Gestational Diabetes Support Group - Page 6

[kamesennin]

I hate all the conflicting and confusing doctor advice that surrounds GD. There is no standard of care, test levels that all doctors adhere to, or even which medicine is prescribed. My hospital starts everyone on insulin after checking to see if blood sugar level can be controlled by diet after one week. They claim insulin is safer for pregnant women because it is human insulin and like the one our bodies already create. I don't even know what to think.

Not sure what your dieticians will tell you, but I was to test 1 hour exactly after the first bite of my meal. Also, I found that if I did 10-15 minutes of exercise after eating (30 minutes before I tested), numbers would always be in the 90s or 100s if I didn't overdo it on carbs.

[brandyk]

Originally Posted by avivaelona

Brandy if you can break that breakfast up into two pieces you may have less trouble...I have a very small breakfast when I first wake up and a larger one an hour later. I had greens aversion with my last pregnancy. This time around its the opposite. I'll have to look up what they say about one hour readings.

Ooh, definitely not. Thought yesterday was going to be ok all the way because I figured I needed to add a significant amount of food. I ate breakfast and was woozy one hour after already. Today was completely fine. My snack was even pre-emptive and not in response to me feeling out of it or anything. But who knows what tomorrow will be like. I think some of my problems have to do with my schedule. I don't get out of bed until 7:30 or 8:30 depending what I feel like. I think I would have an easier time if I dragged my butt out of bed earlier in the morning. Then I think you would be right about splitting breakfast. BTW this morning's breakfast was 1.5 servings (3 carbs) of steel cut oats and 1.5 servings of cottage cheese (3 protein). This breakfast wasn't particularly out of control.

Don't talk to me about opposites. Besides the GD & the mild anemia everything has been perfect. I don't want opposite next time! Because that would mean throwing up. Gross!

pbandj - NAILED IT ON THE HEAD!!! And I have said "I don't know what to think" I don't know how many times this week!!!

I haven't found exercising to be helpful in lowering the sugar at all. BUT, I was strolling around the mall today - very very mild activity. This might be more helpful than really exercising. I don't think I'm overdoing it but the exercise I've been doing is probably more active than what they have suggested.

And to add to PB's comment = heaven forbid you go try to find some objective info on your own (like the ACOG bulletin). Dr accused me of finding bad info online. Um, ACOG may be more medically oriented (as opposed to natural/holistic), but yeah, I think that I'm OK challenging the doc to explain why she isn't following recommendations. I have explained to hubby a million times that I already have issues with doctors and I want his opinion too in case I have my head in the sand. He is behind me 100%. We are both skeptics I guess. He laughed at the amount of food they were having me eat and wondered if they KNEW why I was at the dr's in the first place!!! [because i'm pregnant ]

It makes it very hard to trust medical advice when they are trying to starve you.

[avivaelona]

getting up earlier and then going back to sleep always messes with my morning fasting levels. I have no idea why. If you can try eating a few almonds or something at 5 am and then going back to sleep it might help (or it might not, its so individual really).

I don't think they really know all that much about how it works. They know just enough to try to treat everyone with the same hammer that seems to work for those with severe GD and there is no definite standard treatment.

LOL btw, not everything is opposite! Just my food cravings and even then not all of them.

[AustinAmber]

Subbing.

Just got a positive : and I had GD with my first so I'm expecting it again.

[kamesennin]

Originally Posted by AustinAmber

Subbing.

Just got a positive : and I had GD with my first so I'm expecting it again.

Congratulations!! (not about the GD but about your postive!)

[brandyk]

Congrats!!! Another wonderful baby!!!

[Steshi]

Just wanted to drop a note and say how great it is that you have each other for support. I had my son in May 2007 and was diagnosed with GD at around week 32. My numbers were so high I was hospitalized and went on insulin. I had no family history for diabetes and am tall and thin. My son was born very healthy and very late--which drove my docs nuts. Even though I couldn't have the birth I really wanted, I made the best of the situation and had the most natural birth I could have in a hospital. You just have to become educated and advocate for yourself. Good luck to all of you!

[brandyk]

Thanks Steshi!! Please do chime in if you have any advice at all for us!

My fasting got under 100 today (97). My PPs are all over the place so I don't know what's going on except that I am still experimenting heavily with what I can eat. Basically if I eat a big salad with anything my numbers are low and my numbers for breakfast just aren't good unless I eat steel oats & cottage cheese. Seriously, everything else has not worked. I can also feel when my numbers are high (or higher than 120 or so 1 hr after eating). I find it annoying so even if I get it controlled I am starting to wonder if medication is a good option for me. I don't like spending an hour every time I eat something being on some sort of bizarre sugar high - even when my numbers turn out fine!

But hey, at least I'm not getting dizzy/woozy any more. I seem to have fixed that by eating whenever I freaking feel like it.

I have 2 appts at the hospital today. 1 with the nutritionist and 1... I think to show me how my glucometer works?!?! Kaiser is screwed up. What's new??

[kohlby]

Congrats AustinAmber! How far along were you when diagnosed with GD last time?

[rhysmom]

A bit how I'm feeling

I know some of you are struggling to go on drugs (either an oral med or insulin) since your numbers are a bit wacko....

I've been on insulin now for about a month....it was hard at first, i test my BG levels 6x a day, and stab my belly before each meal and again at night around 10pm with a long acting insulin. It's not fun, but we do what we have to do for our baby's, right?

The good news....I can eat again. As in, eat normally. I eat what's on my plan (currently 30g of carbs for bfast, 30 for snack, 45 for lunch, 30 for snack, 45 for dinner, and another 30 for snack) which I couldn't do without my numbers getting crazy high.

I average 78 at my fasting and feel great. Almost always under 130 an hour after I eat and under 100 before I eat. The only times I do go over is if I eat a bit too much....i'm 27 weeks and getting a bit hungrier now!

I haven't had to treat any lows...as long as I eat my snack on time, and don't overdue the exercise I'm just fine.... The lowest I got was after and hour of gardening and missing my snack (it was close to lunch time!) and I was 59...a little shaky, but fine. I ate lunch and was good to go!

So for me, insulin was the right choice..... Everyone's pleased as punch with my numbers and I know I'm growing my baby right! With luck (and a little help as a doula myself, with 2 more helping me for my birth) I'll get my VBAC.

You many ask why I didn't try glyburide or metformin before going straight to insulin. Basically I used oral meds with my first and that was really hard for me to keep stable. I hit lows all the time and was always having to eat crap to keep it up like it should. Since we starting treating my GD at 14 weeks (I requested an A1C that was a tad high, instead of the icky fasting tests) we knew i'd be on insulin anyway, so wanted to start with that when I diet didn't work anymore. Plus insulin does not cross the placenta, glyburide does.....

Anyway folks....I'm not saying it's for everyone...but it's working for me. It's nice to eat the good carbs on my plan and get a great number. I think the stress of that (like only eating 15 carbs and getting a 150 - grrrrr) was really not helping me destress and have a good pregnancy. As stressful as the stabbing is, it's ok. Just 13 more weeks and I'm back to normal!

Take care all!!!!!

[AustinAmber]

Not sure how to do multiple quotes, but thanks for all the congrats!

kohlby, I think I was around 25 weeks when I was diagnosed last time. Not sure though, I need to dig up all my paper from last time and figure things out again.

I am planning on refusing the GTT test this time and monitoring myself, as long as the midwives at my birth center are cool with that. I think they trust me though since I defied my doctors last time!

So I wanted to share my good GD story.
When I was first diagnosed, it was borderline and I didn't need any insulin. My fasting numbers were consistently above 90 though and there was nothing else I could do with diet to get them down so I started insulin, one dose before bed. Sure enough I had a high pp number here and there and the nutrition counselors kept telling me to take more insulin. They would have had me on it before every meal. I refused since the numbers weren't off the charts and not consistently high. In the mean time I had been "risked out" of my birth center and was seeing an OB who wanted to induce me at 39 weeks. I think the thought of having a hospital birth and possible induction was the most stressful thing in my whole pregnancy. Anyway, my fasting numbers started going down to the 70's. Naturally one would think that the insulin was helping, right? Well I had a feeling that wasn't the case so without telling any doctors or midwives I just stopped taking the insulin. My fasting numbers stayed low enough on their own and my pp numbers were the same, a little high, but not too bad. After 2 weeks I called my midwife and asked her if I could come back if I got the OK from the endocrinologist and my OB. Everyone agreed that I did not need the insulin. I went back to my beloved birth center and birthed a healthy 7 lb. 2 oz. baby boy at 39 weeks, 4 days. Moral of the story is that I trusted my instincts and they were right. If I had followed the advice of others I would have been sticking myself with needles 4 times a day and being induced at 39 weeks at a hospital and who knows what else from there.

[brandyk]

Sigh. Found out today that they wanted me testing my PPs 1 hour after I start eating, not after I finish. The nurse who initially trained me gave me the wrong info. Not a big deal but that means my numbers are really high! I felt much more supported with the NP who is a diabetes specialist than my OB. She also confirmed that with my really low 3 hr # on the GTT I should be eating every 2 hours, not every 3. Wish they had me see her first thing before anything at all. I surprised myself and opted to go on the glyburide (1.25mg) starting this evening. I might change my mind and/or it might not work. Honestly, if I had seen Rhysmom's post (which came in as I am writing) I might have chosen insulin, especially since I have a problem with lows already. I knew I was going to choose one of the two today, since I can feel the high blood sugar. Rhysmom can you comment on IV during labor (if you've asked about it) and what your practitioners are recommending as far as tests go?

They want me to do twice weekly NSTs starting at 32 weeks. Very onerous and I am afraid that even if I am ok with that (which I pretty much am) I don't want the monitoring to turn into a circus during birth. I expressed my concerns about the c-section cascade and the NP was very much in agreement with that. That was slightly reassuring, but again, you don't know the caregivers when you go into L&D.

Everyone seemed REALLY concerned about the anemia today too (finally?).

I am definitely struggling with knowing something is wrong and I cannot control it via diet and wanting what I want out of my birth!

[kamesennin]

Originally Posted by brandyk

Sigh. Found out today that they wanted me testing my PPs 1 hour after I start eating, not after I finish. The nurse who initially trained me gave me the wrong info. Not a big deal but that means my numbers are really high! I felt much more supported with the NP who is a diabetes specialist than my OB. She also confirmed that with my really low 3 hr # on the GTT I should be eating every 2 hours, not every 3. Wish they had me see her first thing before anything at all. I surprised myself and opted to go on the glyburide (1.25mg) starting this evening. I might change my mind and/or it might not work. Honestly, if I had seen Rhysmom's post (which came in as I am writing) I might have chosen insulin, especially since I have a problem with lows already. I knew I was going to choose one of the two today, since I can feel the high blood sugar. Rhysmom can you comment on IV during labor (if you've asked about it) and what your practitioners are recommending as far as tests go?

They want me to do twice weekly NSTs starting at 32 weeks. Very onerous and I am afraid that even if I am ok with that (which I pretty much am) I don't want the monitoring to turn into a circus during birth. I expressed my concerns about the c-section cascade and the NP was very much in agreement with that. That was slightly reassuring, but again, you don't know the caregivers when you go into L&D.

Everyone seemed REALLY concerned about the anemia today too (finally?).

I am definitely struggling with knowing something is wrong and I cannot control it via diet and wanting what I want out of my birth!

Hi Brandy, glad you finally got to see someone who knows what they are talking about! Like Rhysmom I was on long acting insulin at night. It was a stress reliever for me as well, once I got over the devastating loss of my homebirth. I kept with the diet and towards the end they kept lowering my dose until the endocrinologist said I wouldn't need any insulin during labor. They stuck an iv in me when I was admitted just because my ob wanted me started on pitocin (long story). I had a high reading of 160 right during transition but the baby was born soon after so I didn't need the insulin during labor. It all depends on how you labor and what is going on at the time, I think.

I also had measurement ultrasounds and NSTs from 32 weeks, then twice weekly starting at 36 weeks. I went to all of them, even towing my toddler along. Some people really object to these but the last thing I wanted was to get fired by my nice laid-back OB and get something on my chart that said I went against medical advice, possibly causing trouble with my insurance.

I took liquid iron (Floradix) 2X a day and it really helped boost my iron levels without making me ill. If you can find that at Whole Foods or a supplement store it is great. Expensive but it works. I have heard chlorophyll works too but not sure on the dose.

I know exactly how you are feeling--like everything you wanted out of your birth is coming crumbling down. It will be ok. It's not your fault, it's the hormones that is causing all this.

[rhysmom]

I took glyburide with my first (for about a month is all) and he's a great kid, smart, active, tall and skinny! So I suppose I'm not as worried about the effects there...so try it for awhile. Just monitor your lows and keep the dialogue there with your doc.

I was told I'd need an IV when i got to the hospital, BG monitored every hour. If I go over 100, they will put me on an insulin drip, and shut it off if my numbers were fine for the next BG test. I'm not that happy about it, but at the end of the day, I'm not as worried about that as I am the other stuff! I'll also need to be monitored constantly because of my VBAC situation, not so much for the GD. my GD counselor isn't too concerned about my numbers during the birth since most mom's won't be sitting down to a big carb filled dinner during labor....so as long as i'm eating a little thru it, I'll be fine. At this point most mom's are hypoglycemic anyway because we eat less with less room to eat!


AustinAmber - I'm excited to see that you needed less insulin as you went...I'm hoping for the same thing too...again I feel like it's more reflected towards eating smaller meals and less towards the end, which i remember with my son. But I have read where that happens....so we'll see.

I'll also be starting NST around 32 weeks... I did this last time, and it wasn't that big of a deal then. This baby is super active, so I'll be in and out of there no problem!!! Drink lots of ice water to get those movements going!

Brandy - Don't be so hard on yourself. You've got this big ole placenta pumping out loads of great (and not so great!) hormones and it's completely out of your control. Now just focus on destressing.....getting lots of rest and only controlling what you can. You are making great choices and doing what you have to do to grow this baby right!

[brandyk]

I had a nice stress free night. my dinner PP was 102! middle of the night 103 & fasting was 98 (no different than day before). Then breakfast was 187!!!! Same breakfast as usual. Can't figure that one out. The call nurse started lecturing me on 1 carb for breakfast. I told them it was just not possible, they are going to have to figure out something else, because 1 carb for breakfast I am crashing before 1 hour is up already. So I am stressed out today again Yesterday I felt good that everyone acknowledged that the standard stuff wasn't right for me and today I felt back to square one again. blah.

I haven't been good about my floradix but I do have it. We have also been using cast iron. I am good about taking the iron pill, which I switched to night time a couple weeks ago. Between that and eating a lot more meat I think it is helping.

And talk about hormones/sugar stress. It's turning me totally nuts! I feel so neurotic and I'm normally just so chill. Silly placenta! I am looking forward to the peace a couple of you have found with the treatments. I need it back!

All the info on insulin needs dropping & NSTs & IVs is very very helpful, so thank you I hate the IVs and anything in my veins. yuck yuck yuck. My baby is quite active as well but it is still not easy to fit twice weekly visits into a very busy work schedule. I don't think I can get fired by my OB but they did mention yesterday (I have to travel this fall until 35w6d!) that if I was out of area and gave birth after 36w they don't cover it. Fortunately I'll be back home by then.

Rhysmom - I realized from reading another thread that our DDs are only 2 days apart. How fun! I am also jealous of your ltd weight gain. They tested me early for GD (my skinny half sister had it too) and passed the screening - barely - but they waited really long to screen again.

I'm a little ticked that they didn't do some of these tests on me about a month earlier - when my weight gain really spiked for no reason whatsoever. But hey, they didn't have me in for an appt since MAY! (except for the ultrasound, which was with the sonographer). I wish I'd had all this sorted a month ago - I think I could have avoided a lot of the weight gain.

Anyways, I was also hungrier - much hungrier - a month ago. Less hungry now.

Oh one more item I forgot from yesterday - they told me to sign up with medicalert, which I did. Not sure if it is standard or because I'll be traveling a lot. Anyways, I wanted more of a cuff style so I figured I can get the same info engraved on a different style medical bracelet. it made dh happy at least.

Another question (when will this reply end? ever?) = can your blood sugar be higher if you haven't had enough water? I realized when I took my vitamins this morning I hadn't had any water in the middle of the night.. I usually drink nearly a liter overnight (very dry climate).

Ok I am done for now. You guys are all so great to the newbies I'm sure it will all be old hat to me as well in a couple of weeks.

[kamesennin]

Originally Posted by brandyk

I had a nice stress free night. my dinner PP was 102! middle of the night 103 & fasting was 98 (no different than day before). Then breakfast was 187!!!! Same breakfast as usual. Can't figure that one out. The call nurse started lecturing me on 1 carb for breakfast. I told them it was just not possible, they are going to have to figure out something else, because 1 carb for breakfast I am crashing before 1 hour is up already. So I am stressed out today again Yesterday I felt good that everyone acknowledged that the standard stuff wasn't right for me and today I felt back to square one again. blah.

I haven't been good about my floradix but I do have it. We have also been using cast iron. I am good about taking the iron pill, which I switched to night time a couple weeks ago. Between that and eating a lot more meat I think it is helping.

And talk about hormones/sugar stress. It's turning me totally nuts! I feel so neurotic and I'm normally just so chill. Silly placenta! I am looking forward to the peace a couple of you have found with the treatments. I need it back!

All the info on insulin needs dropping & NSTs & IVs is very very helpful, so thank you I hate the IVs and anything in my veins. yuck yuck yuck. My baby is quite active as well but it is still not easy to fit twice weekly visits into a very busy work schedule. I don't think I can get fired by my OB but they did mention yesterday (I have to travel this fall until 35w6d!) that if I was out of area and gave birth after 36w they don't cover it. Fortunately I'll be back home by then.

Rhysmom - I realized from reading another thread that our DDs are only 2 days apart. How fun! I am also jealous of your ltd weight gain. They tested me early for GD (my skinny half sister had it too) and passed the screening - barely - but they waited really long to screen again.

I'm a little ticked that they didn't do some of these tests on me about a month earlier - when my weight gain really spiked for no reason whatsoever. But hey, they didn't have me in for an appt since MAY! (except for the ultrasound, which was with the sonographer). I wish I'd had all this sorted a month ago - I think I could have avoided a lot of the weight gain.

Anyways, I was also hungrier - much hungrier - a month ago. Less hungry now.

Oh one more item I forgot from yesterday - they told me to sign up with medicalert, which I did. Not sure if it is standard or because I'll be traveling a lot. Anyways, I wanted more of a cuff style so I figured I can get the same info engraved on a different style medical bracelet. it made dh happy at least.

Another question (when will this reply end? ever?) = can your blood sugar be higher if you haven't had enough water? I realized when I took my vitamins this morning I hadn't had any water in the middle of the night.. I usually drink nearly a liter overnight (very dry climate).

Ok I am done for now. You guys are all so great to the newbies I'm sure it will all be old hat to me as well in a couple of weeks.

Brandy, have you tried eating "dinner" for breakfast? Leftovers from the night before, maybe. I have done this with good results, esp. if I include chicken. You could try 1/2 c. brown rice, vegetables, and a protein to see if that changes anything. Also maybe 1/2 w.w. pita or bread with scrambled eggs and cheese w/ some lettuce. That is usually more filling for me than oatmeal, for some reason. It really depends on what type of carbs you can handle in the morning. I had shit readings every single morning--mornings are just bad for me. I tried all kinds of stuff. Finally I had to cut out milk, fruit, instant oatmeal and all cold cereals. I usually had 1/2 piece of w.g. bread with peanut butter and nuts (although this would probably not be enough for you). I did much better with having dinner or lunch in the morning. Also, can you try eating your snack 1 hour after breakfast? That might tide you over until lunch. Good luck! Keep us posted.

[avivaelona]

Brandy if you get a really high result like that do try washing your hands and retesting ok? You could have had something on your hands? Or if you let the blood sit around too long before you get your meter to beep and read it you can also get abnormally high readings. If you did and it was still that high, you could try different carbs for breakfast (some people have trigger foods that carbwise should be ok but just aren't for them...I have a big problem with tomato sauce for example, but not plain cooked tomatos, don't know why)

Just to clarify, If you have primary Gestational Diabetes and did not have PCOS or any kind of sugar/insulin issues before pregnancy I don't think there is anything wrong with using insulin, I don't think there is a whole lot of information out there that its helpful for those with anything but severe diabetes, but I don't think there is anything particularly harmful about it, and if it lets you eat normally that is a big plus.

Why I feel it can be harmful is that GD is essentially a problem with insulin resistance, not underproduction of insulin, so here is a body that is already producing extra insulin and then you are putting more in there. If your body isn't already producing extra insulin before pregnancy than I doubt it would be that much of a problem but if you already have hyperinsulinemia I don't think its healthy to just keep pouring insulin in there, you've already got way too much of it. Hyperinsulinemia causes problems just as too much glucose does. That said if my blood sugars were going really high, I'd still take insulin, just not for borderline cases, and I prefer to try medications first...that doesn't mean that medication first is the right answer for everyone.

I think the thing is though that there is no real evidence that for mild GD you actually need anything...thus far intervention has not been shown to improve outcomes in mild cases, only in cases where there was extent type II, or very severe GD absent extent type II (which is very unusual)

[brandyk]

Originally Posted by pbandj

Brandy, have you tried eating "dinner" for breakfast? Leftovers from the night before, maybe. I have done this with good results, esp. if I include chicken. You could try 1/2 c. brown rice, vegetables, and a protein to see if that changes anything.

This might be much easier if I had a microwave! We got rid of ours when we moved to a place with a built-in. And then we moved here because of baby. I haven't had a microwave for about 5 months. We've done just fine without so I haven't bothered.

[brandyk]

Originally Posted by avivaelona

Brandy if you get a really high result like that do try washing your hands and retesting ok?

Well now that you say that, I should have thought of that. Certainly the call nurse should have suggested it. I think it was high, but I don't know if it was that high. I will remember that for sure.

[rhysmom]

Brandy - To avoid insulin/drugs earlier this summer i had to eat 15g of carbs for bfast around 8, then 45g for snack later followed by 45g for lunch. That seemed like a ton of food! Sara Lee makes a low carb bread, you can have 2 pieces for 19 carbs, which for me is pretty satisfying, then I add a protein like p. butter (thinly spread) or cheese. Or butter and a little s/f jam. Then I'd test my BG after bfast, and then have something more filling for snack later. It was a pain, but really got my numbers down for awhile.

My dietician is pretty strict for what I can have for bfast anyway... No fruit, juice, or cold cereal. If I want pancakes or muffins, I have them later in the day for snack or a meal. I can have oatmeal, or those low sugar instant packets work well for me with a no sugar added yogurt. And at night for snack I'll have a bit of cold cereal for milk if I still want it!

Avivaelona - Yep, PCOS is a complete other ball of wax....and you're right about the insulin issues with that!