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mellyrose
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For those of you who experienced gestational diabetes, were you able to control with diet, or did you need insulin?
If you were able to control with diet, how quickly did following the diet bring your numbers under control?
I was diagnosed a week or so ago, met with the nutritionist and got my monitor and meal plan late Wednesday. I haven't had a reading low enough to fit the parameters yet (testing 4x/day). I've been following my meal plan to the letter. I'm seeing my doctor on Monday and just wondering if I'll be leaving with a prescription for insulin.
Also, how did it affect your birth plan/choices? I was hoping for a natural birth, IV and med free, staying home as long as possible. From things I've read, my chances for intervention and induction jumped the moment "gestational diabetes" was added to my chart.
I know none of you are medical doctors, but of course I have these questions late on a Friday night and am looking for personal stories -- not medical advice :)
thanks!
Melanie
Mom to Colin (6), Nate (4), and baby girl on the way
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JodieLyn
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| Posted: March 30 2007 at 10:42pm | IP Logged
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as long as the GD is controlled there shouldn't be any impact on the labor and delivery.. that's not to say that docs won't push interventions in the name of GD.. I use a midwife myself and am pretty skeptical about the majority of docs leaving things alone.. though I know there are some out there.
I don't know how fast the diet should get things stabilized but exercise is very important too.. I'd try getting a walk in after meals and seeing how that affects the numbers.
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JennGM
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Melanie,
I had to use insulin, but just barely. My situation was a bit different, as I found out I had the GD at 12 weeks, rather than later. So at 20 weeks we went on insulin, but it was a very low dose. They used some term "brittle" for my numbers. Plus, I couldn't exercise due to my pregnancy, so I couldn't "help" my numbers.
But even with insulin, diet is EXTREMELY important. Actually insulin is much harder, because low blood sugar crashes can happen fast and without warning and can be very dangerous, so the multiple meals is even more rigorous and important.
I would suggest following a different diet than the one from the doctor. It had way too many carbs for me, even on insulin. I think there's a thread around here that discusses some good diets. Think complex carbs, high protein. No white flour. Almost a South Beach diet. Find a list of glycemic index foods and stick to the low glycemic index. Follow the Brewer's Diet.
If you have sweets, they should have a higher fat/protein content to have a balance. For example, a cookie is terrible to the blood sugar, but a small amount of ice cream keeps the numbers more stable. Cheesecake would be better than chocolate cake. But all small, of course, rare, planned treats...
Don't drink fruit juice. If you have fruit, eat it wholly natural, not processed in any way, and balanced with a protein.
Breakfast is the most important. Don't eat cereal...it's a bomb for your sugar numbers.
Drink lots and lots of water. Hydration helps your numbers go down.
And walk if you can. Exercise helps.
I can't help you with the birth plan. I had to have a c-section. The GD added more complications and extra doctor visits and such. My son was born exactly at 37 weeks, and they gave the steroid shots to develop his lungs, and they monitored my sugar. They made a mistake in my IV and added glucose, so post-partum my numbers were higher than all through pregnancy (300?). My endo was extremely worried until she found out it was their mistake and not my body having problems.
They will monitor your daughter's glucose blood levels for hypo or hyperglycemia. Many times babies will become hypoglycemic when they are born. Mine had no problems, which was a blessing. But it is something to keep in mind.
It is so hard. I carried my little lunch box and had my planned snacks, forcefed myself food at all hours of the night and day...those extra sacrifices for your child!
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Jennifer G. Miller
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JennGM
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| Posted: March 30 2007 at 10:59pm | IP Logged
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One more thought, Melanie. If you're doing all you can and you're still having high numbers, don't be hard on yourself (stress gives higher numbers, too). Your placenta is sending mixed signals and it's not your fault! Don't feel like a failure or feel guilty if you have to do insulin. It was a relief to me that I had something to help. It's more dangerous for your unborn baby to have those higher glucose levels than to have insulin. And, having the high numbers makes the baby larger, and that can bring you to a c-section...etc.
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Mary G
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| Posted: March 30 2007 at 11:05pm | IP Logged
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I'm still uncertain whether I truly HAD gd with Maggie -- altho I flunked the 3 hour GTT, I was able to keep my readings within spec the whole time I tested (and I often "cheated" on the diet  )....sometimes I think that when we're stressing over GD, our levels are higher????
Also, I only had GD with the 2 girls (who are 8 years apart) and NONE with the boys
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JodieLyn
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Mary the GTT is known to be a very poor test.. even the 3 hr one. Some doctors now if approached will let you do the testing at home with the monitor etc just like if you were GD.. it's again the "we have to have a test in the office because it's too hard for women to do on their own" and/or "we can't trust the patient to provide good numbers so we have to test in the office so we can watch that they're not cheating"
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KerryK
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| Posted: March 31 2007 at 8:14am | IP Logged
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Hi,
I haven't had the opportunity to post too often on these forums, but I wanted to post a reply since I just delivered my son after my third GD pregnancy. This time I was diagnosed early (18 weeks), and initially controlled it pretty well with diet, but ended up on insulin by 28 weeks. I also was having pre-term labor issues, so couldn't use exercise to control it. If you can exercise, it can really make a difference. The only other things that were affected by my diagnosis were: more ultrasounds to moniter baby's growth in third trimester, and non-stress tests to check on the baby. This baby was my smallest, weighing in at 8.5 lbs.
If you follow the diet closely, you can get some pretty good results. One important point is eat the snacks...if you get too hungry you'll eat a lot and your number will be higher. The idea is to space it out throughout the day and keep your numbers steady.
Good luck and don't worry...you will be fine!
Kerry
Mom to Matthew (10)
Mary (6)
Samuel (1 month)
and 8 angels in heaven
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JennGM
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| Posted: March 31 2007 at 8:15am | IP Logged
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JodieLyn wrote:
| Mary the GTT is known to be a very poor test.. even the 3 hr one. Some doctors now if approached will let you do the testing at home with the monitor etc just like if you were GD.. it's again the "we have to have a test in the office because it's too hard for women to do on their own" and/or "we can't trust the patient to provide good numbers so we have to test in the office so we can watch that they're not cheating" |
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Jodie, The blood glucose monitors are helpful, but not completely accurate. So the blood draws and the HbA1c are really the best accurate markers. As far as the 3 hour, it is torturous and a bit unrealistic...after all, who drinks straight sugar down?
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Maryan
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| Posted: March 31 2007 at 8:19am | IP Logged
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I had it with my oldest and was able to manage it with diet. Technically, I flunk the urine test at the end of each my other pregnancy's but at that point I'm 39 weeks, so they don't do anything. (I also NEVER schedule a morning appointment BTW -- that's when your sugars are at your worst.)
HOWEVER, I give up my coffee with sugar for the last month and a half of each pregnancy and move ice cream to the afternoon instead of after dinner.
But anyway -- with my first -- due to fear of an ultra big baby, I was EXTREMELY faithful to the diet -- however, my numbers were so good that the doctor just had me check my sugars in the morning and evening. And...he let me on occasion have a treat mid-afternoon as long as I went for a walk following the treat. I found the book "SUGAR BUSTERS" very informative (it explains why potatoes, corn, white bread etc. are also not good for you...)
When it came to delivery, I hoped for no intervention -- but that's not what they wanted because of the GD. BUT I was VERY fortunate that I didn't know that I was in labor when it came -- so 10 days before my due date when some show was going on -- I went in to the hospital at 7 cm  and delivered John Paul without meds, without an IV, without intervention...by default -- there was no time! I'm tall and they say that happens in tall women. 
So everyone's reaction to sugars is different. You'll have to see how your body reacts. But I will say that while I was on the GD diet -- I felt fantastic. It's a very healthy diet and lifestyle.  And I could stay on it because I was scared to death of delivering a 13 pound baby!!  I think fear is a big motivation for me.
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Maryan
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| Posted: March 31 2007 at 8:21am | IP Logged
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JennGM wrote:
As far as the 3 hour, it is torturous and a bit unrealistic...and who drinks straight sugar down?
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And I'm with Jenn -- even with sugar in my coffee...it doesn't even come close to that nasty orange drink's sugar content! That stuff could make you loopy. 
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Maryan
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8kids4me
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| Posted: March 31 2007 at 11:47am | IP Logged
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JennGM wrote:
I would suggest following a different diet than the one from the doctor. It had way too many carbs for me, even on insulin. I think there's a thread around here that discusses some good diets. Think complex carbs, high protein. No white flour. Almost a South Beach diet. Find a list of glycemic index foods and stick to the low glycemic index. Follow the Brewer's Diet.
And walk if you can. Exercise helps.
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I agree. Cutting out at least the "unnatural" carbs will help(bread, pasta, white sugar, etc.). Oatmeal as a bedtime snack helped me have lower numbers in the morning when I awoke. I still had my OJ, but either 1/2 hour before or 1 hour after breakfast, and only what would fit in a juice glass. A 10 minute walk after supper will bring down your sugar levels a lot.
I was able to control my levels with diet for all but the last two babies. Can't help with the birth plan, I had HUGE babies, all 8 of them C-Sections.
Good luck and keep us posted on how it goes!
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Mare
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Melanie,
You've gotten great advice from everyone. I couldn't agree more that eating protein at each meal/snack and exercising are great ways of keeping the numbers down. I thought I'd add a few more things.
You may want to look at the ingredients of the foods that you are eating. In our family, anything with High Fructose Corn Syrup (HFCS) will set the sugars high. I couldn't believe how much food is made using HFCS. For some, milk will also send the glucose level higher.
There are some "good" foods that are high on the glycemic index like carrots. You just have to watch how much you eat at a given time. (You can find the glycemic index on Google.) Whole wheat bread isn't too much different than white bread on the glycemic index but it is a healthier choice.
HTH,
Mare
Mom to 4 dc
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mellyrose
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Thank you all for the wonderful tips and ideas (and support!)
The meal plan I was given is very high protein / low carb and is also very limited. Everything is pretty much natural -- just whole fruit (but none before noon which is hard for me), meat, whole vegetables, dairy and then processed bread items (but careful to avoid any with added sugar and looking for high fiber). I'm also eating 6 times/day. Artificial sweeteners give me a headache, so I'm only drinking water (and lots of it).
I found that my numbers are okay if I eat about 1/2 of what is suggested, but I know that won't be a solution -- since I'm still under my pre-pregnancy weight by about 5 lbs. I was overweight to begin with, but the end of my last trimester is not the time to lose any more weight. Oh, and also the fact that I'm hungry all the time if I cut the plan in 1/2.
I will look into the glycemic indexes of different fruits and vegetables, so I can make better choices there.
Thankfully, I"m heading into week 34, so I've got no more than 6 weeks ahead of me (DS#1 was born at 40 weeks, DS#2 was born at 36).
Thanks again!
Melanie
Mom to Colin (6), Nate (4) and baby girl on the way!
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Angie Mc
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Hi Melanie! Wow...34 weeks...how wonderful!
You might want to call R. Fowler from the SHHE group. She has been in the same situation for at least her last two pregnancies. If she has no new information for you, she will definitely have a lot of sympathy  .
Eat, Drink, and Be Healthy has a lot of good information about glycemic loads in general. I have it on my bookshelf and will be glad to loan it to you if you think it will help.
Hang in there, Melanie! Your are doing a great job taking care of yourself and your little one.
Love,
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JennGM
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| Posted: March 31 2007 at 9:35pm | IP Logged
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8kids4me wrote:
JennGM wrote:
I would suggest following a different diet than the one from the doctor. |
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I forgot to mention that my endocrinologist TOLD me to stray from the AMA suggested diet. It wasn't working for me!
[QUOTE=8kids4me] I was able to control my levels with diet for all but the last two babies. Can't help with the birth plan, I had HUGE babies, all 8 of them C-Sections. |
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EIGHT C-SECTIONS!!!!??? Wow! You are one special lady!
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missionfamily
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I have had gestational diabetes for the last three of my five pregnancies and have had success controlling with diet only but this pregnancy have taken an oral medication called glyburide which is safe for pregnant women and at least is not having to deal with insulin. I started taking it after I weaned my nursing baby, probably about thirteen weeks into the pregnancy and have not had an elevated blood sugar thus far (now at 3 weeks). I ahve always had c-sections so the concern about delivery is null for me, however, I have always requested there be no intervention with the baby until he has had a chance to nurse a few times. No intervention was ever required with the babies. God bless you and your little one, Colleen in Louisiana
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J.Anne
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I had GD with #2 - it was complicated by medication for preterm labor. I was able to control it through diet, but depending on when I took my meds, my levels could be off. Walk if you can after meals - it helps. The diet isn't so bad.
I was able to deliver naturally without the epidural etc. in only 90 minutes. I can't see why the GD would affect that. The drs. did insist on an IV . And I had a pizza delivered to my recorvery room that afternoon. Pizza seemed to be the one thing I wanted and couldn't have at all.
Prayers for an easy end to your pregnancy.
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4Real Forums : Mothering and Family Life
Topic: gestational diabetes question
