this time.

Things that may help your fasting numbers are adding a 1 carb + 1 protein before bed snack. High fasting numbers can be because of a bg crash overnight, so if you can even out the night time some people have good luck lowering their fasting numbers. I second Sharr610's advice for a good walk in the afternoon/evening. Thirty minutes has been proven time and time again to increase insulin sensitivity, less will work for some people. Third, cinnamon can help regulate bg from some reports. It's a little controversial, esp for pregnant women because of a blood thinning effect cassia cinnamon contains. If you use Ceylon cinnamon instead of Cassia there isn't a blood thinning affect.

Darlingrick74- good luck! you must be so excited to meet your little one! and excited to be done with this GD crud too

AFM:
I've had one high fasting level (99), and a few pp that are higher than average for me, but I've developed a nasty cold/flu thing. I know illness can make your sugar go up, so I'm not too worried. My highest pp has been 122, it was a one hour after a crappy dinner (I was too lazy to make something better for me.... bad bad bad mama).

In bigger and better news I transferred hospitals on Tuesday. I just couldn't deal with the crud I was getting at the hospital associated with the b.c. I had originally booked. That went well, and the midwife there assured me I was still "low risk" and was happy with everything else!! yay!!

THEN- yesterday I got an email back from a HB midwife group I had contacted when I was scrambling in the first few days. I qualify, it's a free service and I'm going for it. I've filled out an application and will find out in the next couple of days if they have someone in my area. Then we'll make an appt and the midwife will evaluate me, and we'll get a final decision. SO, it looks like this GD diagnosis, as frustrating as it has been, may have lead me to the HB I wanted to begin with. Weird how life works sometimes
post #45 of 201
Thanks guys! I was CRAVING icecream before bed last night so I had some of that but I paired it with a couple handfuls of almonds and today my fastin number was 88 I am good with that

I was able to go for a walk yesterday afternoon, I had been doing at least a mile a day but then it rained here for like 2 weeks and I was missing it. But that could have been what helped me last night too who knows but I am feeling a little better about things


That's great Bubblette about getting to a different hospital, that's one of my goals of why I don't want to be on insulin, there is a great hospital, it's almost 2 hours away but I don't care, and in order to get in with their midwives I have to NOT be on insulin... so fingers crossed. I hope they have someone in your area! And that the eval with whoever is in your area goes well!!
post #46 of 201
Hi Ladies,

SO very sorry but this is going to be a drive-by posting. I've been meaning to get over here all week long and have been so busy, I don't even have the time to be here right now but I'm blowing off a phone call to get on here quick!

The long story short is that my fasting numbers have all been near 110 and my post-meal numbers after dinner have been in the 120's & 130's. After only a week they put me on 2.5mgs of Glyburide 2x/day. I've been on it since Tuesday and my numbers really aren't coming down. After talking with one of my OB's y'day at my appointment, she seems to think that - based on the pattern she's seen in other GD mama's with my numbers - I'll be on insulin by the time I'm 30 weeks & that I may as well just go on it now because it will probably help me earlier

I just faxed my numbers in to the perinatologist an hour ago so I'm waiting to hear back from them by the end of the day. I'm hoping it's not going to be what I think they're going to say...
post #47 of 201
Headmeister- I don't understand why they are so quick to put you on medication. Personally, I've not had problems with fasting numbers so I guess that's a pretty big deal, huh? But your post meal numbers are not that bad. And if I read correctly you've only been working at this for a week. I hope this doesn't sound judgemental towards you at all I just don't understand.

rlandnl - Congrats on getting that fasting number down and with ice cream too, yum!!

Bubblette - your numbers are great. Don't kick yourself over 122 and your a great Mama. Hope you get that HB!!
post #48 of 201
I'm just stalking this thread. Hoping to conceive again very soon. I had gd with ds & my doc thinks it is pretty much a given I will again (I have pcos as well), but really I am ok with that as I feel I am so much more prepared & knowledgeable this time. Unfortunately the midwives I would love to go with will risk me out if I have to go on insulin again - not sure if I'll even attempt to go with them & risk the disappointment of having to change to an ob.

Sorry, I'm counting my chickens before they hatch (heehee) but ... well, it's hard not to.
post #49 of 201
hi all - alum of the really old/long thread. had my GD baby dec 2008 and expecting another dec baby! [9 lbs 3 oz, she didn't look like a GD baby but she was BIG!] don't know what to expect this second go round, but thought i'd check in now because i'm CERTAIN i will have sugar issues well before the usual diagnosis time.

since giving birth, i continued to have blood sugar issues, and lost 100 lbs on 100-125 carbs per day. yes, that's right, that's the amt i had to eat to actually lose weight. i'm extremely sensitive to carbs and grateful i found out the cause of a lifelong weight issue. went off the weight loss phase of my diet (and maintained successfully) so we started trying again for baby #2. already gained 5 lbs right away (bloat or carbs, not sure) so i'm getting worried.

i feel a little jittery but my BS is fine right now. i'm afraid the amount of carbs i will need (or not need...) to keep to in order to not gain the 70 lbs i did last time just isn't sustainable for pregnancy. in my experience the prescribed diets contain way too many carbs for me.. didn't matter whether they were processed or not, it was really just TOO MANY. i didn't really realize this after giving birth!

so this is my early pregnancy vent/hello/rejoin.
post #50 of 201
Hi brandy!

I got a GOOD Job on my blood sugars from last week, Friday sat were good so far this week, but Sun and monday my fastings were 99 and 100 I think I am extremely sensitive to no sleep because my diet wasn't different. I have been having trouble sleeping the past couple of days so I bet that had something to do with it. It was raining all weekend too so I didn't get my walk in, but today I walked a little between the showers. I wasn't feeling well though. been nauseous all day.
post #51 of 201
Subbing. I have pre diabetes and monitor my bs at home so I know I will have some issues with this pg. My fasting averages 110. Not sure if I'll get back on cinnamon or what. First baby they didn't diagnose me but I had a 9 pounder, last time I was really strict and had a 7 pounder. So I hope to do as well as I did last time but my condition is probably a lot worse.
post #52 of 201
Hi BrandyK -
Congrats on your new baby! I always self test starting in the second trimester cause I always have sugar issues.

So, Last night I had a very strange blood sugar moment. My numbers have been totally under control and well under 120 after an hour. If I keep them under control it gives me an occasional day where I can eat cereal or something and not have it affect my numbers. Well, yesterday my blood sugars went all the way up to 193. I know why it happened buy I've had other times where I've eaten carbs with not protein and not had a problem. I'm not sure if this is a sign that I'm getting further into the pregnancy (24 wks) and will start seeing higher numbers. It was crazy and kinda freaked me out but ever since then they've been fine.

Hope you all are doing well. I'm exhausted these days and ready for a rest.
post #53 of 201
Hi everyone. This is my first post, so sorry if I violate protocol in some way or otherwise goof. I've been following this group and sniffing out others as well.

I'm 30 weeks pg with my first and was diagnosed with gd a few weeks ago. After trials of glyburide, strict diet and exercise after every meal, my numbers are failing to appease my midwife. She wants to put me on insulin.

I should mention that I've spent the last few weeks reading every bit of research I could get my hands on; both the "for" and "against" sides of taking insulin while pregnant. The bottom line is that I haven't found a single study showing why the benefits of taking insulin outweigh the risks. I have found article after article stating this, but I can't accept someone else's opinion, someone else's conclusory recommendations, without proof to back it up. Show me the evidence-based reasoning, please. Does anyone know if credible studies exist either for or against taking insulin?

My burning question to you all is.....has anyone here refused insulin, and if so, what happened as a result? I ask because I'm with a birth center midwife, and the law says she must risk me out and xfer me to the hospital if I am on insulin. If I'm not on insulin, the decision to treat me remains with her. If there's no good and solid scientific proof that insulin is more of a benefit than a risk at this point, why would I consent to take it? People hear that I'm considering not taking insulin and they instantly tell me about the risks of stillbirth, hypoglycemic infant, shoulder dystocia, etc., but no one can back up these beliefs of risk, most notably the medical professionals. They don't know how or why they "know" this, they just "know". I understand why this stance is taken by professionals, particularly in the states, for fear of lawsuits. It might be good for malpractice insurance premiums, but it's not good for quality maternity care (or any health care, for that matter.) I digress.....

Thanks so much for any feedback. I sympathize with everyone here. The anxiety caused by the gd diagnosis is maddening!
post #54 of 201
Sammikins - gd is terribly frustrating & maddening. I've read so much about it since developing it with ds & honestly it doesn't seem like there really are any hard & fast rules. For me glyburide, diet & exercise were nowhere near enough to bring my blood sugars under control. I did go on insulin, it sucked but it did immediately bring my blood sugars under control & reduce my stress (honestly I think the stress was more damaging than anything else).

I don't have any concrete studies to give you. If you accept that high or varying blood sugars are potentially damaging (& not everyone necessarily believes this) than the need to reduce blood sugars &/or keep them stable becomes important. Really that is the crux of the issue. If you do not believe that blood sugars are important than treating high or unstable blood sugars seems rather pointless. If you do want/need to bring the blood sugars down & stabilize them than insulin really is a good option especially when other means have not worked.

I guess what I'm trying to say is I do not believe the taking of insulin is necessary the issue but whether or not gd is truly a concern to begin with.

I'd speak with your midwife about it more. You may be able to refuse the insulin & you may very well be risked out anyway for maintaining blood sugars that are too high. It sucks, I will be facing very much the same situation for my next pregnancy (as it is extremely likely I will have the gd diagnosis again) & it is already keeping me up nights.
post #55 of 201
sammikins -
Personally, I've always been able to control my numbers so I have not been faced with the particular issue.

Maybe we could help if you posted some more specifics about how high your numbers are after meals or your fasting numbers. Some of things that you've been doing to get the numbers down and are you exercising after each meal even for a 15 minute walk. I only ask these things because my dietician was horrible and was no help in getting my diet balanced and controlled and I ate very strictly.

My opinion is that undiagnosed diabetes can cause complication. My friend went undiagnosed with her first and he was a 10 pound baby who wasn't breathing at birth and had a lot of extra mucous in his system. He survived and is a fine boy now. I guess like the previous poster said you have to decide for yourself what is considered out of control for numbers and what is not. If your numbers are in the 140's with an occasional 150 and drops right away you maybe fine but if you are seeing numbers in the 180's to 200's I would proceed with great caution.

Good luck Momma! You are faced with some tough decisions and I'm sure the people here will help how they can. We've all been through our roller coasters and personally, I'm happy to share more of my experience as this is my third time going through this.
post #56 of 201
Headmeister- I'm so sorry you're having trouble controlling your numbers. I hope you can work it out so that everyone is happy and you're poking yourself a minimum times a day. Fasting numbers are a big deal though- have you tried an evening walk and protein rich snack? or a middle of the night snack (it's be cheese or almonds for me).



lifeguard- Good luck TTC!!! I hope everything works out beautifully! and that you don't have to join us officially on this thread



BrandyK - Welcome! and congrats If you know what works for you go for it. Well at least that's my feeling. Baby needs extra calories (not that many either) vitamins, minerals, essential fatty acids, and for your bg to be stable- none of that is contained in carbs. So if you need to keep it low carb in order to have a healthy pregnancy do what works, or at least that's what I'd do. Good luck!

rlandnl- not feeling well and lack of sleep def make my numbers start to creep up. I was sick last week for a few days and my numbers were all higher than normal for me, on the same diet.


MoonStarFalling- welcome! good luck this next time around, sounds like you did well last time


nixnux- How strange and scary. I haven't tried a carb without a protein, don't know that I will, but I'd be kinda freaked out if something I'd previously gotten away with all of the sudden made my sugars spike. I'm glad things returned to normal quickly.


Sammikins- I'm sorry you're having such a hard time with your numbers. You could try the exercise just before your meal, and playing with your diet even more. You might be one of those ladies like BrandyK who just needs to be on low low carb for things to work well. What have your numbers been??

I haven't been faced with the insulin conundrum, but I do realize there is some controversy. My understanding, and my midwife's is that your fasting numbers are the most important numbers of the day, and pp numbers are not correlated to negative pregnancy outcomes. The other thing the research digs up is that your BMI before falling pregnant is much more indicative of problems than your pp numbers. Maybe you could look up some of those studies to help make up your mind, or start a conversation with your midwife.

Personally, if my fasting were routinely above 90-95 and I could not get them down, I'd want to go on insulin.... I'm not comfortable with the safety of the oral drugs at this point in time - from my own personal research.


AFM:
I've been doing great. Three weeks + of monitoring and my fasting are under 90 (except for one 99 on the morning I got a flu thing), 2 hour pp are all under 120 (except for one 122). I had a meeting with the HB midwife yesterday and she sees no reason I shouldn't have a home birth. So we're having this baby at home It's been quite a twisty road to get here and I feel a bit under the gun planning a HB in 2 weeks.... but it's all wonderful and exciting.

I'm getting a bit bored with food, honestly. I've been leaning on berry smoothies frozen mixed berries, coconutmilk, protein powder and cinnamon. I miss lasagna, cookies, and random crap but it's all worth it.
post #57 of 201
Bubblette - that's so great that you are getting a HB! Congrats! I'm sure it will be an amazing experience.

Has anyone had an A1C test during pregnancy? How about a fasting blood draw prior to becoming pregnant (not metered, but at a lab)? I ask because my A1C draw at 12 weeks pregnant was within normal range (4.8) and I found out that my pre-pregnancy fasting was 95 last October. I'm just feeling a little like the stress of GD makes things worse, when perhaps some people tend to have a little bit higher blood sugar not pregnant (which could def be a problem long term and should be addressed - for me I know I need to drop 30 lbs!). The cutoffs just seem really arbitrary, at times. Obviously they need to have some cutoffs, but I hear mixed numbers - is it below 90 or 95 fasting? When you are stuck between the two commonly cited cutoffs most of the time it can become a little bit confusing. Sorry for the ramble, I'm just feeling a little bit frustrated and trying to not worry so much.

I'm waiving the glucose tests this time and home monitoring. I've had consistent fasting numbers between 88-96 for the past 4 weeks, most are right around 92. My 2 hour pp numbers are generally in the 100-120 range, with an occasional 130 if I cheat and have white carbs.
post #58 of 201
Quote:
Originally Posted by prettyuglybefore View Post
Has anyone had an A1C test during pregnancy? How about a fasting blood draw prior to becoming pregnant (not metered, but at a lab)? I ask because my A1C draw at 12 weeks pregnant was within normal range (4.8) and I found out that my pre-pregnancy fasting was 95 last October.... Obviously they need to have some cutoffs, but I hear mixed numbers - is it below 90 or 95 fasting? When you are stuck between the two commonly cited cutoffs most of the time it can become a little bit confusing.
Hi Prettyuglebefore,
From a scientific point of view you have to pick a cut off because you have to be able to analyze your results. If a group doing a study looked at bg in increments of 5 (on the American scale) you wouldn't get statistically significant results the vast majority of the time. So the researchers pick one of the "normals" some of them pick 90, some 95. So yeah... it's a bit arbitrary- very frustrating for us on the other end.

I spent about 4 days doing research on GD from primary published lit right after I was diagnosed, and I should have saved all the studies I found interesting.... Sorry I don't have links.


All from my understanding of what I read:
The A1c while really useful for determining type1 and type2 does not reflect outcomes for GD pregnancies. So your result was an awesome indicator that you do not have diabetes outside of pregnancy. If your normal fasting is 95, then that's what I'd be comfortable setting as a personal limit. By normal I mean I'd have to be convinced that was average for me pre-pregnancy- not just a once off but probably over a week or so (my personal neuroses being what they are). There is a study out there that showed fasting levels above 90 were significantly more indicative of complications in GD than after meal numbers. The study did not try a second cut off at 95, so who knows really? Another study showed that women who were "normal" and "overweight" (using the BMI scale, which is why I'm using quotes) before pregnancy and were diagnosed with GD were able to approximate normal outcomes when their GD was diet controlled. While women who were "obese" had outcomes that looked like uncontrolled GD even if they were diet controlled, but got back to normal levels of risk when using insulin. Multiple studies I read about outcomes looked into those two things, or used those two things to look at their data. I'm pretty convinced those two piece of the puzzle are very significant.

So I guess it really comes down to finding a HCP that is comfortable with the same definitions you are. If you are happy with fasting under 95, your pre-pregnancy weight, monitoring at home without the 3 hour test then find a HCP that is happy with that too and you'll be all set. I'd urge you to do some really good research on the subject and develop your own opinions that you can back up. Because in the end you are perfectly right, the lines are arbitrary, and there is no "normal" just an average (or median or mode depending on the study ) There will be some people for whom a fasting of 95 is perfectly normal and ok, and some people where 95 is way too high - we're all on a continuum.

Finding my HB MW was so freeing for me for just that reason! She's looking at me from an overall HEALTH perspective, not just my diagnostic test numbers which were abysmal.

I hope that helped a bit..... I probably just confused the issue more.
post #59 of 201
Bubblette - THANK YOU! I totally needed that. I'm working with the same OB that I did during my first pregnancy and she has completely relaxed on the numbers in the past four years. I'm not sure what changed for her, but I'm glad that they did. I felt under the microscope my first time and now, she seems to feel comfortable with me keeping track and in check.

I'll have to ask her about her theory on checking my A1c - she is sending me in again this week to get it checked.

I still bring up my numbers every time I see her. I'm going to continue to go with the 95 cutoff for now and try not to stress about it. My home monitoring is going fairly well, though I'm a bit of a slacker on checking my pp numbers at times.

Finally, my naturopath recommended a chromium supplement - anyone heard of that? I haven't started it since I haven't had time to research it on my own yet.
post #60 of 201
There was a lot of talk about chromium and type 2 diabetes years ago. It's supposed to improve insulin sensitivity.

Cinnamon is also supposed to help--but you have to make sure you're getting "real" cinnamon.

As for HbA1c, I've been to four different MFMs during my various GD pregnancies. Two have done HbA1c during the pregnancies, two have not. As I'm sure you know, it's retroactive--deals with control the past 4 months. I've always had it done in the 3rd trimester--my guess is that it's a way to tell them if they should expect more placenta issues, etc. If it was elevated, that might be a clue that the diabetes wasn't as well controlled as they thought. Both times, it was in the 5% range--so I don't think it was an issue.
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