Gestational Diabetes: Fasting levels too high

[GreenEight]

Hello, all

I'm almost 18 weeks pregnant and was diagnosed with GD at 14w. I had it with my last pregnancy and was diet controlled (but didn't find out till far later on in pg that time as had a routine GTT rather than an early one).

I've been OK at my mealtime control (few blips here and there, but for understandable reasons), generally readings starting 5, 6 and 7.

But my fasting reading should be 5.3 or below and since I started measuring 23 days ago, it's only been under that once. I've had a few under 6, but the majority are between 6.2 and 6.7. I started taking a bedtime dose of 500mg Metformin about a week ago but it hasn't done anything to the fasting sugar levels (which I was advised might be the case, but we thought it was worth a try!). I've tried having a snack before bed, not having a snack before bed, eating my last meal earlier, eating it later, etc. I've been for walks after dinner (harder in the freezing cold/rain!). Nothing seems to have any effect - my fasting sugar is only really a little bit less than my hour post evening meal level.

Any suggestions before I go onto insulin, please? Thanks in advance!

 

[azure]

What did you try for snacks? And have you tried setting an alarm during the night to test to see when it's rising? That might be useful information.

 

[GreenEight]

Thank you for replying! Various things - peanuts, cheese, glass of full-fat milk.

I took my levels after a 7.0 reading after lunch and it was 4.6 (three hours after lunch).

I do get up to the loo most nights, so I could test then too!

 

[azure]

If it was me, I'd systematically test various combinations of carbs, fat and protein. I'd also consider trying a very small snack when you get up to go to the toilet (test first). Just ideas to try

You could try oatcakes and cheese or peanut butter maybe. Or a small slice of rye bread plus the same.

I think testing during the night will give you useful information and help you choose a good snack.

 

[GreenEight]

OK, sounds like a good plan - thank you!

 

[GreenEight]

3.35am = 5.4.

Fasting this morning = 5.4.

I'm baffled! Post meal last night was 9.6.

 

[azure]

That sounds a little better, at least. I have Type 1 but was told to try to keep fasting below 5.6. Remember that meters have a margin of error too.

All you can do is keep experimenting and keep records of what seems to work. At least then if you do need insulin, you'll know in your own mind that it's a wise choice.

What snack did you have last night?

 

[GreenEight]

I didn't have a snack - I ate quite late (finished at 9.20pm).

I'll def try testing before I get out of bed tomorrow morning - I generally get up, go to the loo, wash my hands (thoroughly and rinse with water twice so as not to leave soap residue), then test. I retested this morning after I'd done that and was 5.9, so am wondering whether getting out of bed makes the difference!

Thank you for your support, much appreciated!

 

[azure]

There's something called a 'waking rise' where your liver pushes out glucose when it detects you're awake and up, so it could be that.

Perhaps your late meal acted as a kind of 'snack' and helped keep your fasting sugar down a little?

 

[GreenEight]

Mm, could be, though I do often eat fairly late. I reckon it's the waking rise, as you say. Will see what tomorrow brings!

 

[azure]

How were your sugars last night/this morning?

 

[GreenEight]

Last night was 9.7, but I went out for dinner (didn't go mad but hard to know exactly what's in stuff when you don't cook it from scratch yourself!). 6.1 this morning. Gah!

 

[azure]

Last night was 9.7, but I went out for dinner (didn't go mad but hard to know exactly what's in stuff when you don't cook it from scratch yourself!). 6.1 this morning. Gah!

Have you been given targets for after meal blood sugar or just the fasting level?

(And yes, eating out is hard when you're not sure what exactly is in your food - frustrating sometimes)

 

[GreenEight]

One hour after meals should be 7.8. It generally is less than this and I can always work out why it's not. It's the fasting that's less explicable!

 

[azure]

Ok Sadly, the fasting is less easy to control - as you're finding.

Another suggestion that you might want to consider is to have the same evening meal (exactly the same - ie weigh things to ensure the carbs are the same, and keep the same portions, etc) at the same time for a few night and then exoeriment with your bedtime snack to see if that's having any effect or if it is a waking rise that you can't control. Keeping exactly the same meal at the same time removes one variable and may give you a clearer idea about whether tweaking your snack can help.

If you choose to try this, test during the night too, so you get a better picture.

Just an idea - it may not be practical for you

 

[GreenEight]

Yep, I can try that def. Thank you, good idea!

Hmm, what to have that I can eat several nights in a row...!

 

[GreenEight]

Dinner (beef casserole, small bit of mashed potato, carrot, broccoli, small amount of sweetcorn) was 7.5 (finished eating at 6pm, so much earlier than usual). Just tested again before going to bed (no snack) - 4.9.

Am sure you're all on tenterhooks as to what the morning will bring...!

 

[GreenEight]

4.8!

I reckon it may be the waking rise that's caused my higher levels in the past. I will experiment more though...

 

[azure]

It might also help that you ate earlier. Eating a main meal too late can often cause issues as your body is still dealing with it when it should be moving into the nighttime phase of hormone production.

So possibly an earlier evening meal would help. It would also help if you could keep it around the same time (roughly).

Even if you still neeeded a bedtime snack, if, say, you ate at 6pm then had a small snack last thing, you may find that works best as you're 'working with your body' and its rhythms

The waking rise is harder to,deal,with, but you may find a tiny amount of food as soon as you wake up helps stop your liver dumping glucose.

 

[GreenEight]

Had finished dinner by 7.20 last night. Post meal 5.6 (even though I had potato!) and fasting before I got up was 5.3 this morning. Another 0.5 rise after getting up, etc.