Advice Needed from those who've had Gestational Diabestes

[mommylamb]

I'm trying to get my head around this whole diabetes thing, and could really use some advice and thoughts from those of you who have gone through this.

Background: I took the 1 hour test on November 16. Failed badly. I took the 3 hour test on November 21. Got the diagnosis officially on November 23. I couldn't get in to the diabetes teaching clinic until yesterday, December 1, because of the Thanksgiving holiday. In anticipation of failing the 3 hour test, I started on a low carb diet on November 21. So, I've been doing very low carbs for nearly 2 weeks.

When I finally met with the dietician yesterday, she gave me a plan that has a range for carbs for each meal and snack. Turns out, my carb intake since I started on the low carb diet has been a lot lower than what it should be according to the dietician. So yesterday afternoon, I started trying to increase carbs up to the range she indicated for my afternoon snack and evening meal.

This was also the first time I started actually testing my blood sugar. And it was higher than it should have been. I'm supposed to be under 120 after each meal (I'm supposed to test 2 hours after each meal), and under 90 at the fasting test in the morning. Last night my after dinner test had me at 127. The fasting test this morning had me at 122 (holy sh*t!!). I went way low carb for breakfast because the fasting number scared me. So, I should have been between 26-35 carbs for breakfast, and I did 5. My blood test after breakfast had me at 120, so even at the low carb level, well below where the dietician said I should be, I was still right at the top of where I should be.

So, my question for you is, do you think my body acclimated to the low carb diet over the last 2 weeks, and therefore, eating carbs (even within the range provided by the dietician) gave it a shock to the system and that's why I was getting such a high blood glucose level? Am I messing up the test somehow? Or am I likely to be one of those people who is unable to control it with diet (my nightmare)?

I'm currently at 30 weeks pregnant. When I went in to the OB 2 weeks ago, I had gained 15 lbs total for the pregnancy. When I went into the OB yesterday (I had both OB and the diabetic clinic yesterday), I had actually lost 1 lb, so now I'm just up 14 for the whole pregnancy. I'm not obese (yes, I would have liked to have weighed less going into this pregnancy, but I'm not outside the normal range). I have no history of diabetes in my family. I did not have GD when I was pregnant with DS.

Anyway, I'm totally freaked out over here and could use some kind advice.

[wencit]

First of all, . I know it's scary, but try not to freak out about it all. I was in the same boat as you (no family diabetes history, perfectly fine with DS1, GD with DS2) and everything turned out OK in the end -- including DS2, who is perfectly healthy and happy (and weighed a totally normal 7lb 5oz at birth!).

It is possible that your body is still adjusting to the extra carb intake, but I never went very low carb while pregnant, so I have no BTDT experience with that. Insulin resistance is highest in the morning, so you'll find it harder to control your numbers then. I remember I had to eat the lowest recommended carb limit at breakfast in order to stay within normal blood sugar range, but I could it up a little at dinner and be OK.

Also, are you exercising at all? As much as I despised it while pregnant, I found that exercise was key to keeping my blood sugar in check. You'll have to experiment with numbers a bit, but I had to walk for a minimum 20 minutes after each meal for a total of 60 minutes a day. Yes, it sucked, but I was probably healthier then than I was 6 months post pregnancy! Fiber was also extremely important to keeping my numbers within limits. If I didn't eat enough fiber, my numbers crept up.

Finally, even if you are unable to control GD with diet and exercise, I hear that insulin shots are actually less painful than the 4x/day finger pricks. It's apparently the same insulin that your body produces, so nothing "harmful" for the baby. Again, no BTDT with the insulin shots, though.

It's scary, I know, and it will take a little bit of time and experimentation, but it will be OK.

[mommylamb]

Thanks for responding wencit. I haven't been exercising, and I know that's something I need to start. From a schedule perspective it is difficult. There's no way I can do it after breakfast, because I'm commuting to work at that time. I'm off to go for a walk now after lunch. Dinner is tough because I have so little time to spend with DS (working and commuting) that it will be hard to devote an hour of my 2.5 hours a day with him to exercising. Weekends are different of course. I'm going to do my best.

Anyway, I appreciate hearing your experience and the hugs. I'm in a bad state at the moment.

[MommyAllison]

No BTDT, but a good friend of mine had GD and was not able to control it through diet and exercise alone. She ended up on insulin shots, and she said they really were no big deal once she got over the initial "eek!" of the first few times. IIRC (her DC is almost 7, so it's been a few years), her blood sugars were controlled quite easily once she went on insulin. So sorry things are rough I hope you are able to get to a good place with the GD soon.

[acmom]

I had gestational diabetes with both pregnancies. My OB was really surprised as I had no risk factors. I completely understand being freaked out about it- I was both times. Did the dietician talk at all about balancing the carbs with fiber and protein? My numbers were much better when I had carbs that included fiber (whole grain stuff, apples, sweet potatoes, etc.- she gave me a list of "better carbs"), and also balanced them with protein and fat (cheese, meat, nuts, etc.). I was on bedrest (b/c of preterm labor, not GD) for 8 weeks with both, which cut out exercise, and I had to take steroids for lung development (also preterm labor related) both times, which messed with my blood sugars some. I briefly went on oral meds around that time to help control blood sugar with both pregnancies, but my sugars would drop really low on those (40-60), so ended up just going back to diet. I had a few friends who had success with the oral meds though. Both my babies were fine, no ill effects of GD - healthy and only 6 lbs 4 oz and 5 lbs 10 oz. And I have had no issues since. I would just keep talking to your dr. and dietician - I found it just took a little while and some tweaking to find the right combo of carbs, other foods and exercise that works for your body. I know it is hard seeing those high numbers though, especially when you thought you were doing/eating what you should! Hang in there!

[newbiemom]

I've been there.
One thing to try to get your morning sugars lower - (I don't know if you already do this, but I don't think you mentioned it) eat some protein before you go to bed. Something that tides you over. One reason why my blood sugar would spike would be if I didn't eat for a while, then ate carbs. It just went off the charts. But when I nibbled throughout the day, and had protein with carbs, and then protein at night, my numbers would always be fine. And if I had a higher than normal carb meal, I'd go for a walk and that would help keep it down immensely.

[sidmand]

Not GD but I am diabetic and had to take insulin during pregnancy. Some people just can't control their blood sugars no matter how low the carb intake is. Insulin is VERY scary, I won't lie, but once you get over that in your own head, it's is so so easy. And as someone told me, insulin is naturally occurring in your body so less of a risk than the (for me) medication I had been taking before pregnancy.

I will also say that the numbers they are telling you are just a guideline. 127 really isn't so different than 90. If your numbers were consistently 150 or above, that would be cause for concern, but it's really okay. And it's okay to take insulin if you need to. I felt like I had failed by not being able to control things without it but it really wasn't that at all. They say if you just lose 10% of your body weight, sometimes that "cures" diabetes (it can never be fully cured but you may not need insulin or medication) so by the same rules if you've gained 10% of your body weight (which you often have by 28 weeks+) then there may be nothing you can do.

I agree that even a small amount of walking/exercise can greatly help either GD or any type of diabetes in general. And you should definitely take an evening/bedtime snack of something that contains protein (string cheese, peanut butter, etc.).

My only problem with insulin shots is that it's the only time in my life I've gone *too* low and I had to watch out for that. Especially in the middle of the night it would happen but I had to learn to have a juicebox or something similar right near me at all times!