Gestational Diabetes... or not?!

[Happeesupermom]

My 1 hr. glucose test came back a little high, so they sent me in for my 3hr gtt. My #s were: 94 (fasting), 210 (1hr), 180 (2hr), 97 (3hr). So they said I have GD.

I had been under stress, lack of sleep and eating eratically... so I wonder if my numbers could have been a false high reading? This is why.....

Since then, I have gotten a glucometer and been monitoring my bg numbers at least four times a day: fasting, then 2 hrs after each meal... and 1 hr after any snacks. My numbers have averaged around 88-90. My fasting #s are between 75-95. My 1 hr #s (after a snack) are between 80-110. My 2hr #s (after meals) are between 89-124.

These numbers don't seem high to me. Am I wrong? Could it be that when I took my gtt was just having a bad day??? (I'm afraid to hope...)

The GD label means I can't deliver with the midwives (unless Dr. gives the "OK" if I have my GD under control... but I've heard he doesn't do that very often). I have an appt. with the Dr. on Tues, and I plan to take in my bg/meal log and ask if I can go back to the midwives.

This is pregnancy #5 for me.... First was a c/s, the other 3 were VBACs in hospitals, but not very good experiences overall. I'm REALLY wanting to experience a peaceful, natural birth without all the interventions, pressure from Drs & Nurses, etc. found in a hospital! Now, I'm trying to hold on to the shrivelling hope that it's still even possible for me!

Please, respond with personal experience, knowledge, suggestions! ALL are appreciated. Thanks in advance!

--TryingNotToBeAfraid.

[SeattleRain]

Originally Posted by Happeesupermom

My 1 hr. glucose test came back a little high, so they sent me in for my 3hr gtt. My #s were: 94 (fasting), 210 (1hr), 180 (2hr), 97 (3hr). So they said I have GD.

I had been under stress, lack of sleep and eating eratically... so I wonder if my numbers could have been a false high reading? This is why.....

Since then, I have gotten a glucometer and been monitoring my bg numbers at least four times a day: fasting, then 2 hrs after each meal... and 1 hr after any snacks. My numbers have averaged around 88-90. My fasting #s are between 75-95. My 1 hr #s (after a snack) are between 80-110. My 2hr #s (after meals) are between 89-124.

These numbers don't seem high to me. Am I wrong? Could it be that when I took my gtt was just having a bad day??? (I'm afraid to hope...)

The GD label means I can't deliver with the midwives (unless Dr. gives the "OK" if I have my GD under control... but I've heard he doesn't do that very often). I have an appt. with the Dr. on Tues, and I plan to take in my bg/meal log and ask if I can go back to the midwives.

This is pregnancy #5 for me.... First was a c/s, the other 3 were VBACs in hospitals, but not very good experiences overall. I'm REALLY wanting to experience a peaceful, natural birth without all the interventions, pressure from Drs & Nurses, etc. found in a hospital! Now, I'm trying to hold on to the shrivelling hope that it's still even possible for me!

Please, respond with personal experience, knowledge, suggestions! ALL are appreciated. Thanks in advance!

--TryingNotToBeAfraid.

I'm in a similar situation. I failed the 1 hour and was unable to take the 3 hour for medical reasons so we skipped right to the GD diagnosis and the glucometer. My numbers have all been normal except for ONE in while I literally had a carb-fest for lunch. Are you keeping track of your numbers in the logbook that came with your glucometer? If so, it would seem like with numbers like yours you could be considered "under control."

All of the complications of GD are eliminated by keeping your numbers under control and there seems to be no reason why you shouldn't be considered low risk with numbers like yours.

[Happeesupermom]

Thanks for your reply! I appreciate your encouragement!

Good news-- Dr. said my numbers were good & he didn't see why I couldn't go back to the birthing center & continue seeing the midwives! Woohoo! I'm so excited! I will continue monitoring my bg #s and they'll be asking to see my log each time I go in... but as long as my #s stay well within range, I can deliver there! Yay!

[umsami]

YOur postprandial and fasting numbers are normal, so I don't think you have GD.

In general the targets given are:

Fasting: Under 95, although some docs do 90

1 hour post-prandials: Under 140

2 hour post-prandials: Under 120

[WaitingForKiddos]

Seems that the numbers depend on your dr/midwife. My healthcare team wants my fasting numbers under 80 and 1hr post meal under 120. Your numbers would have a GD status. My endocrinologist supports diagnosis of GD for those numbers but ts
not an automatic risk out or aggressive treatment. Just a diet change, home monitoring and contact with him for a month. Depending on what changes, or not, he will send the pt to a nutritional counselor. Mw is the same...just more monitoring and numbers alone wouldn't risk someone out.

Endo told me at our visit that the ACOG is about to support the lower numbers as their new guidlines and focus on nutritional changes.

[umsami]

Originally Posted by WaitingForKiddos

Seems that the numbers depend on your dr/midwife. My healthcare team wants my fasting numbers under 80 and 1hr post meal under 120. Your numbers would have a GD status. My endocrinologist supports diagnosis of GD for those numbers but ts
not an automatic risk out or aggressive treatment. Just a diet change, home monitoring and contact with him for a month. Depending on what changes, or not, he will send the pt to a nutritional counselor. Mw is the same...just more monitoring and numbers alone wouldn't risk someone out.

Endo told me at our visit that the ACOG is about to support the lower numbers as their new guidlines and focus on nutritional changes.

God, I hope they don't go to fastings under 80. That's insane. Even with insulin, I'm rarely under 80--and when I am, I'm miserable. I've had GD with four pregnancies... and they keep lowering the numbers. I'm beginning to think it's a plan to get more women on insulin or meds.

If you go to the Joslin website, they have a good Gestational Diabetes guide. They are more strict with Type 1 and 2 diabetics--in that they want 1 hour post-prandials...and slighly lower than GD.. but still, I've never seen below 80 for fastings. Honestly, hope I never do.

[prettyuglybefore]

Originally Posted by umsami

God, I hope they don't go to fastings under 80. That's insane. Even with insulin, I'm rarely under 80--and when I am, I'm miserable. I've had GD with four pregnancies... and they keep lowering the numbers. I'm beginning to think it's a plan to get more women on insulin or meds.

If you go to the Joslin website, they have a good Gestational Diabetes guide. They are more strict with Type 1 and 2 diabetics--in that they want 1 hour post-prandials...and slighly lower than GD.. but still, I've never seen below 80 for fastings. Honestly, hope I never do.

I was thinking the EXACT same thing when I saw that. I'm regularly 92-96 fasting this pregnancy and my Dr. is not worried at all. I'm lucky if I EVER go under 80 fasting. I think the lowest this pregnancy was 83 and that only happens every few weeks.

[WaitingForKiddos]

I agree with both of you! When they told me 80 my jaw dropped. I can do it if I don't drink juice with dinner but barely. As far as the acog goes, I wonder of will be their answer to flack for the section rates, 'See! We don't like sections but if you ladies would just stop having too big of babies we could get it down! And it's gd that makes these huge 8.5 pound babies!' idk

[Happeesupermom]

**I apologize for this being so long-- I guess I'm "venting".**

Well, even though the DR. isn't worried about it, and said my #s were well within range, the CNM I'm seeing says that she wants to see fasting #s below 90 (preferably 80), and 2hr pp under 120. She also said a 1hr gtt of over 200 is AUTOMATICALLY diagnosed as GD.... so I guess they just ordered the 3hr gtt for the fun of it?!

It didn't matter that I've had over 37 bg #s that were great (my 14 day average is <95)! It didn't matter that I didn't sleep the night before my gtt b/c I was stressing & worrying about it.... or that I forgot the "fasting" part and ate something after midnight... or that the lab tech drew my "hourly" blood sample 15 minutes early twice.

I left feeling very frustrated. And defeated. And confused. Why would the OB NOT be worried about my #s and tell me I don't have GD... and she is insisting I do? Sure, I've cut out sodas & eat a little differently now, but those are good changes for ANYBODY!

She said today, "It sounds like you just don't want to accept that you've got GD." Well, I'm thinking, "I don't want that in my file if I'm not!" I'm just scared of the GD label and that it would automatically put me in a "high-risk" category if I decide to get pregnant again.

I mean-- the only times my numbers get a little high are when I go ahead and eat the high-carb, fried stuff (rarely now!)... and wouldn't ANYBODY's #s get a little high after that? (By "high" I mean 149 2hrs after meal.)

Maybe I'm just holding on to this too tightly, but I SOOOOOOO wanted to enjoy this pregnancy! Instead, I'm feeling scared, frustrated, defeated, sad, overwhelmed, angry and defiant... and lately I've been wondering if I'm not also depressed? This just can't be good!