[amyfarr]

I posted this on another forum I am on so if you're on that board to you'll have seen it before.

I am currently reading Born in the USA by Marsden Wagner and I find it very interesting that he says GD doesn't really exist. He says "The authors put gestational diabetes in quotation marks because there is no such thing as gestational diabetes. It is an invention of obstetricians that describes an elevated glucose level in the blood, a level that is normal in pregnancy and without serious consequences." I have also read his book Creating Your Birth Plan and I know he says the same thing in it. I personally know 3 women who have been diagnosed with GD and 2 of them were with ob's and they were scared into having c-sections and the 3rd was with midwives and she had a very gentle induction on that they started on her EDD because the MFM ob wouldn't let her go past her EDD. So I am just interested in what others think. I went to midwives with both of mine and they tested me for it and I passed both times on the one hour so I never really did any research and I haven't had any doula clients that have had it so again I really haven't researched much. Any thoughts?

Thanks
Amy

 

[Amydoula]

We have a whole gestational diabetes support thread in "I'm pregnant". Lots of links and good info if you are interested.

 

[Cheshire]

Not a pro but from personal experience, yes, it exists. I had it with my second pregnancy and before I was diagnosed I felt awful. My blood sugar would get extremely high if I ate a lot of carbs/sugars. When I learned how to eat a diabetic diet and learned that I needed 2,200 calories just to maintain my weight I felt great.

I can't imagine how I would have wound up at the end of that pregnancy without careful monitoring of my blood sugars. I was able to control it with diet and exercise.

With my third pregnancy I recognize the symptoms. My OB and I agreed that it would be a waste of time to do the GTT. I'm on the diet again and I monitor my blood sugar at home. I keep a log and share it with her at my visits.

I think if a mom doesn't know or doesn't care that she has it then it can be trouble. I know that if I don't watch what I eat my sugars go up and my heart races for a while, I feel awful, thirsty and then have a big crash where I'm super sleepy. I've had that happen twice and I won't do it to myself (or my little one) again. The baby goes crazy when my blood sugar is high and I hate the thought that she's buzzed out on sugar at the same time.

I also have to make sure I eat at the right times or else I get low blood sugar and feel awful.

My family has a history of type II diabetes and my docs keep telling me I don't have that (yet). But, I know that I have a pretty good shot at developing it later if I don't take care of myself, maintain a healthy weight and exercise. I figure this diet is a good one while pregnant and I'll modify my calorie intake down after I have the baby to lose the pregnancy weight and then just stay on it forever. It's actually pretty easy to follow.

 

[MsBlack]

Quote:

Originally Posted by Cheshire I think if a mom doesn't know or doesn't care that she has it then it can be trouble. I know that if I don't watch what I eat my sugars go up and my heart races for a while, I feel awful, thirsty and then have a big crash where I'm super sleepy. I've had that happen twice and I won't do it to myself (or my little one) again. The baby goes crazy when my blood sugar is high and I hate the thought that she's buzzed out on sugar at the same time. I also have to make sure I eat at the right times or else I get low blood sugar and feel awful. My family has a history of type II diabetes and my docs keep telling me I don't have that (yet). But, I know that I have a pretty good shot at developing it later if I don't take care of myself, maintain a healthy weight and exercise. I figure this diet is a good one while pregnant and I'll modify my calorie intake down after I have the baby to lose the pregnancy weight and then just stay on it forever. It's actually pretty easy to follow.

You make a couple of important points here--

first, is that you are symptomatic. People who are actually having blood sugar regulation issues DO get symptoms such as those you mentioned (most common). IF a woman had symptoms, then I'd want her to do home testing as you have done, first to find out if the symptoms really are about blood sugar levels--later to keep an eye on bs levels after diet, etc, changes are being made.

second is that you have a fam history of type 2 diabetes, which to me means most likely 2 things: one is a genetic component--but I think it needs to be understood that in the VAST majority of people, that genetic 'predisposition' does NOT manifest UNLESS the person has a crappy diet. It takes genes PLUS diet to make a type 2. The other thing about this family history is that you learned to eat from these people! Of course they were doing their best, but so often, parents/families just don't know what constitutes a healthy diet, and/or have sugar addiction, and/or at some point in the family history (if not presently) there was a sufficient degree of poverty that dictated a substandard diet which became part of family tradition and was passed down the generations.

third is your comment about 'eating at the right times'--also important, especially for pregnant women. We DO burn a ton of calories even when sitting still during pregnancy--and of course, individual metabolic rate is involved, some need to eat more frequently than others. If you don't understand your own metabolism, and mistakenly believe that '3meals a day' is a good norm (or even just 2 meals is what you're used to), then you will not necessarily eat when you're starting to get hungry. This impacts bs levels and 'steadiness' (or lack thereof) as well.

I don't really believe in 'gestational diabetes' as a disease, either. But I do understand that pregnancy challenges our bodies in every system, is 'extra work' for us physically and on all levels. Those who come into pregnancy with a carb-heavy diet (particularly sweets/refined flours) and no exercise habit, are those most likely NOT to well-meet the challenges and extra work of pregnancy. If your family history is type 2 diabetes, then likely it will be your pancreas that is the 'sensitive spot' where lifestyle deficiencies and/or excessive stresses will manifest--you'll have a hard time regulating blood sugars. For other women (no type 2 fam history), those deficiencies and stresses will manifest in other ways, according to personal and familial matters.

Finally, just want to reiterate your point about healthy 'GD Diet'--it is absolutely a healthy diet for anyone! And most especially for those with a predisposition to type 2 diabetes.

 

[CarolynnMarilynn]

Another consideration is the passenger: babies can become very ill after birth when born to mothers with blood sugar issues. Babies can become life-threateningly hypoglycemic after birth when born to moms with 'GD'. The signs can be subtle and easily-missed. That is one reason some moms choose the testing in my practice is to identify those babies who are significantly higher risk of unstable blood sugars after birth. I've had babies in my care whose blood sugars are 1.5-1.9 AFTER the initial breastfeed, within 2 hours of birth. They didn't look or act ill, and weren't jittery. These draws were lab draws and thus really accurate. I've also had babies born to GD moms who looked like they felt terrible and needed two weeks to stabilize their blood sugars. Some babies bounce back quickly and their own insulin levels level out quickly, and some babies stay unstable for days. Keeping a mom's blood sugar levels stable and in the normal range help ameliorate this and keep the babies' postpartum life more normal.

The other consideration is that there is a real connection between women who test positive in pregnancy and who will become Type 2 later in life. I see it as a warning sign that that woman may want to make changes in her life to ward off diabetes later in life. Some women want to know this information about their health.

Also some women's blood sugar becomes unstable enough that she requires insulin. Then the risks to her baby increase exponentially, and her risk category changes. You can't tell externally which woman's glucose control is going to go wildly out of control from diet-controlled to insulin-dependent.

In my practice I discuss the issue and offer it to all women because the community standard sees this as the minimum. Many women decline the test. For those women who have risk factors I recommend but of course don't pressure. It is an informed choice discussion and decision in my practice. I liberally share the information on the controversy of this test, what we can know by testing, how we can affect outcome, and what risks a woman might face by declining.

 

[Amydoula]

Quote:

Originally Posted by MsBlack You make a couple of important points here-- first, is that you are symptomatic. People who are actually having blood sugar regulation issues DO get symptoms such as those you mentioned (most common). IF a woman had symptoms, then I'd want her to do home testing as you have done, first to find out if the symptoms really are about blood sugar levels--later to keep an eye on bs levels after diet, etc, changes are being made. second is that you have a fam history of type 2 diabetes, which to me means most likely 2 things: one is a genetic component--but I think it needs to be understood that in the VAST majority of people, that genetic 'predisposition' does NOT manifest UNLESS the person has a crappy diet. It takes genes PLUS diet to make a type 2. The other thing about this family history is that you learned to eat from these people! Of course they were doing their best, but so often, parents/families just don't know what constitutes a healthy diet, and/or have sugar addiction, and/or at some point in the family history (if not presently) there was a sufficient degree of poverty that dictated a substandard diet which became part of family tradition and was passed down the generations. third is your comment about 'eating at the right times'--also important, especially for pregnant women. We DO burn a ton of calories even when sitting still during pregnancy--and of course, individual metabolic rate is involved, some need to eat more frequently than others. If you don't understand your own metabolism, and mistakenly believe that '3meals a day' is a good norm (or even just 2 meals is what you're used to), then you will not necessarily eat when you're starting to get hungry. This impacts bs levels and 'steadiness' (or lack thereof) as well. I don't really believe in 'gestational diabetes' as a disease, either. But I do understand that pregnancy challenges our bodies in every system, is 'extra work' for us physically and on all levels. Those who come into pregnancy with a carb-heavy diet (particularly sweets/refined flours) and no exercise habit, are those most likely NOT to well-meet the challenges and extra work of pregnancy. If your family history is type 2 diabetes, then likely it will be your pancreas that is the 'sensitive spot' where lifestyle deficiencies and/or excessive stresses will manifest--you'll have a hard time regulating blood sugars. For other women (no type 2 fam history), those deficiencies and stresses will manifest in other ways, according to personal and familial matters. Finally, just want to reiterate your point about healthy 'GD Diet'--it is absolutely a healthy diet for anyone! And most especially for those with a predisposition to type 2 diabetes.

I just want to point out some things. First I do have GD, I'm thin, healthy and have low blood pressure. Both of my parents are type 2, yes they do not eat as they should BUT they are not poor, trust me they have plenty of money, it has nothing to do with whether they eat healthy or not. I scrimp so that I can buy organic but they could easily buy it and would rather eat the way they do. I did NOT learn my eating habits from them, I've always eaten lots of organic veggies, fruits , whole grains, pastured meat,etc. etc. I've found that eating less carbs makes me feel great, even though I was eating "good" carbs before. I'm obviously quite insulin resistant. I still can't get my fastings down to where they would like them even with lower carbs and exercise but luckily my midwife looks at the whole picture and is keeping me diet controlled since my after meals numbers are so good. I had NO symptoms of GD except high blood sugar levels. Yes I was more tired, and could get a bit lightheaded sometimes but many pregnant women feel that way. Just wanted to point out that not everyone fits the "typical" GD profile.