Anyone with Gestational Diabetes here?

[IFinTN]

I just barely failed my 3h GTT this week (26.5 weeks). It was not surprising given that baby boy had a big growth spurt these last three weeks and is now measuring 2 weeks ahead:)  

I have to go do my consult soon. I already have a glucose monitor because I have insulin resistance and take metformin already.

Anyone else here with it? Enough for a check-in? Or am I the only one missing out on chocolate for the next 3 months?

[ProfessorChaos]

((hugs)) Sorry for your diagnosis. I know another IF grad with it - paging grailseeker14!

[nutmeg8484]

I just barely failed at like 11 weeks? only one of the draws so I have to check once weekly which isn't too bad. I'm sure as I get farther along it will become a daily thing which won't be too fun. I think the fact that I wasn't eating much at all leading up to the test due to being unbelievably nauseous all the time and then drinking straight glucose was a factor in my failure. ugh.

Anyway, no one seems to be too concerned about it at the moment and after stressing about every little thing leading here I have decided to just go with the flow. If my OB becomes concerned, then I will worry. Sorry that you have to deal with GD too!

[grailseeker14]

Member of the GD club here! Thanks for paging me in ProfessorChaos

I was diagnosed I think at 26 weeks, something like that. I failed the fasting and first hour portion, 2nd hour was okay. Tried managing on diet+exercise (although truth be told the exercise portion was harder to get going because 3rd tri... ugh). I had a 2 week gap between getting diagnosed and meeting with the dietician and OB nurse to get my plan going, during which time I kicked sweets and carbs to the curb. I lost a little weight, but my OB wasn't concerned. With the dietician, I got target ranges for carbs and proteins in each of my meals and snacks (30 carbs for breakfast, 15 carbs AM snack, 60 carbs lunch, 15 carbs afternoon snack, 60 carbs dinner, 30 carbs bedtime snack) and some ideas how to meet those target ranges. That was the biggest adjustment. Sweets are still a no-no for me because it feels like it's just not worth the # of carbs I give up and I'm scared to tip the apple cart too much. But I can still have some carbs, aiming for complex, slower-to-digest carbs (whole grains, etc). All of that helped, but once I started checking my blood sugar (4x/day: fasting/first thing in the morning, and 1 hour after each meal) my fasting #s were not cooperating at all. I was really resistant to the idea of insulin at first, but eventually accepted the idea that some things truly are beyond my control and the medication would help. My OB started me on insulin a couple weeks ago and it's helping tremendously. It took about a week to get up to a helpful dose, and that week was hellishly frustrating to be injecting meds but not seeing any benefit. But once I got to a helpful dose, it's been miraculous. I'm up to 30 units insulin at bedtime and that's keeping my fasting # below 90. My after-meal target is 120, and for the most part managing that just fine except when I experiment with something new. Your doctor and team will give you your targets for carbs and proteins as well as blood sugar goals and, if needed, insulin dose targets, all based on your unique situation.

It sucks, all the needle pokes/etc, but I'm thinking of it just as a continuation of all the needle pokes from the IVF cycle The insulin shots are exactly the same as the lupron injections I did for suppression on through my cycle. Honestly the insulin injects are easier than the finger pokes to test blood sugar (I still hate those). I'm also very much counting down to being done with it all after delivery, and I am fantasizing about the things I miss that I want to have once I'm cleared by the doctor. Also, I'm trying to think of this as an opportunity to clean up our diet/lifestyle for the long haul so we get baby off to a good start nutritionally, and leave the fun sweets/etc for rare treats.

Practical things aside, I had an emotional panic when I was first diagnosed, so upset that we had worked so hard to get where we are and somehow I managed to foul it up by getting GD. It took some time and a lot of convincing from my OB, nurses, and husband for me to accept the fact that it's not my fault - nothing I could have done caused it or prevented it, it's just an artifact of the placenta doing its job. so keep that in mind - IT'S NOT YOUR FAULT.

As far as monitoring goes, my doctor is adding 2x/week NSTs starting this or next week and a growth ultrasound in the next couple of weeks. Since the big risk is a bigger-than-usual baby, he's watching for signs that we may need to induce early or schedule c-section. He's reassured me that GD =/= automatic c-section or induction, just wants to be prepared with information so we can make the best decision for us.

So far it seems like baby is growing along just fine - and at my last 2 OB appts I too was measuring 2 weeks ahead, but that was based on fundal height so there's a margin of error. She's vigorously moving and hanging out above my belly button, I think she's partially breech with her head up by my ribs on the right side. Since I've been managing my diet pretty strictly, I haven't gained much weight in 3rd tri, but my doctor says that's okay. He says when I step on the scale at home I'm not seeing baby's weight plus my weight, just my weight, so baby is growing and putting on weight even if the scale doesn't show it. I have no clue how the physics of that works, but he's not concerned so I'm not concerned.

I'm sorry you've gotten the diagnosis - feel free to page me or PM me if you want to chat about anything or pick my brain for meal/snack ideas (I'm always experimenting, and I've found it helpful to learn from other pregnant mamas who have experience with GD or regular diabetes). Bottom line - it is manageable and your doctors will be watching you closely to help you with that. It does take time to adjust and it's important to take it easy on yourself emotionally - YOU DIDN'T CAUSE IT! (((HUGS)))

[grailseeker14]

Also - my doctor said that sometimes insulin resistance gets worse as pregnancy progresses, so each day is a new day as far as what works and what doesn't. I'm at 32w and what worked a month ago doesn't work now, even with insulin on board. So it's important to stay flexible and know that it's the nature of the beast and not a failure on your part. Close contact with your doctor will help keep you grounded/centered and within range of your targets/goals.

[IFinTN]

THANK YOU grailseeker14, that was all very helpful!!

I saw this coming since pre pregnancy I was insulin resistant PCOS. I still take 1500mg metformin daily, which is probably what helped me pass the test at 14 weeks. However, I know that insulin needs ramp up after 24 weeks by 2-3 times normal, so I would be surprised if I did not get it. Luckily my fasting and 3hr numbers were perfect and my 1 and 2 hrs were slightly elevated, so it could always be worse.

I think my biggest issue is that I've had MS throughout and have only gained 5lbs total at 26 weeks...the only things that sound good to eat are carb/sugar/fat heavy things. Otherwise I have serious food aversions. I'm considered obese, so losing weight during pregnancy is OK for me...I'm just worried I'm going to lose weight because I stop eating and not because I'm eating the right things. Any advice on that front?

Thank goodness there's only 11 1/2 weeks left for me as my OB says no more than 38 weeks until delivery.

And you're right, after IVF drugs...insulin, meh:)


Again, thank you for your detailed response. It helps to know what to expect over the next couple of months.

[IFinTN]

nutmeg8484 will they test you again later? I took the 1hr at 11 weeks, failed by 1 point. Took the 3hr at 14 weeks and passed. Then failed the 3hr at 26 weeks. Insulin needs ramp up in third tri, so make sure they are monitoring that for you. Although, you may notice it like I did with a big growth spurt for baby...measuring 2 weeks ahead by ultrasound all of the sudden for me:)

[grailseeker14]

Feb 25, 2015 15:19:31 GMT -5 IFinTN said:

<snip>

I think my biggest issue is that I've had MS throughout and have only gained 5lbs total at 26 weeks...the only things that sound good to eat are carb/sugar/fat heavy things. Otherwise I have serious food aversions. I'm considered obese, so losing weight during pregnancy is OK for me...I'm just worried I'm going to lose weight because I stop eating and not because I'm eating the right things. Any advice on that front?
<snip>.

I had no MS or food aversions in 1st or 2nd tri, but OMG a week or so in to GD meal plan and I was having trouble choking down any meat or egg form of protein. I don't know if that's specifically what you're struggling with, but to solve that problem for me my dietician suggested 1) "hiding" my protein source in casserole/mixed type dishes or pairing bites of protein with something else to trick my throat into swallowing it, 2) using sauces and/or seasonings to make the protein more palatable or, again, trick my body into not realizing it's chicken/fish/beef until I've already swallowed it, and 3) including more nuts, beans, and dairy as sources of proteins to vary up the ways I get protein in.

For the sweet tooth, I was struggling with that too because I am a bit of an emotional eater and carbs/sugar are my go-to. I've been somewhat successful satisfying that with:
1) KIND bars - they fit the profile for a snack in terms of carb limits go, have protein, AND have a bit of chocolate My favorite ones are the dark chocolate + sea salt. Yum! Just be sure to check the label, some of the flavors are higher carb per bar than I am comfortable with. I limit myself to 1 per day because they're kind of expensive.

2) Greek yogurt - I like the yoplait flavored ones, they have decent protein, carbs fit the profile for a snack and give me a bit of sweet that feels "normal" for me. You can also add nuts to them for texture if you like.

3) Cottage cheese + 1 c fresh berries (fresh = harder to get this time of year but much better than dried in terms of carbs). I've been having 1/2 c cottage cheese (yay protein!) with 1c blueberries and it tastes to me like a slice of heaven. The 1c blueberries = about 15 carbs, so again, fits the profile for snack and gives me a bit of sweet to offset the boringness of cottage cheese. I couldn't get a big batch of blueberries this week so I'm trying it out with raspberries and blackberries this week... I'll have to report back on how that goes.

All of those seem to be working well for me, but you'll have to experiment and see how something like that acts in your system. It's all trial and error, I think Hope that helps!

[nutmeg8484]

Feb 25, 2015 15:24:02 GMT -5 IFinTN said:

nutmeg8484 will they test you again later? I took the 1hr at 11 weeks, failed by 1 point. Took the 3hr at 14 weeks and passed. Then failed the 3hr at 26 weeks. Insulin needs ramp up in third tri, so make sure they are monitoring that for you. Although, you may notice it like I did with a big growth spurt for baby...measuring 2 weeks ahead by ultrasound all of the sudden for me:)

The OB hasn't mentioned doing another GTT or anything to me yet, but I'm only 18 weeks so I'm sure these things will come up as I get farther along. I think that they are mostly just monitoring weekly so that if a trend starts to develop they can ramp up the monitoring/ treatment. When I met with the dietitian she said that you are normally classified as GD when you fail 2 or more of the 3Hr draws and I only failed one of them so it makes me think they just want to keep a closer eye on me due to family history, PCOS, and weight. I'm sure that if a trend develops later on they will be doing more to control and monitor me.

[nutmeg8484]

grailseeker14 Thanks for all the great info!

[IFinTN]

Thanks for the tips grailseeker14, I have a feeling I'm going to be forcing myself to eat. Sigh.

[IFinTN]

Which BTW is really unfair! The one time in my life where it's OK for the scale to go up 15-20 lbs and I'm losing weight instead:)

[grailseeker14]

Feb 25, 2015 16:27:40 GMT -5 IFinTN said:

Thanks for the tips grailseeker14, I have a feeling I'm going to be forcing myself to eat. Sigh.

Yeah - there is a bit of that.
That's actually my problem this very second - it's beyond lunch time, and I'm only just now getting hungry, and nothing that I have on hand that I planned for lunch sounds appealing. I'm forcing myself to have a grilled chicken salad, but I'm definitely not excited about it

GL!