Gestational Diabetes Thread « Back to Group Discussions

[buko]

Just starting one because I know most folks are beginning to be tested. 

I can start it out with good news-- hopefully that will encourage you!

My (HB) MWs are very informed-consent about GD testing and very neutral.  I didn't get a vibe that they didn't take it seriously or that people shouldn't bother being tested, but OTOH, they clearly feel it is overdiagnosed and definitely implied the test was skippable if your diet was already basically the "GD diet" (as it is for a lot of their crunchy clients, LOL) and you didn't have any other risk factors.  They did discuss the complications and issues, though.

I went ahead and did it last week (1 hour, non-fasting GTT) because my mother and one of her sisters were both diagnosed with it, and my mother suspects her mother might have had it, b/c she had "big babies" (4 of 5 were 9.5-10.5 lbs). 

I didn't feel that any of those things were proof positive of a high risk on my part (or even that they definitely had GD-- my brother, the "GD pregnancy," weighed 7 lbs 2 oz at term, FWIW).  But I did feel I had risk factors, and that my diet wasn't as fantastic as most of my MWs clientele, so I went ahead and had it done.  I was very anxious about it for a couple of weeks, because I have a lot of psychological issues around dietary "restrictions"-- basically, an eating disorder that tends to be triggered by restrictive behavior and thinking.  So... I wasn't looking forward to any sort of strict diet.

HCPs vary pretty widely in what they consider a "passing" score-- from as low as <125 to as high as <145.  Amazingly, my (non-fasting!) score was 85.  

Here's hoping that the same holds true for you if you choose to be tested!

So, are you planning on being tested?  Thoughts?  Worries?  Share here!

[Chapsie]

I will be testing my sugars at home for 6 days starting this week (26 and 27 weeks)-- a fasting glucose and 2 hour post prandiols after each meal.  

I passed the 1 hour glucose screen with both kids, and they even had me take the 3 hour GTT with my DD because I had polyhydramnios (which can be from GD, even though I passed the one hour).  All of my numbers came back FANTASTIC.  But... my kids were both 9.5 lbs (my daughter had a lot of belly fat (15" belly which is HUGE) and looked like a GD baby... so it makes me wonder if I did have some insulin resistance going on even though it wasn't picked up on the screening tests.  

My mom is diabetic, too... and I was 10 lb 8 oz at birth... so too many risk factors for me!

I am eating a mostly GD diet now in hopes to grow a smaller (but healthy) baby and keep my sugars regulated.  So far, the couple of times I've tested my glucoses, they've been fine, so maybe I'm overreacting...

But it is nice to be able to get that individualized care from my midwife.  I asked her about it and she pretty much let me pick whatever I wanted for testing.  

[buko]

That's great, Chapsie.  Sounds good! 

[maydaymom10]

I did my one-hour at my last appointment a few weeks ago. I found out that I passed with flying colors & was on the very low (bordering on low blood sugar) end of it. I wasn't really concerned going into the test, as I didn't have problems with DS and neither my mom or sister have ever had issues. So, I feel good that it's just one thing I don't have to worry about for the duration of this pregnancy. :)

[buko]

That's great, Beth.  I'm relieved, as well. 

In the back of my mind, I have been keeping the "Big 6" relatively common pregnancy "complications," hoping to beat them all.  I mean, I think 80-90% of women have none of these, but they're still a bit of a concern of mine.

1) HG-- definitely lucked out on that one.

2) GD-- no problem there (I was at most risk for this one, of the 6, though it's also the most manageable)

3) SPD-- I do have some pubic symphysis pain, but it's still pretty minor and MUCH less since I decided to stop sleeping on my side (I-- for now-- sleep on my back, but on a very, very high angled wedge).  I am hoping to escape without this one, as the median onset is 26 weeks (standard dev. range 20-32), and I am close to 30 weeks already.

4) Breech-- as of now, babe is head-down, though it's still early

5) Previa-- no u/s for me, so it's a bit of a crapshoot, BUT it seems pretty clear from palpation that my placenta is fairly high and to the right, so, fingers crossed.

6) Pre-e-- at lower-than-average risk for this, but it's so, so random.  Onset is usually after 32-34 weeks, so it's too early to tell.  There's only one activity I know of that has shown a significant correlation with a lower rate of pre-e (I am skeptical of diet)...

http://www.ncbi.nlm.nih.gov/pubmed/10706945

I would do this anyway, so...    Hopefully, it's helping.

Have I just made everyone paranoid?  LOL...  I don't spend much time thinking about these things, but when I've "beaten" one, it makes me feel better.

[spughy]

Well THAT is one of the more interesting abstracts I've read in a while!!!!   And, er... how did you come across that one, Buko????

I'm doing the 2-hr fasted GTT later this week (have to phone the lab and see if I need an appointment).  My midwife, in her awesomeness, managed to track down some non-orange-flavoured glucose goo and is having it sent to the lab in our neighbourhood.  I am happy to drink it.  Well, you know, not happy - but at least it won't leave a gaggy sensation in my throat from the flavour, just the general omg-I-just-ate-too-much-sugar kind of nausea.  Is it cheating to do a workout before?  I'll still be fasted, but I think a huge shot of glucose will be much more welcome and less yucky if my body feels it could actually use most of it.  I don't have any problem not eating before 9 or 10 am, workout or no.

I've been checking my blood glucose levels with a home monitor.  My fasting levels are still slightly elevated but not enough to fail the fasted part. (Usually between 5.2-5.8 mmol/L)  Postprandials have been fine, I think - although if I eat constantly throughout the evening (like at a party with nibbles or something) my levels are still elevated at bedtime (around 8.7 mmol/L) and are higher in the morning.  So I'm not sure if I'm going to pass the 2-hr or not.  75g is a buttload way more glucose than I EVER take in at one time.  It's more than I eat most days.

[chocolatechip]

My midwives also made clear that it is an optional test, but it's another one of those things where if I were to end up transferring to a hospital, and I didn't have GD test results, they would want to check the baby frequently for low blood sugar, and I want to avoid baby getting pricked as much as possible. So, I think it makes more sense for me to take the test now. I'm kind of curious, actually, though not looking forward to the test itself. I hope I will just pass the screen, because fasting before taking a glucose drink sounds pretty unpleasant! spughy, I can't imagine fasting, then working out, then drinking the glucose! But I have always had to make sure I'm fed before exercising - my body doesn't work well otherwise.

buko, maydaymom, congrats on clearing this hurdle. 

chapsie - sounds like you are taking a very reasoned approach!

[madelaine]

Shucks. I did not pass the 1 hour (non-fasting) test, so I'm in for the sucky 3-hour fasting test. I was too flustered to ask for my actual number over the phone... Didn't have any problem with this last time, but I probably haven't been eating as well as I should have lately anyway.

I wonder if the half of a banana I ate at breakfast messed me up? I'm trying not to stress about it, but I had a bit of a nightmare last night that I had an altoid before the test and failed again. How weird. Congrats to those of you who made it through, and wish me luck.

[Chapsie]

Well so far today, my sugars have actually been low! Fasting was 68, and my 2 hour post meal sugars were 78 and 77.

Makes me wonder why I had such big babies in the past... Maybe some women do just "grow 'em big!" Super curious to see how big this baby will be.

[writermama12]

Chapsie, your post made me wonder if your sugars are being positively affected by your better diet this time around...or did you follow a GD diet last time too?

[Chapsie]

I am eating more nutritious foods this time around and trying to eat protein with my carbs. I think that is really helping to keep the sugars regulated. I didn't eat terribly with my other pregnancies, but maybe the simple changes I've made this time are more effective than I thought they would be. I am not eating less than before, just more protein and less (almost none) refined sugars.

Well... I'm hoping for a baby 9 lbs or less. . (DS was 9lb 6.1oz and DD was 9lb 7.8oz). Only time will tell with this one! I'm still carrying pretty big and I was measuring 1-2 cms ahead. But I haven't gained any weight in the last 2 weeks (since I really started my diet changes). (I am +16.5 lbs from pre pregnancy)

I think that overall, I feel great. I can tell that I feel pretty awful after slipping up and eating a junk food snack.

My midwife is having me full out a very detailed food diary too that we will go over together at the next appt. This has been quite an interesting experience for me!

[cocoanib]

The GTT is something that I never liked the idea of.

With DD, my midiwfe did a non fasting, drink juice testing and just monitored my diet and other factors.

My levels were fine and there were no worries.

This time around, I was under midwife care at first and have now gone to standard care and they "require" the fasting GTT.

I just went ahead and did it, because with them I am picking my battles, so I don't spend my whole prenatal time fighting.

The drink was not as bad as I thought, but I did not feel at my best for the rest of the day after that.

I passed and I'm glad that it's over and done with.

[Meggsy]

I am using a regular OB and find that this, as with so many of the tests, is not presented as an option but as a thing you just do.

That said, I think this is one of the most important tests, and would have consented, only because there are a lot of risks for having a child naturally if you do have GD. Since there is so much sugar floating around in your blood stream when you have GD, the baby essential gets over-fed and you run the risk of a very large baby to push out, which brings a lot of other risks.

Still, I wish I had been given the option of informed consent. Am thinking of switching to a midwife but it is hard to find one at this late date :(

[buko]

Actually, I have a problem with the GTT (even though I totally opted in, completely of my own accord) and the entire idea of GD is really questionable IMO.  I do believe it exists.  I don't believe that "true cases" (caused by or greatly exacerbated by pregnancy) are more than rare.  What I think happens with the problematic macrosomia (and, more rarely, fetal death) we see more commonly in women diagnosed with GD is more a correlation with other factors (age, certain habits, pre-diabetic/undiagnosed diabetic status before pregnancy, etc.)

This is a pretty well-cited article that I mostly agree with...

http://www.gentlebirth.org/archives/gdhgoer.html

It's not that I think that problematic macrosomia, etc. (as opposed to non-problematic larger babies) is not a serious issue.  It's that I don't think that the way "GD" is currently being diagnosed and treated is really...  preventing that in a great way, and said diagnosis/treatment is causing a lot of problems for a lot of women (they are seen as ticking time bombs based on an often questionable/non-replicable test, which leads to more intervention and more morbidity).

Just my 2 cents. 

[withlittlelungs]

I'm taking the fasting 3-hr test tomorrow morning. Not at all looking forward to it. Originally I was going to do the non-fasting 1 hr, but the MWs really recommended me taking it after we found out there were 2 babies. Since I'm more than likely switching to OB care for the birth, I figured I might as well just do it now. 
I  barely failed the 1 hr with DS, but there are a lot of false positives with that test. I'm not worried about passing tomorrow, but we will see with my luck!

[writermama12]

I am taking the 1 hour today. Have my fingers crossed. I've never had a problem before, so I'm not too worried. Maybe just a little. 

[babytoes]

I found out yesterday I passed with a 93!! WOO HOO!! 

I wasn't too concerned, all three of my other pregnancies were fine. But still, any test makes me a tiny bit nervous.

Hope everyone that is taking the test passes with flying colors!

[spughy]

Big fail for me.  Full-blown GD. At 1 hr my bg was at 12.6 mmol/L and at 2 hours it was at 11.8.  (that's 227 and 212, for you Americans)  I don't have official results yet, that's with using my personal monitor at the same time as the blood draws.  But it's not even close, there's no point hoping that I might have passed on different equipment.

The good news is, the lemon-lime flavoured glucose goo is WAY less gross than the orange and I felt fine throughout the whole test.  No nausea at all.

Congrats on passing babytoes!!!

[happylemon]

I have not tested my last three pregnancies. I agree with Buko. I have not read the article yet though. Flagging it for later when I have more time. Thanks for the link. It does bother me that if we were to transfer for something completely unrelated the hospital could really hassle us about it, but I suppose we will deal with that if we have to. It would just be one of many things they will lecture me about! (no ultrasound, no GD test, no strep B test, no eye ointment, no vit K, no hep B.... It would really be a nightmare to transfer)

[madelaine]

I have the 3-hour fasting test tomorrow morning. I agree, the lemon-lime crap is less crappy, spughy. I'm supposed to not eat from 9 tonight until like lunchtime tomorrow. That may be the longest I've gone without food (ever?) and I'm not really looking forward to it.