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Lisbet
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| Posted: Aug 04 2008 at 8:16am | IP Logged
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I need a little advice here ladies. I had my first prenatal (I am 13 weeks) last Thursday. Seems my blood sugar was a little high and my iron a little low. We have always check blood hemoglobin, and I've always had to work really hard to keep it above 12, it was 11.8 - not terrible, but a sign that I need to work on things.
But the blood sugar - here's the thing...My midwife, who has been practicing for over 30 years, lost her first baby a few years ago. To make it even worse, it was her grandson. Baby experienced decels, they transported to the hospital where mom underwent an emergency section, the baby passed during the prep. The hospital screamed "Baby was hypoglycemic". (that is all the information that the family is sharing, and autopsy was done...) We have aways checked urine for sugar spilage, but since losing her grandson, we now check blood glucose levels at each visit. This began when I was pg with Mark. Each time my blood glucose levels were in normal ranges for when I had eaten last etc...
Well, on Thursday, we checked and it had been 2 hours since I had a nice hearty lunch and 3 hours since a big bowl of Hagen Daas.  My urine showed no spilage, but my blood glucose levels were 121 - I was lectured to no end by the ladies. They told me to stop all sweets, watch my carbs, and that we would keep very close tabs on my sugar from here on out.
Being really clueless about all of this, I came home and did some research. Seems that 140 or above is considered gestational diabetes, and there is much conflicting information over whether or not 121 is even 'high blood sugar'.
I follow the Brewer diet very carefully. I eat everything recommended each and every day. And yes, ice cream is my weakness and I do eat it a couple of times a week, but not to the detriment of following my diet. I am looking at things wondering:
1. Is this really even a 'problem' or is it a reaction of my midwife based on her experience with her daughter/grandson? Is she over reacting?
2. What can I change? I am SO good about what I eat, is the ice cream really the culprit? Is it because I'm getting older? (which is what one of the midwives suggested.)
Those of you that have dealt with this before, how did you eat? What are your thoughts? Thanks for any input or further info you can give me on this! (and prayers too, if you don't mind!)
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Lisa, wife to Tony,
Mama to:
Nick, 17
Abby, 15
Gabe, 13
Isaac, 11
Mary, 10
Sam, 9
Henry, 7
Molly, 6
Mark, 5
Greta, 3
Cecilia born 10.29.10
Josephine born 6.11.12
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Elizabeth
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| Posted: Aug 04 2008 at 8:25am | IP Logged
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Lisa,
I'd go ahead and get a check kit. You should be under 95 when fasting first thing in the morning (some prefer under 90). Then, under 140 an hour after a meal and under 120 two hours later. The 140 is the most variable-you don't want it much higher though. If the other two are consistently good, then you're fine. Also, a meter can be off a few points. That 121 could easily have been 118 on the next stick just a minute later. As it is, it's borderline and bears watching. The diet isn't a "bad' one. It's a really proactive one.
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Elizabeth Foss is no longer a member of this forum. Discussions now reflect the current management & are not necessarily expressions of her book, *Real Learning*, her current work, or her philosophy. (posted by E. Foss, Jan 2011)
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JennGM
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Lisa,
Like Elizabeth said, that is the high range of the 2 hour check. The midwife's reaction is due to the fact that you're in very early stages of pregnancy and the number is already high. The placenta hormones dominate over the pregnancy and cause blood glucose levels to go higher.
But an isolated blood check isn't a good measurement. Fasting glucose numbers and a pattern of high numbers will confirm the problem.
And yes, age has a LOT to do with it. The diet isn't hard, and you could adjust the Brewer's diet easily to make this work. The protein is perfect, you need to move your simple carbs so that they aren't isolated as a snack but tied with a protein, and count the carbs you are doing.
Ice cream is one of the better snacks, since the fat helps regulate the blood sugar levels, but you need to have VERY small portions, and make sure you drink lots of water and exercise when you do have those treats.
There are so many other factors involved -- stress, exercise, fluids -- that affect the numbers.
I had more serious gestational diabetes requiring insulin, but I have been helping my youngest sister battle borderline diabetes from 28 weeks just with diet. This was her 3rd child, nothing happened in previous pregnancies. It was extremely frustrating to her to get high numbers and not be able to pinpoint why. There's so many variables.
I just want to stress while you can help things with diet, if you have blood glucose problems, IT'S NOT YOUR FAULT. Unlike outside of pregnancy, you have no control over this! This is from the placenta. It can be completely frustrating, and a big hardship, but don't feel guilty! Get a blood glucose monitor, keep track of your fasting and 2 hour numbers, and just keep down the carbs. Following the diet will help keep the numbers under control.
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Jennifer G. Miller
Wife to  & ds1  '03 & ds2  '07
Family in Feast and Feria
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Martha
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| Posted: Aug 04 2008 at 8:49am | IP Logged
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121 isn't considered high by my dh's endocrinologist for a pregnant woman, esp if you had ice cream and lunch within 3 hours of the testing.
If concerned, I'd test before eating and again after 1 hour.
She may not be concerned about the 121, but concerned about how high it might have been before it got down to 121. For example, if it's 121 3 hours after eating, was it just 125 an hour after and is actually leveling out just fine with no real spikes or was is more like 200, showing an insulin problem and maybe some high/low spiking? That's a huge difference. The first shows no real worry, the second could be a heads up to be much more vigilant.
So I wouldn't worry yet, I'd check my sugars just to ease MY mind and decide on whether to worry or not based on those results.
Oh and if there is an insulin problem, they should be sending you to an endo and dietitian to develop a custom management plan. And it should not mean you can't have a homebirth either.
My dh's peeve is drs who send patients to a specialist if they sneeze wrong, but don't send diabetics to an endo for the latest treatments and mangagement advice to suit their individual needs.
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Martha
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Lisbet
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| Posted: Aug 04 2008 at 11:31am | IP Logged
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Thanks everyone. I purchased a monitor at Walgreens this morning. I am eating lunch right now, whole grain (homemade) macaroni with cheddar cheese, steamed spinach, 8 oz. steak and 2 lg. cherry tomatoes with kefir to drink. I will check it around 3 pm then - it should be below 140 - right?
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Lisa, wife to Tony,
Mama to:
Nick, 17
Abby, 15
Gabe, 13
Isaac, 11
Mary, 10
Sam, 9
Henry, 7
Molly, 6
Mark, 5
Greta, 3
Cecilia born 10.29.10
Josephine born 6.11.12
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Elizabeth
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| Posted: Aug 04 2008 at 11:45am | IP Logged
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Not sure if we're caught in time zone differences. Check it one hour after you began that meal. It should be below 140. Check again at 2 hours. It should be below 120. keep track for a few days. check first thing in the morning. It should be below 95 (or 90). Be sure to wash your hands and get all traces of soap off before you stick. That can skew things.
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Elizabeth Foss is no longer a member of this forum. Discussions now reflect the current management & are not necessarily expressions of her book, *Real Learning*, her current work, or her philosophy. (posted by E. Foss, Jan 2011)
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Milehimama
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I'm always diabetic - diet controlled - and monitor throughout pregnancy.
There is a blood test, the A1C, that can tell overall blood sugar levels/control for the previous two weeks. If your midwife is really that concerned, do the blood test and get an overall picture.
I've also gone by the guidelines of under 95 fasting, under 140 1 hour post meal, under 120 2 hour post meals.
I've found food combining to be very helpful - eating grains with protein and fiber, for example. (Whole grain noodles - no. Whole grain noodles with cheese and veggies - yes).
Also, certain foods just seemed to "do me in", so keeping a food diary can be helpful!
HTH!
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Milehimama
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Also, the food diary was helpful to find out that I wasn't consuming enough protein.
It helps to "water down" sweets - drink water or unsweetened tea with them, not milk, sweet tea, or a drink with calories in it.
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JennGM
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Milehimama wrote:
I've found food combining to be very helpful - eating grains with protein and fiber, for example. (Whole grain noodles - no. Whole grain noodles with cheese and veggies - yes).
Also, certain foods just seemed to "do me in", so keeping a food diary can be helpful! |
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I was going to say the same thing! Each person can react differently, even though the food might be "whole grain" or low on the glycemic index (which is a good thing to follow for fruits and veggies, especially). And sometimes the same food can have a different reaction on different days.
Follow the 6 meal plan -- 3 main meals, 3 snacks. Snacks need to be combined carb and protein. Bedtime snack (protein and complex carb combo) is extremely important.
Oh, and you might pick up a ketone tester at the pharmacy. They are inexpensive. They can help indicate if you're eating enough for your baby.
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Martha
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Lisbet wrote:
| Thanks everyone. I purchased a monitor at Walgreens this morning. I am eating lunch right now, whole grain (homemade) macaroni with cheddar cheese, steamed spinach, 8 oz. steak and 2 lg. cherry tomatoes with kefir to drink. I will check it around 3 pm then - it should be below 140 - right? |
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Just mentioning since the other ladies didn't...
You should test your sugar BEFORE eating as well. The number before eating should affect what you eat. For example, if it was 70, you'd know to eat a bit more and to get to it asap. If it was 130, you'd know that you really can't indulge that sweet or carb item and to stick to a smaller protein snack instead of a bigger meal.
ETA: dh reminded me to mention that you should double check your thyroid, if it hasn't been checked yet. (Usually done with that first round of bloodwork after the first appt.) His endo says a thyroid even a bit out of wack can affect insulin/sugars too and is very common in pregnant woman, esp "older" pregnant women. (Is anyone else a bit flustered to find themselves called "older woman"? When did THAT happen?! )
We go with dh to his endo appts and his dr always takes the time to talk to the kids and remind me that pregnant woman should watch their sugars and thyroid. Every 3 months I hear him bemoan about the many people that don't take it serious and it snowballs in their 40s after years of not being treated. The poor man is just giddy to see a healthy pregnant lady, type 1 diabetic, and our 8 kids. He spends about 10 mintues on dh and 45 chatting about all things pregnancy and healthy kids. 
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Martha
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Lisbet
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| Posted: Aug 04 2008 at 12:20pm | IP Logged
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Jenn,
I can't imagine that I'm not eating enough. The 2 hour fast thing makes me hungry just thinking about it! I forgot to mention that I am nursing 2 kiddos too, although Molly only nurses once or twice a day. What is a ketone tester?
I'm going to monitor for a few days with my current diet (sans the ice cream of course!) and go from there. Thanks so much everyone for walking me through this.
__________________
Lisa, wife to Tony,
Mama to:
Nick, 17
Abby, 15
Gabe, 13
Isaac, 11
Mary, 10
Sam, 9
Henry, 7
Molly, 6
Mark, 5
Greta, 3
Cecilia born 10.29.10
Josephine born 6.11.12
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Lisbet
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| Posted: Aug 04 2008 at 12:22pm | IP Logged
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Martha, just to test the thing out, I tested when I got home, about an hour after a small snack of whole wheat bread with nutbutter and some water, it was about an hour before lunch, and it was 99. (is that good??)
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Lisa, wife to Tony,
Mama to:
Nick, 17
Abby, 15
Gabe, 13
Isaac, 11
Mary, 10
Sam, 9
Henry, 7
Molly, 6
Mark, 5
Greta, 3
Cecilia born 10.29.10
Josephine born 6.11.12
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JennGM
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| Posted: Aug 04 2008 at 12:26pm | IP Logged
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99 is good, Lisa. Some more reading on ketones. This mom has some good advice on GD on her site.
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Martha
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Yep 99 is very good. Usually you want to keep it between approx 85 and 110, with 90 - 100 being the ideal goal.
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Martha
mama to 7 boys & 4 girls
Yes, they're all ours!
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Lisbet
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THANK YOU ALL! You are wonderful! 
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Lisa, wife to Tony,
Mama to:
Nick, 17
Abby, 15
Gabe, 13
Isaac, 11
Mary, 10
Sam, 9
Henry, 7
Molly, 6
Mark, 5
Greta, 3
Cecilia born 10.29.10
Josephine born 6.11.12
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Lisbet
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Alrighty, I'm begining to think it was the ice cream. Before lunch it was 99 (about an hour after a snack) Here I am at an hour after lunch and it is 111. I will check again in anther hour, but I'm begining to think it was just the ice cream that sent me over last time.
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Lisa, wife to Tony,
Mama to:
Nick, 17
Abby, 15
Gabe, 13
Isaac, 11
Mary, 10
Sam, 9
Henry, 7
Molly, 6
Mark, 5
Greta, 3
Cecilia born 10.29.10
Josephine born 6.11.12
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nissag
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Lisa,
Thank you so much for reminding about the Brewer Diet. I'm having some blood sugar problems, but I think my numbers are low, not high. I'm thinking of running to CVS for a meter. I've had a really rotten pregnancy so far with nausea, fatigue, headaches and irritability. We checked the thyroid and it was perfect, and my iron was, to quote the midwife, "amazing". OK, I like green stuff... And if this is a boy, I'll need to watch my PH doesn't stray into the acid realm.
But I digress. I'm so glad you appear to have gotten to the bottom of your "sugar high". I'm sure your midwife will be relieved. Poor woman, what a terrible blow for her. I can certainly understand her fears.
Blessings,
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Nissa
Deacon's wife, mother of eleven, farmer, teacher, creator, cook.
At Home With the Gadbois Family
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Donna Marie
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If it makes you feel any better...
Last time I was pregnant I ate some plain yogurt that my dd put too much maple syrup in...I ate it as she was so proud of it...it made me flunk my stick sugar test big time...they told me that a sugary snack can do this. Other than that my blood sugar was always fine. I knew enough to stay away from the bad stuff as it would have negative consequences that I didn't want to deal with...
HTH!
God love you,
Donna Marie from NJ
hs momma to 7dc + one more due 10/08!!
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Donna Marie from NJ
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Finding Elegant Simplicity
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juststartn
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Well, I've been very fortunate that I've not had to deal with gest diabetes yet (even in spite of my large number of predisposing factors with the twins). But I'm on metformin for my PCOS, which I stay on the entire pregnancy (its a drug used for diabetics), and eat a lower carb diet and try to carefully balance my proteins:carbs...
I'm glad that the other ladies have been of help (and given my risk factors again this time), I can use all of the reminders I can get.
Rachel
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phplists
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I had elevated blood sugar also in my last pregnancy (at age 39). I had a 28-week blood glucose of 129. I refused to do further testing, but just bought a meter, as Elizabeth has suggested. Through diet alone (I did give up all refined sugar and carbs - my only carbs were whole grain, like oatmeal or brown rice or non-commercial 100% whole wheat bread). Through diet alone I was mostly able to keep my blood sugar under 95 fasting, and under 120 at one hour post-meal (postprandial). I checked my blood sugar 4 times a day with the little meter. Because I was under homebirth midwife care, and I did not go with the OB's suggestion to do the longer 3-hour test (I felt that if a one-hour test made my sugar go high, there was no need to put myself and the baby through the even GREATER blood sugar fluctuation of a 3-hour test!), I did not get a formal diagnosis for insurance purposes and therefore the insurance did not pay for my monitor or my test strips. That did get a little expensive but it was worth it to me to avoid the additional worry and hassle.
There is an excellent chapter on this in Anne Frye's book Understanding Diagnostic Tests in the Childbearing Year. I'm sure your midwife can lend it to you, or someone near you has it (or maybe you have it). If not, I can send you my copy of the pages related to gestational diabetes - it really explains it all very well.
Good luck and I will pray for you. It is a worry, especially when you have had healthy pregnancies in the past.
Pam
Mom to Ben, 9, Daniel, 6 and Jonathan, 3 (the one with leukemia who was prayed for on this very list - thank you!!)
http://www.exceptionalmarriages.com
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4Real Forums : Our Lady of Good Remedy and Care
Topic: Pregnancy, Diet, and Blood Sugar
