Help? Late diagnosis GD

[hummingbird125]

So, I got the call I was dreading. My doctor was out so the nurse called to tell me my #'s from yesterday's 3-hr glucose test were slightly elevated and I have GD. She told me I needed to make an appointment with the MFM specialist ASAP. I called that office but have to wait for them to call me back with an appointment. I am crossing every finger that by some miricle they can squeeze me in today, since I'm home, but I know that's a long shot. I'm so upset that I may have had this going on for several weeks and it's been completed unmonitored/untreated and I'm just so scared that I've hurt this baby.

I need to do whatever I can to manage this starting now, and I'm hoping to get some advice from others with GD who have been figuring this stuff out for a while longer. I've done so much googling but all I know is that I have to watch/limit my carb and sugar intake, eat smaller meals instead of fewer big ones, and make sure I get enough protein to balance out the carbs (or something like that?). I know everyone is different, but if anyone could give me a rough estimate of # of grams for carbs/sugars/protein/fats and/or the genera rules they stick to, it would really be appreciated. According to Wednesday's ultrasound, baby is already about 6lb 10oz, so every day matters and if I can't get into the MFM until next week I need to know I'm doing the right things until then at least.

TL/DR: Just diagnosed with GD at 36w 1d (previously failed the 1hr test but passed the 3hr test, was retested yesterday after u/s showed a big baby and excesss amniotic fluid. Please tel me what to do!

[joy]

This is out of my wheelhouse, but I wanted to offer you some ::hugs:: I know you were concerned about this and now it's true. At the very least, you were aware that it could happen and know enough to get on top of it starting right now. Those are all good things!!!

You have good care and you will get tons of advice here. ::hugs::

[elm1214]

No experience, but I'm glad they at least caught it now! I hope the MFM can get you in quickly.

[agpjt413]

No advice but also wanted to offer lots of hugs hummingbird125. I know there are wise ladies on our BMB who can offer insight.

[Rama]

I'm so sorry. I know you were worried about this. *hugs*

I think the numbers you're looking for are very dependant on a person's specific circumstances, so only the nutritionist/dietitian can really give you those. But there are some good general guidelines to follow, let me grab you a link.

www.ucsfhealth.org/education/dietary_recommendations_for_gestational_diabetes/

[dorkusmalorkus]

I'm sorry you got the late diagnosis; that seems like it would be extra-stressful!

It seems like different dietitians recommend different things for different people, but here's what mine told me:

Eat every 2-3 hours (some say every 3-4)
Breakfast = 30 carbs
AM snack = 15-30 carbs
Lunch = 30-45 carbs
PM snack = 15-30 carbs
Dinner = 45-60 carbs
Bedtime snack = 30 carbs

For every 15 grams of carbs, you should eat (at least) a serving of protein with it.
I count net carbs, because the other counting systems they gave me weren't working for me. To count net carbs, you take the number of carb grams listed on the nutrition info & subtract the dietary fiber. There are some low-carb tortillas that are shot full of extra fiber, though, to get it down to 6 net carbs, and my body is not fooled by that. Also not fooled by most sugar substitutes.

Just FYI, a lot of diabetic recipes online (even those approved by the diabetes associations) just cut carbs & don't add protein; this was crazy-frustrating to me until I realized the problem/importance of protein. Protein grams, for me, should be in the neighborhood of 2/3 the number of carb grams.

I can give you my basic daily menu if that would be helpful to you?

[bocaburger]

((Hugs))

[hummingbird125]

Somehow they had a 12:00 appointment available, so I threw on some clothes and rushed over here. Waiting to go in now. Thank you so much for all the good vibes and advice!

[Rama]

Jul 8, 2016 11:00:04 GMT -5 hummingbird125 said:

Somehow they had a 12:00 appointment available, so I threw on some clothes and rushed over here. Waiting to go in now. Thank you so much for all the good vibes and advice!

please let us know how it goes!

[Rogue]

Good Luck at your appointment hummingbird125!

I have pretty strict dietary issues since my sugars were so high. It sounds like your case is pretty mild and you won't need to change too much.

When I first got diagnosed, I was limited to 15 total carbs per meal or snack and take medication at each meal.

Now I can do up to 60 carbs per meal but require more medication depending how many carbs I'm having. I also have to check my sugars before and then 2 hours after eating a meal.

What dorkusmalorkus, said is about what I do. Breakfast I do around 30 carbs. Depending on my 2 hour sugar levels I will figure out what I'm doing for snack. Lunch I do 30 to 60 carbs and again depending on sugar levels I determine snack. Dinner is 30-60 also. I almost always have to have something after dinner and before bed because my sugars get too low in the night.

The toughest issue I had initially was figuring out the carb to calories. You may or may not have to do a daily Ketone test which determines if you're eating enough calories or not.

There are a lot of foods you can have that are suuuper low carb and totally worth eating ALL of. The low to no carb foods I have on hand are peanuts, pickles and cheese. You can also do as much protein as you want since it is also low to no carb. We very often do steaks, kabobs, or chicken since I can have as much as I want to feel satisfied.

You shouldn't have a meal that leaves you feeling hungry after. If you still feel hungry then add more low/no carb food to it. My favorite meal to go out for is at Jason's deli. I can have half a sandwich, side salad and cup of soup for lunch. The bulk of carbs all come from the bread of the sandwich and the soup, but I get filled up with the salad bar items like eggs and pickles. I feel so full after its great!

[dc2london]

I know nothing, but I just wanted to offer hugs. I'm so glad they caught it and that you are in the capable hands of an MFM now.

[kaitkat]

No advice just huge hugs and thinking of you!

[gratefulgirl]

First things first, breathe. They caught this and now you can manage it. The diet can even be, dare I say it, kind of a fun challenge.

Second of all, I actually found that other than teaching me how to use my blood glucose monitor, the dietician was worthless. I instead follow the glycemic index or glycemic load to pick my carbs. Google will give you a great overview, and there are books on a low GI diet you can get if you really want. That said, what spikes my sugars (which happens to be most grain flours) won't spike yours. Your issue might be fruit, it might be flour, it might be potatoes, it might even be nothing as long as you stay in the carb limit. You kind of figure it out once you get your blood glucose monitor. If you want to start now, maybe call your MFM and ask if they have a rec, call insurance and ask what they cover, and get a prescription stat. The monitor is what tells you 99% of what you need to know.

Doctors vary on the protocol for testing. All have you test when you get up. My OB's cut off is 95 for the fasting, but some go as high as 105. I have no trouble staying under so far, but plenty of people do. If your case is mild, this may not be an issue for you. Then I test 2 hours after the start of every meal. For that I have to be under 120. I am most of the time so far, but I have had a spike or three. Some doctors tell you to test an hour after the start of a meal and be under 140 and other doctors will say yet another thing. Just do what your doctor says.

The ADA counts one "carb" as 15 g. carbohydrates. I'm supposed to have 12 a day - 2 at breakfast, 1 mid-morning snack, 3 at lunch, 1 mid-afternoon snack, 3 at dinner, and 2 at bedtime snack. It actually ends up being more carbs than I usually eat in one sitting sometimes because I'm such a snacker. Your total carb servings will vary based on your weight and activity level and that's where a dietician or doctor comes in. They can also give you a hand out with what foods are what carbs, but I usually just use Google and add stuff up.

Spark Recipes and a few others will let you plug in a recipe and get the total nutrition data out. I prefer to just count up carb grams in each meal and snack that way instead of limiting myself to a "serving" of this or that and having only blah, bland meals made of strictly one thing like the sample meals they give you (chicken with brown rice and peas comes up often - I would go crazy with that sort of "this, then this, then this" every day).

Always eat carbs with protein and/or fat. It slows digestion and helps blood glucose issues.

Ketone strips make sure you are getting enough carbs. If you aren't your body starts breaking down fat stores and that may not be great for the baby. I find my OB has been pretty dismissive of my ketone issues, but some are stringent.

[hrushka]

((hugs)) I'm sorry. But glad they could squeeze you in today. Hopefully having an appointment now will help you feel more at ease going into the weekend.

[hashbrownnofilter]

hummingbird125 hugs!! I'm so glad they were able to fit you in. I hope it went well.

[lennonkdc]

hugs hummingbird125!!! So glad the MFM could get you in today!!!

[pttomato]

I'm sorry you got this diagnosis. I'm glad you were able to get in with the mfm today. I think everyone's covered the general recommendations pretty well.

This something I am not good at myself, but try not to be too hard on yourself you you have some numbers outside the limits your doctor gives you. Things other than food that you can't control, like how well you sleep, lots of stress, or illness, can affect blood sugar. And even non-diabetics can have numbers above the recommendations. Like doctors typically will say to stay under 140 at an hour and 120 at 2 hours after a meal, but for the 3-hour GTT, the cut offs are usually 180 for 1 hour and 155 for 2 hours. I've found the doctors care more about overall trends.

It may take a little time to figure out what meals work best for you, that's normal. It's so individual it can take some experimenting. Like glycemic index doesn't work well for me, and I can't do hardly any fruit, but I can do whole grains ok. I think the other posters gave good advice on stuff to eat. You've got this!

[ameliabird]

Hugs! Hope you can get into the MFM quickly!

[hummingbird125]

Hey guys - my appointment with the MFM was fine. He walked me through the basics of everything - didn't give me strict carb #'s to stick through just talked to me about what foods to eat and to avoid, so I will definitely be using the general #'s I've read here to get started. I was feeling okay about eve thing until I tried testing for the first time. 3 finger pricks and hardly any blood came out, not enough to test. Idk if I'm chickening out and not pushing as firmly at the last second or what, but I'm frustrated. Going to wait until H gets home to try again.

I fainted during my last blood draw yesterday, and now I have to see my own blood 4x a day. Why can't they have come up with an easier way to do this by now?

Vent over. Carry on.

[dorkusmalorkus]

Jul 8, 2016 16:19:45 GMT -5 hummingbird125 said:

Hey guys - my appointment with the MFM was fine. He walked me through the basics of everything - didn't give me strict carb #'s to stick through just talked to me about what foods to eat and to avoid, so I will definitely be using the general #'s I've read here to get started. I was feeling okay about eve thing until I tried testing for the first time. 3 finger pricks and hardly any blood came out, not enough to test. Idk if I'm chickening out and not pushing as firmly at the last second or what, but I'm frustrated. Going to wait until H gets home to try again.

I fainted during my last blood draw yesterday, and now I have to see my own blood 4x a day. Why can't they have come up with an easier way to do this by now?

Vent over. Carry on.i


Did they give you the tips of washing hands with warm water, massaging your finger before doing the finger prick, and then squeezing the blood out? I don't know if that's standard, but in case they didn't mention it.... There are times I don't get enough out, either; I think sometimes I'm going in at an angle, rather than straight-on? Hugs, again! I know it took me at least a couple of weeks to start figuring out what worked for me, and I still have surprises 22 weeks later. Hopefully your H can be a good support!

[gratefulgirl]

Jul 8, 2016 16:19:45 GMT -5 hummingbird125 said:

Hey guys - my appointment with the MFM was fine. He walked me through the basics of everything - didn't give me strict carb #'s to stick through just talked to me about what foods to eat and to avoid, so I will definitely be using the general #'s I've read here to get started. I was feeling okay about eve thing until I tried testing for the first time. 3 finger pricks and hardly any blood came out, not enough to test. Idk if I'm chickening out and not pushing as firmly at the last second or what, but I'm frustrated. Going to wait until H gets home to try again.

I fainted during my last blood draw yesterday, and now I have to see my own blood 4x a day. Why can't they have come up with an easier way to do this by now?

Vent over. Carry on.

It took me for-ev-we to figure out how to get enough blood. I was crying in my bathroom over it while DD2 was wailing for mommy in her crib. All my sympathy!

My tricks: a) it looks dumb, but shake your arm and hand for 10-20 seconds in advance to get blood flowing. B) massage all around your prick. C) use a deep needle setting (it stops hurting after a few). D) prick closer to the pad of your finger than you were probably shown, at least I have to.

((Hugs)). You'll get it and you only have a few weeks to go!

[hannahbear]

HUGS!!

First off, don't blame yourself! You did nothing wrong. And as others have said, it sounds like your case is mild. You did not hurt your baby! Most importantly, you now know and can monitor the situation.

The advice given above is excellent. The thing that helps me the most is my blood sugar meter - it's more data that will help you learn what works and what doesn't. I actually test up to 10 times a day -- that is a lot, and definitely not something you need to do. For me, testing often just gives me the reassurance that things aren't out of control, and it really helps me understand how my body metabolizes certain foods. I don't necessarily follow certain carb counts (because I take insulin), so I won't be helpful in that regard. The blood sugar testing guidelines I target are:
Fasting in the am: under 95
Two hours after each meal: 120 or under
Before I eat a meal or snack: 100 or under

Some really easy ways to cut down on carbs: ditch white grains and starches. Be very careful about sweets and fruits (a banana, for example, can have 35 g of carbs!!! That's basically a cookie, carb-wise). Berries are pretty low sugar, and are super yummy with some whipped cream. gratefulgirl has shared some amazing recipes lately that I've loved trying out!

One last thing that has helped me tremendously, and I've repeated on this board before (sorry if you've already read it) - is saying this mantra whenever I worry that I've harmed baby. "Dear baby, please take the nutrition you need, and leave the rest for me!"

[hollyberry]

No advice, but plenty of hugs! You will be a pro at this in no time!

[spicysalmonroll]

Dont have advice but I'm so sorry you're dealing with it and I'm thinking of you and little one and his health.

[Rogue]

Did you figure out the finger prick? My stabber has different numbers on it. The bigger the number the deeper the prick. Go for the sides of the tips of your fingers, think the part you don't use when you type (hurts less). Start with a big number cause then you're guaranteed to get enough to test and don't have to stab again. Then adjust it down until you relatively consistently get the right amount and not too much. I use alcohol swabs to clean the area before. If not enough comes out A second wipe after the prick makes more come out and then I milk my finger.

Also, SO is a big fainter but I can prick him without him fainting even though he complains for days about the pain of one prick.

[hummingbird125]

Ok I swear a wrote a whole long post last night... And idk where the heck it went?!

Anyways - I'm up at youdontsay 's SURPRISE BABY SHOWER :-) but I wanted to let you guys know that I followed you advice as far as washing with warm water and shaking my arm around a bit before pricking, and I finally got t last night. This morning with my fasting one, it took me two tries, but my post breakfast and post lunch ones I got on the first try. I'm still not liking this one bit, and it's been a struggle to figure out what to eat, but I know that'll just take some time. Right now I'm just happy that baby is getting the right nutrients from me.