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Discussion Starter · #1 ·
I finally bought the test strips to start checking my blood sugar. Yesterday, about 3 hours after eating, it was 78. This morning (fasting) it was 101, and 30 minutes after eating breakfast (egg, whole wheat toast, slice of tomato and glass of oj) it was 135. Orange juice isn't normally something I'd drink, but I'm trying to follow the Bradley diet and thought that would help me get my vit C.


My sister is diabetic and seems a little concerned by today's numbers. I can't find any definitive range of what is acceptable. Is there anybody here who can help me interpret these readings? FYI, I'll see my midwife on Saturday and will review everything with her as well.
 

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You should read the Glucometer instructions for testing. WHEN you test is very important. I have a Lifescan One Touch Ultra.

Fasting (ie first thing in the morning) normal range is 70-105. 1 hr after meals less than 160, 2 hrs after meals less than 120.
 

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I am monitering because I failed the GD tests (although my levels have been very normal when testing fasting/after meals).

My providers are looking for numbers under 140 1 hour after meals, and under 100 when fasting (first thing in the morning).

I'm using an Ascensia Contour by Bayer.
 

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My guidelines are the close to sunmama's -- fasting (when you wake up) under 100 and one hr after eating under 135. These numbers seem to depend on the guidelines set for GD by your medical provider. At the medical group I go to they are VERY strict. My fasting #s were coming in just over 100 and they put me on insulin at night right away.

Did you have a GD education class? These are very helpful as they will tell you how many "exchanges" of carbs you should be having w/ each meal & snack. FYI, juice of any kind is a no-no when you have GD.

Good luck!
 

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Discussion Starter · #5 ·
I'm using my sister's monitor ... it's a Lifestyle ... that's all I know about it.


I haven't been diagnosed with GD. I was borderline with dd (though they didn't tell me that until I was about 38 weeks
: ). Since we're seeing a lay midwife, I won't be having the glucose test. I would just rather do the self-monitoring and adjust my diet as necessary, ya know? Plus, if my numbers do get out of hand and diet doesn't help, I want to know so that we can transfer care to an ob if necessary.

Also, I feel like an idiot. Yesterday, I cleaned my finger with alcohol before I tested. With today's first 2 readings, I didn't ... I just washed my hands. With soap made from milk & honey. D'oh! The 3rd reading (2 hours after eating), I swabbed with alcohol and it was 82. I have no idea if that affected the readings. Basically, I feel like today's readings were useless and I'm going to try again tomorrow.
:
 

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Quote:

Originally Posted by loree View Post
My guidelines are the close to sunmama's -- fasting (when you wake up) under 100 and one hr after eating under 135.
The guidelines for GD are stricter than regular diabetes, I forgot that. The numbers I posted are from the Glucometer's general diabetic guidelines. I had GD last pregnancy and thanking the Universe that somehow I was lucky enough to not have it this time!

I think it's great that you are watching with your own testing. From what I know, I would stick with the one hour after eating test (this is one hr after the START of meal, not after finishing) for a more accurate reading.
 

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Discussion Starter · #7 ·
Quote:

Originally Posted by mom2emerson View Post
(this is one hr after the START of meal, not after finishing)
THANK YOU for that! I started timing from the end of the meal today. Oops.
 

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Hmm, I was told to test 2 hours after the END of the meal, because sometimes you can finish a meal in 5 minutes; other times 45 min to an hour.

I'm allowed the occasional juice, if my numbers are very low, for example. And I have to pair it with protein. But I've found that's the best way to keep my levels very steady: pair my proteins with carbs, and include a fruit or a vegetable at every meal and just about every snack.

I've also learned I shouldn't have juice or fruit before lunch, as insulin resistance is highest in the morning (and this does seem to be the case with you). Make sure to have a bedtime snack of protein and whole grains, it'll actually help keep your BSL from going too high overnight and give you a decent fasting level in the morning.

And try to test at consistent times after eating.
Good luck!
 

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The fasting # of 101 is a little bit concerning. I was dx with GD during my pregnancy and they wanted the fasting number to be below 90.

For a "normal" diabetic I think the acceptable range goes up to 105, but most GD protocols are more conservative.

Unfortunately, the fasting # is the hardest to affect with diet. It is also probably the most indicative of an actual problem. I would definitely watch your diet VERY carefully just to be sure.

I would definitely do some reading on GD and keep testing. As far as the before/after meals testing, my particular protocol was to test right before the meal and then 1 hour after *starting* to eat. The pre-meal # was not supposed to be over 90, and the post-meal # was not supposed to be over 120.

However I have seen some protocols for GD that suggest testing at 2 hours from the start of eating, and which suggest that if you do test at 1 hour, up to 140 may be acceptable.

What I did, and what I suggest you do, is to test hourly for a day, if you have enough test strips. Record what you are eating very precisely and when you eat it, and test on the hour. This will give you a more accurate picture of how your blood sugar is going up and down throughout the day. Some people's bs spikes very high right after a meal (that would be me) and testing at 2 hours after the start of a meal will not catch the high (it will come back down into normal range by then or even go low).

Henci Goer's articles on GD are very informative, as is the chapter on GD at that site that used to be www.maternitywise.org...I think they have changed the name of the site but that link should still work.
 

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I also wanted to share my meal tips. I totally threw out the "GD diet" that I was given at the hospital GD class (which was full of misinformation and scare tactics...yuck).

You will need to tailor your diet to when YOU go high or low, which may be different from what others do. I had a *very* hard time with breakfast. Almost anything I ate made my blood sugar go sky-high. I figured out a perfect breakfast that always always worked: one egg fried in butter (or scrambled), with 2 cinnamon graham crackers. Anything more (even 4 oz. of milk) and I would go over. But at lunch I could eat a big sandwich and a glass of milk or a yogurt and I would be fine, and at dinner I could eat even more without going high.

Snacks should never be just a carb - pair a serving of protein with a serving of carbs. A serving of carbs is 15 g and that is NOT a lot. A slice of bread often has more than 15 g of carbohydrates! Look at total carbohydrates on the label, if you are buying food with a label, not net carbs.

A serving of fruit should be no bigger than the size of your fist, otherwise that is too much sugar at once. If you go hypOglycemic (low blood sugar) for some reason, drink 4-6 oz. of juice to get you back up and then in 15 minutes eat something with protein.

Foods high in fiber will tend to help your blood sugar, as will...cinnamon! It has been clinically shown to lower blood sugar by up to 20%, but you have to eat a *lot* of it. I put it on EVERYTHING. My fave treat was cinnamon in plain whole fat yogurt. Dark chocolate (the real, dark, 70% cocoa kind) in STRICT MODERATION (like 3 squares at a time, at a time of day when your blood sugar does not run high) can also, strangely enough, help lower blood sugar!

Good fats are important. Eating small meals frequently is important. I'm sure you know all of this, but just in case, I'm mentioning it.


Google those Henci Goer articles. They are fab.
 

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Oh no! Sorry for the serial posting, but...

I just noticed you are only 17 weeks into the pregnancy?? I have to say that I would definitely see an OB if you are already having fasting blood sugar of 101. GD typically does not occur until well into the 2nd trimester - that is why they don't test for it until the 24th week or so. High blood sugar before that may indicate undiagnosed Type 2 diabetes, which can have more serious implications for the pregnancy.

Blood sugar levels rise in pregnancy, so if you are already having a fasting level of 101 at 16 weeks, that does not bode well, I'm afraid. There is a blood test that you can request which will give you an "average" blood sugar level for the past 3 months. That should tell you whether there is possible Type 2, or not. I am REALLY not a GD alarmist but I strongly urge you to talk with your midwife about this and consider consulting with an OB.

Of course, if you just haven't updated your ticker and you are much further along than 16 weeks, disregard this post!
 

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Discussion Starter · #12 ·
WOW. Thanks so much for all the info! I've read Henci Goer's info on GD but feel like it can't be recommended enough. I really think that the GD test just sets people up to fail: give somebody a ton of sugar, then see what happens. Heh.

The diet tips are great.
I don't eat fruit regularly, and normally I might drink fruit juice a couple times a year. It won't be any stretch to not have those things.
I ate low-carb (lean meat & LOTS of veggies) for years, so I'm well-versed in the carb content of most foods, but it's interesting to me to see *exactly* how combining certain foods can radically change the effect on one's blood sugar.

I was 17 weeks yesterday. I really do think that this morning's # was a fluke, though. Because of my family history & weight, I have had my blood glucose levels tested at least once/year for years, and they are always fine. I'll test again in the morning and we'll see how it goes. I'll see my midwife this Saturday and will review all my data with her.

Thanks again, mamas! Y'all have given me a lot to think about.
 

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Discussion Starter · #13 ·
Update:

Just did today's fasting. Guess it wasn't a fluke, 'cause it was 101 again. Does brushing your teeth before you test matter? I know I'm asking a lot of "stupid" questions, but I just don't know ....

My niece needs the monitor this morning, so I won't be able to test any more until this evening, but I'm supposed to get my cbc panel back today and will have an opportunity to review it with an RN (through work), so maybe I can ask some of my questions then.

Thanks again, y'all. I really appreciate all your help.
:
 

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So why are GD numbers more conservative than regular diabetic numbers anyway?
 

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Quote:

Originally Posted by heathenmom View Post
Update:

Just did today's fasting. Guess it wasn't a fluke, 'cause it was 101 again. Does brushing your teeth before you test matter? I know I'm asking a lot of "stupid" questions, but I just don't know ....

My niece needs the monitor this morning, so I won't be able to test any more until this evening, but I'm supposed to get my cbc panel back today and will have an opportunity to review it with an RN (through work), so maybe I can ask some of my questions then.

Thanks again, y'all. I really appreciate all your help.
:


No, brushing your teeth before the test shouldn't matter (that I know of!) but if you're concerned, put the glucometer next to your bed so you can test right away when you wake up tomorrow.

As to why the blood glucose targets for GD are stricter than regular diabetes, this is because of the fact that high blood sugar is impacting a growing fetus, and so it is considered more important to maintain tight control of blood sugar.

It's important to differentiate between the risks to the fetus in the first trimester (when organs are forming) and subsequently. The risks of GD (that is, high blood sugar starting mid-pregnancy) are primarily macrosomia - a big baby, and also low blood sugar in the neonate. Not birth defects. However, high blood sugar while the baby's major organ systems are forming can have more serious consequences. This is why Type 1 and 2 diabetics have to be very carefully monitored and tight control maintained of their blood sugar.

So for GD, the tight controls are out of an excess of caution, IMO, but it is important to note that while most pregnant woman experience rising blood sugar levels as their pregnancy progresses, NOT every woman has "high" blood sugar. It is something to be concerned about, although it may not necessarily have any effect on the baby. For instance, my baby was only 6 1/2 pounds. Obviously my high blood sugar didn't negatively impact her, at least not in any way we could tell. But you just don't really know - the high levels *may* indicate a baby that will grow too large, or they may not. Sometimes women end up with huge babies without having failed the GD test or having had any symptoms of GD. The relationship between blood glucose testing in pg and the size of the baby is definitely not a linear one.

I think that GD is a real phenomenon BUT I think that the medical community has not come close to sorting out what kind of phenomenon it is. So they really cannot offer evidence-based "treatment" at this time. However, I think it is always prudent to try and keep one's blood sugar under the target levels, because we just do not know whether it's going to be a big problem or not, and watching the diet (or even taking insulin if needed) is not risky to the baby. (It IS risky however not to take in enough calories, and I really disagree with the calorie-restricted diet I was given by my HCPs). Oral diabetic medications are being prescribed for GD more and more but IMO their safety profile has not been well-established, whereas insulin has been shown to be quite safe in pregnancy. (The dosing is VERY important, though - sugar lows are to be avoided as much as sugar highs, and I think sometimes doctors give GD patients too much insulin - a lot of people on a GD board I posted on had hypoglycemia a lot).

The earlier in the pg that the high levels appear, the more care needs to be taken, IMO. However, don't let anyone scare you, OP. I would talk to the MW, talk to a (good!) OB who is experienced in dealing with GD - I had 2 appointments with a fantastic perinatologist who was VERY supportive of my take on GD - and read the medical literature, if needed, and make your choice about how to monitor things. I will say that if your fasting levels continue to be this high you will likely be advised to take oral diabetic drugs or insulin. Insulin seems the safer choice, from my research, but I would have the doctor explain to you in great detail why he or she advises this, if indeed they do. Then if you need to do this, you will feel comfortable with it. I found that (even though I never needed insulin) I felt much better about the GD once I had talked my fears through with a medical professional who respected me, would discuss specific studies with me, and who agreed with my perspective on things. I would have really listened if she had said "look - you need insulin" whereas if a doctor who I didn't respect had said that, I would have blown them off.

Don't worry, heathenmom, everything will be OK, and your MW or OB may just want you to keep monitoring things. I would definitely have the Hemoglobin A1 c testing (known as HA1c) to see what your average blood glucose levels have been over the past 3 months.

Of course take my post with a grain of salt, as I'm not an expert - but I did read A LOT about gestational diabetes when I was pregnant. I looked at the ACOG's statement on GD (you can Google and find the full text online, I believe) and I also used my husband's university privileges to look at the full text of the medical studies relating to GD. It is a very unclear area of study right now, that I can tell you. So if you talk to a doc and think he or she is full of BS, find another doc - there is definitely more than one accepted approach to high blood glucose levels in pregnancy.

Sorry to write a book. This is sort of a pet issue of mine since it was so upsetting to me to be diagnosed GD.

Take care and let us know how things are going! PM me if you like and I can hunt up more resources for you.
 
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