Gestational Diabetes – Please Share Your Experience

Miscellaneous and Personal Stuff I Must Share
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Standard Disclaimer: I am not soliciting for medical advice, just your own experiences.

I’m currently awaiting my 3 hour glucose tolerance results after having failed my 1 hour test quite spectacularly. I have been researching options and medical opinion in the interest of being informed if the results do come back as expected, but I would also really appreciate hearing about your personal experience with gestational diabetes. For example, when were you diagnosed? How did it affect the remainder of your pregnancy? Did you need insulin? If so, what type of medical supplies did you have to purchase? Do you feel your condition affected your labour or the health of your child? Did the condition resolve itself immediately following the birth? (I have read that a small percentage of women go on to develop Type 2 diabetes). I would be grateful for any insight you may have into the condition.

Thank you!

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I failed my gestational diabetes screening at about 6 months. The doctor sent me to a dietician/nutritionist who worked out an eating plan with me. (I counted carbs before it was popular. Ha!) I had to check my blood sugar and keytones each morning. The hospital rented me a blood-sugar-tester-thing for the duration; I think it wasn’t too expensive. I didn’t have to do insulin because once I started counting carbs, I don’t remember my BS ever being off the charts.

The most difficult thing about having GD was shoving all that food into me with an ever-growing fetus. The stomach starts to get pushed up there, and it seems like one saltine would be plenty for each meal. :wink: Kidding. So it wasn’t a bad experience at all. I can’t recall being tested after the birth for diabetes. Guess it helps that my stepdad’s diabetic and my mom also watches her food intake; it’s kind of ingrained in me now what’s good, what’s bad, and how to balance them (or take advantage of the poor old pancreas* and get one hell of a sugar high!).

*I couldn’t tell you if it’s the pancreas that has anything to do with the breakdown of glu -ten -cose -stuff. I just wanted to come off as smart for one half of one second. :smiley:

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Thank you, BrattiAtti.

Has anyone else had any experience with gestational diabetes?

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I have had gestational diabetes with each one of my daughters.

Daughter #1: I was diagnosed at about 29 weeks. I was not overweight prior to the pregnancy; by that point in the pregnancy, I had only gained 11 pounds. I was placed on a restricted calorie diet (about 1850-1900, if I recall) and told to exercise 30 min. per day. I did so. I didn’t have to check my blood sugar at home. The first week on the diet, I had it checked by the doctor’s office twice; the next two weeks, once per week. Each time, my blood sugar number was good. By the time I was diagnosed, I had already developed a GD side effect, polyhydramnios (too much amniotic fluid). I never used insulin, just diet and exercise, so I didn’t purchase any medical supplies. I was ferociously hungry constantly, which was rough. My condition definitely affected my labor and delivery. My daughter was born after premature rupture of membranes and preterm labor. I had an increased risk of both thanks to the gestational diabetes. I also developed toxemia, which may or may not have been affected by the GD. The gestational diabetes did resolve itself with her birth. Incidentally, due to the diet, after I gave birth, I actually weighed about five pounds or so less than I had before I got pregnant.

Daughter #2: I was diagnosed again at about 28-29 weeks. I was not overweight prior to the pregnancy. Once again, I was placed on a restricted diet – total calories, 2000 – and told to exercise by walking 30 min. per day, which I did. I didn’t have to check my blood sugar at home or use insulin. My blood draw schedule at the doctor’s was similar to the above. My blood sugars remained good each time they were checked. However, I developed a pretty good case of polyhydramnios again. Also, as soon as I was placed on the diet, I either lost weight each week or held steady, gaining only about 15 pounds total over the pregnancy. This did not make my OB happy, since she apparently thought I needed to gain more in order to be healthy. I was quite hungry this time, too, although not quite so severely.

I’m not sure if the condition affected my labor or delivery. I had preterm labor from before my GD diagnosis (25 weeks), but with moderate rest, I kept my baby inside until 36 weeks, 5 days. Her delivery was rough. She developed multiple pneumothoraxes (sp.?) as soon as she was born, and either had pneumonia in the womb or developed it almost immediately thereafter. It appeared that her lungs might have been somewhat underdeveloped for her gestational age, which can be a side effect of GD. According to her doctors, she was also under stress in the womb, enough to stunt her prenatal height by about an inch. I’m not sure what kind of stress, exactly, or if it was caused by the diabetes.

She ended up in the hospital for an additional 8 days after the birth. The gestational diabetes went away after she was born, but next week I’m having my sugars tested again, since I strongly suspect I’ve either developed hypoglycemia or full-blown diabetes.

I recently read in a journal article that up to 50% of women with gestational diabetes develop full-blown diabetes within 5 years of delivering their child. The number seems high to me, so maybe I misinterpreted it, or it’s based on a small study. Just FYI.

Good luck with your GD. It’s a miserable process, IME, in between hunger and blood draws. Although it’s a rough ride, your kid will be worth it. :wink:

Mrs. Furthur

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Thank you, Mrs. Further. I too read that 40 to 50% go on to develop full blown diabetes, but I can’t recall over how many years. In any case, if I ever needed incentive to try to improve my lifestyle after the baby is born…

I had just finished reading a report that said mothers with GD have a higher risk of developing preeclampsia (toxemia) and therefore premature delivery. Frightens me, obviously, but at least I’ll know to watch for symptoms and perhaps I ought not travel too far from home in the last couple of months.

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I did NOT have GD, but I too failed the 1-hour test and then passed the 3-hour test, which according to the many frantic hours of research I performed, is quite common. So I just wanted to give you a bit of encouragement. In fact, I turned up pretty hypoglycemic on the 3-hour test, which surprised my OB. She said if I ever have to have a 3-hour GTT again I should do it in a hospital in case I pass out! (And I very nearly did during the last hour of the test.)

So try not to worry (I know, that’s easier said than done). I have a couple of acquaintances who’ve had GD and with careful monitoring their pregnancies and deliveries were just fine.

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This same thing happened to me with all three of my children. Don’t worry overly much until you get your final results, Cyros.

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I had GD. I required insulin to keep my blood sugar under control. I have written about some of my experiences not too long ago. I did not experience any blood pressure complications such as toxemia. What helped me the most was finding a dietictian that did not see diabetes as punishment for being fat.

It was very hard to eat enough to gain the correct amount of weight without eating too many carbs. One thing that the doctor did not suggest that helped me was little pee strips to test for ketones. You want to eat enough so that you don’t spill ketones which are associated with some birth defects. It was hard for me to believe that I had to eat 2300 calories. You might not, but those little strips are good guides.

The very hardest thing was recording exactly what I ate and only eating the correct ammounts of starch, fat, protien, dairy, fruit and vegetables. I had spread sheets to record every thing I ate and calculate the various amounts of each type of food.

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So, after a long and sordid ordeal involving an incompetent phlebotomist, inattentive office dimwit and three glucose screenings, I found out yesterday I do indeed have gestational diabetes.

Here’s the thing: I’m leaving on a trip tomorrow and not returning until July 15th (late) and won’t have any further guidance from a doctor or dietician until after that date. (My doctor couldn’t accomodate me yesterday or today, and the referral to the dietician “takes time” apparently).

So. I got a prescription for testing supplies (which I picked up today) and some cursory advice from a dietician over the phone. She advised me to test several times a day (in the morning, and before and 2 hours after meals - although not necessarily every meal yet). She told me what the ranges for blood sugar should be (Canada uses a different standard than the US, 4 - 7 mmol?) She was kind of shocked my doctor wouldn’t have me in immediately to discuss the impact of this (I haven’t spoke with him at all) and to prescribe insulin just in case.

Anyway, I’m just supposed to wing it until my doctor’s appointment on July 19th, test often and try to eat “healthy”. Did anyone get any reference material when they had GD? Are there any books I should buy? I am incredibly pissed that my results were delayed by over a month and I’m now 30 weeks and having to wait almost 2 more weeks for any guidance. I just want to get on the right track so no (further) harm is done to the baby.

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There are no good books discussing gestational diabetes. Believe me, I’ve looked.

I know you’re late in your pregnancy to be thinking about this, but is there any way you could transfer to a new obstetrician? This guy doesn’t seem to be taking your problem very seriously, and while it’s not really life-threatening, it is kind of a big deal, and you deserve a doctor who’s going to have your and your baby’s best interests in mind. He should have had you in immediately to discuss your diet and medication (if any) regime and to talk about the impact of your diagnosis.

This is probably going to be long, but here goes. I was diagnosed with gestational diabetes at week 28 of my pregnancy with my first baby. I failed the 1-hour test quite spectacularly (198) and didn’t even need to take the three-hour test, although my doctor wound up ordering it for me anyway, possibly just to cover her butt. I don’t know. Anyway, failed it too, to nobody’s surprise, and immediately was referred to the Joslin Clinic in Seattle, specializing in diabetes care. I spoke with a nutritionist and got put on a relatively strict dietary plan, although not as strict as I remember my Type 2 diabetic grandmother’s diet being. Anyway, after a week of following the diet religiously and still failing to keep my blood sugar in control, I was placed on insulin shots. I continued taking insulin, adjusting my dosages every couple days or so, until Whatsit Jr. was born, at which point I immediately discontinued insulin and was assumed by all the medical staff to have no further problems with blood sugar.

I found, by checking my blood sugar on my own, that my blood sugar actually didn’t return to 100% normal. After much consultation with various doctors, it was determined that I was what they call “impaired glucose tolerant” or “pre-diabetic.” In other words, higher than normal but not officially diabetic. Knowing that my blood glucose numbers were higher than the target ranges for pregnancy, I went to the University of Washington Pregnancy & Diabetes clinic before even attempting to get pregnant with my second baby. They agreed that I should start pre-pregnancy treatment, and I started insulin shots again before even trying to conceive. Got pregnant 3 months later, and 2 months into the pregnancy switched from insulin shots to the insulin pump, which was pretty awesome. Had MiniWhatsit with a minimum of difficulty and discontinued insulin again. So here I am today, still technically “pre-diabetic” and hoping to stay that way.

I’ll share with you the guidelines that my nutritionist initially shared with me. They worked out very well for me during both pregnancies. Basically she had me count carbs, as I expressed a preference for this over the older “exchange” program. Counting carbs gives you a lot more flexibility in what you eat. The plan she placed me on consisted of 30g of carbs at breakfast, a 15g snack between breakfast/lunch, 45g at lunch, 15g snack before dinner, 45g at dinner, and a 10-15g snack before bed. I tested my blood sugar two hours after each meal; the target was less than 120 mg/dL. (During my second pregnancy I also started testing my blood sugar before meals.)

A few nutritional guidelines, also: whole grains take longer to digest and therefore release glucose into your bloodstream more slowly, which means they tend to raise your blood glucose less than refined grains. Try brown rice instead of white rice, whole wheat bread instead of white bread, etc. Avoid “white foods”, i.e. potatoes, white rice, white bread. Always, always, always make sure to eat some protein with your carbs. It slows down glucose absorption, and also you just need a lot of protein when you’re pregnant anyway.

I found personally that getting a brisk walk in after a meal dramatically helped to reduce my blood glucose numbers. Exercise in general will help with your blood glucose, probably. (Apparently not true for everyone, but true for many.)

There’s some excellent gestational diabetes information here: http://plus-size-pregnancy.org/gd/gd_index.html

I also wrote an article on attempting diabetic VBAC that has some basic diabetes and pregnancy info in it here: http://www.storknet.com/cubbies/vbac/diabetic.htm

I would be happy to answer any questions you have. I’ve been dealing with this crap for a long time now and I’ve done a lot of reading and a lot of asking questions about it. I AM NOT A MEDICAL PROFESSIONAL and all of the above is personal advice gleaned from my own medical professionals, but I am happy to share my experiences.

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I don’t mean to be rude to your doctor, but that’s incredibly irresponsible of him. He’s putting you at increased risk of complications, IMHO, since he’s not making sure that you have the right advice to handle your GD. If you stick with him after this, I’d ream him when I saw him next. I don’t know how your doctor perceives this, but when I was diagnosed with GD both the first and second time, that immediately elevated my pregnancy to high-risk status. He should be taking it very seriously when one of his patients becomes high-risk. And they should refer you to a perinatologist as well.

That said – until your two weeks are up, what Mrs. Whatsit said. And keep your OB’s number handy. You may not be in his physical presence for a couple of weeks, but definitely call if you experience any symptoms out of the ordinary.
It might not be a bad idea to look up the names and phone numbers of several OBs/hospitals/quick care centers in the area you’re going to be staying, just in case you need them.

Mrs. Furthur

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Wow MsWhatsit! Thank you for the very informative post!

I can’t switch doctors (I live in a province where I’m lucky to have an OB, and sadly, my OB is the most highly recommended in the area). Actually, had the phlebotomist (at a private lab) not screwed up royally, I would have known my fate at only 24 weeks. I’m still annoyed that they can’t get me in sooner of course.

We use the mmol/L standard (whatever that means) to measure glucose - I wonder what the conversion factor to the US system of measurement it? I find lots of information on the net about optimum blood sugar, but since the numbers don’t match up, I can’t figure out where I stand.

I tested today several times. Whole wheat toast with peanut butter and a cup of milk put me way over at the 2 hour mark. Before my next meal, I was way too low (the monitor asked me if I needed a snack). A chicken fajita (with no condiments) actually produced an ideal reading two hours later. I guess we’ll have to see if there’s a pattern over the next couple of weeks that I’ll be able to share with the dietician and nurse team I’ll eventually see.

Exercise is going to be a bit of a problem. Something horrendous has happened to my hips in the past few weeks and it’s agonizing to navigate the 3 flights of stairs to my apartment. And I vomit from the heat now too (pregnancy is such a beautiful time :rolleyes: ) I really like to swim (and it helps my back and hips tremendously) but I can’t afford the ridiculous fees at the only pool in town right now ($11.50 a day or $50 a month plus $25 to “joining fee”.)

I’m extremely anxious to start treating my GD as soon as possible. Diet, whatever exercise I can figure out to do, insulin… I will just want to avoid any unnecessary complications and keep this baby healthy.

I just read your article - it’s very well written and informative. And thank you for the other link as well. Any info I can get makes me feel a bit more in control.

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If you have soy milk in your area, you may want to investigate switching to it instead of cow’s milk. I found a brand that had 7g of carbs per 1-cup serving, as opposed to 12g of carbs in 1 cup of regular milk. Not that big a difference but it adds up and soy milk just always seemed to work better for me. The refrigerated kind is pretty tasty; I’d avoid the stuff in boxes in the unrefrigerated section.

If you’re not on insulin currently, it’s interesting that you had a low reading, although I’ve heard that some people experience bouts of hypoglycemia as a prelude to diabetes.

Conversion tool here, btw: http://www.onlineconversion.com/blood_sugar.htm

My hips killed me during the late second and third trimesters also. You could always try doing something involving just your arms, like lifting 5-pound weights or something. Anything that gets your heart rate up will help, I bet.

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**Mrs. Further **, hopefully I’ll get a better idea of what’s going on at my next appointment. I asked around, and apparently I will have a bunch more tests and ultrasounds, but I’m not even sure if we have a perinatologist in my area. We have few specialists in my region now. Health care cuts and all that. I’m familiar with the area I’m visiting and know where all the hospitals are (and my aunt’s a nurse at one of them).

MsWhatsit, I’m thinking my low reading was because I waited too long to eat. I think I’m going to have to set a timer to remind me to have a healthy snack between meals. That’s a great idea about the weights and thanks so much for the link!

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Sorry for all the posts, but once started on this topic I literally cannot shut up. It is like some kind of scary compulsion.

Anyway, just wanted to say that the important thing at this point is to keep your blood sugar in the normal range, which in mg/dL (you can run the conversion) is generally accepted to be <100 fasting and before meals, <140 one hour post-meal, <120 two hours post-meal. If you can do that, you and your baby should have a totally normal outcome. A few high numbers are to be expected, as this disease is not predictable or 100% controllable, but the idea is to get most of the numbers in the target range most of the time. If you’re following your diet and getting a reasonable amount of exercise and you still can’t get into the target range, your medical team will probably want to place you on insulin, which is totally normal and okay for a gestational diabetic. (Although kind of scary at first, depending on how you feel about needles.) This won’t mean you’re a bad diabetic or an out of control diabetic, it’s just that some people’s bodies have more difficulty with glucose regulation than others. And maybe it won’t be necessary at all; some gestational diabetics are able to stay in the target range just by following the diet.

Also keep in mind that blood glucose numbers tend to rise as the pregnancy progresses, due to additional hormone output from the placenta, so if you’re in control now but you have trouble staying in control a few weeks from now, don’t panic, it’s normal. Like I said, the key is to get the numbers back down into the target range as quickly as possible, so keep checking your blood sugar to stay on top of it.

And have a good trip! Try not to stress out too much about all of this; the odds are extremely high that your baby is going to come out perfectly fine. The absolute worst-case scenario in your situation isn’t all that horrible (which isn’t to say you don’t need to take care of the problem, of course!) so don’t panic!

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Er, I feel the need to point out once again that I am not a medical professional, all advice is based on my personal experience, check everything out with your own doctors, etc.

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But of course!

Not too scared about insulin - anything to get the best control over this.

It’s so helpful to hear another person’s experience and know that everything ultimately turned out okay. Reassuring.

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I have two daughters. I was diagnosed both times with GD. My story:

I went in for the 1 hour, finished the test, and was told, “If there’s a problem, we’ll call you.” After a whole month went by, I called them (like I always do! If a doctor’s office tells you ‘we only call if there’s a problem’ call them anyway!) and asked them to make sure of my results. They hadn’t even gotten them back from the clinic! When they did, the nurse told me that I did, in fact, have it!

Needless to say, I was devastated. I am NOT a crying-type person, and I bawled my eyes out. I was so upset (between the “there’s something wrong with me” and the extreme love I had for my baby) So, they sent me in for the 3 hour. Same results. Slightly elevated levels.

So, they sent me to a nutritionist who told me what I could and couldn’t eat. I went to the pharmacy to get a meter and supplies, and they tried to give me a finger tip sticker. I told them I typed for a living and needed an arm version. It was a bit more expensive, even with my insurance, but it was worth it. If you need a meter, ask for the arm version. Save your fingertips! they have them, but you have to ask for them.

During that first pregnancy, only my “fasting” readings were slightly high. I was disgusted about having to do all this testing crap, but I did it anyway.

There are all kinds of horror stories about Monster-size babies and all that. Baby 1 was 7 pounds 1.5 ounces. PERFECT!

Second baby. Same story with the testing (only this time they gave me the results without me having to badger them!) But this time, the readings indicated the fasting number a bit higher than last time. So they had me inject one insulin a night before bed, and the numbers came down in the morning.

The only problem? When I delivered Baby 2, they had to give her sugar water immediately after birth because the insulin had lowered her sugar too much! So my daughter’s first drink wasn’t my milk, but was sugar water. I was very disappointed on that. Baby 2 was 7 pounds 3 ounces. Again, no Monster Baby. (oh, and all ultrasounds showed perfect growth for both girls!)

I am not convinced that I needed to do any of this for either baby. My numbers were just so slightly elevated. I do believe that other people who have off the chart numbers have a legitimate issue that must be addressed, though.

I suppose what I’m trying to say is, don’t let the whole thing scare you too much. It’s a manageable problem. Keep asking questions. When I asked questions that they couldn’t answer, I was met with, “But don’t you care about your baby!?” Of course I cared. I did what they told me. But I’d be danged if I was going to blindly follow directions without being informed about what I was doing. Remember, too, that you’re a raging inferno of hormones! grin

There is one major advantage to being diagnosed GD. You get extra ultrasounds, so you get to see the little one more often. I got 2 extras per baby! I did have insurance to cover it, though. Might not be so much fun if you have to pay the cost out of pocket.

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Thank you for your story, Boggette!

I’ve picked up my supplies already and the meter can test on either the fingers or arm. The meter was actually free with purchase of the strips. The strips were were darned expensive though - $1 a strip, 100 to a box. It’s going to add up, having to test 5 to 7 times a day.

Luckily, any extra ultrasounds will not cost me money. I’m in Canada and they’re covered by my provincial health care. At least that’s one less thing to worry about.

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Sometimes, if your numbers show in the normal range over a test time, they will cut back on how many times you test. During Preggo #1, at first I tested 5 times a day, then I only tested once in the morning and after one meal a day.