Gestational diabetes, high fasting readings

[Jajamcp]

Hi I've just been diagnosed with GD and I'm currently 31wks pregnant. My readings have to be between 3.5-5.5 for fasting and below 8 2hr after meals. Readings for after meals have all been fine but every morning fasting reading is high. Phoned my diabetic clinic and spoke to an awful woman who gave me no other advice apart from stick to 3 main meals and to eat nothing at all after dinner. When I did this got really high reading next morning. I have changed my diet but seem to keep getting high morning readings. Have been told next step would be metaformin but I'm unsure about side affects of this as I have a hiatus hernia and can not take my medication for this at present. Any help or advice would be much appreciated. Thanks

 

[catherinecherub]

I am going to move your post to the GD board @Jajamcp in the hope that someone will help you and give you some advice.

 

[kesun]

Welcome @Jajamcp

My diabetes was originally diagnosed as GD (though it turned out later I'd had it all along but the pregnancy blood glucose picked it up). I remember how frightening it was. Looking back, I think there are two ways of dealing with it: one is to keep eating normally and bank on either being put temporarily on insulin or making it through to the birth without serious effects; or make a change to low-carb eating. The main problem with the first two is that you have to endure several appointments of the nurse insisting that you're not following the healthy plate diet before either the baby arrives or they give up and put you on insulin. The main problem with the latter is that it means making a big adjustment in the way you eat that in all probability you won't need to continue once the baby's born.

I now wish I'd discovered low carb while I was pregnant, but of course that's with the hindsight of now knowing my condition is life-long, not just till the end of the pregnancy, as well as the fact mine was diagnosed at 18 weeks, so I had a lot more pregnancy still to go than you do. On the other hand, if you stuck to it after the birth it would be a great way to lose weight and feel more energetic. For what it's worth, I stuck to the healthy plate diet, put up with being told I must be lying because my levels kept getting higher and fairly soon was put on insulin - and kept on it when a post-natal test showed by blood sugar hadn't come back to normal. I have to say I had no problems with injecting insulin, though I couldn't face injecting it into my pregnant stomach.

Overall, I'd say try not to worry too much: diagnosis this late in pregnancy means you're likely to have GD and nothing else, and if you cut out the really high-carb foods (sugar, sweets and sweet things) you probably couldn't get your BG high enough for long enough to harm your baby even if you tried.

The only caveat is if your readings are really high: are they just a bit above the recommended levels or way up? If it's the latter, I'd suggest you treat yourself as a long-term diabetic and cut down drastically on carbs or insist on insulin.

And finally, I'm not a doctor, and I suspect your doctor/nurse/dietician will give you very different advice. Then all you can do is research as much as you can (lots of good info on this website luckily!) and make up your mind.

Best of luck,
Kate

 

[Jajamcp]

I am going to move your post to the GD board @Jajamcp in the hope that someone will help you and give you some advice.

Welcome @Jajamcp

My diabetes was originally diagnosed as GD (though it turned out later I'd had it all along but the pregnancy blood glucose picked it up). I remember how frightening it was. Looking back, I think there are two ways of dealing with it: one is to keep eating normally and bank on either being put temporarily on insulin or making it through to the birth without serious effects; or make a change to low-carb eating. The main problem with the first two is that you have to endure several appointments of the nurse insisting that you're not following the healthy plate diet before either the baby arrives or they give up and put you on insulin. The main problem with the latter is that it means making a big adjustment in the way you eat that in all probability you won't need to continue once the baby's born.

I now wish I'd discovered low carb while I was pregnant, but of course that's with the hindsight of now knowing my condition is life-long, not just till the end of the pregnancy, as well as the fact mine was diagnosed at 18 weeks, so I had a lot more pregnancy still to go than you do. On the other hand, if you stuck to it after the birth it would be a great way to lose weight and feel more energetic. For what it's worth, I stuck to the healthy plate diet, put up with being told I must be lying because my levels kept getting higher and fairly soon was put on insulin - and kept on it when a post-natal test showed by blood sugar hadn't come back to normal. I have to say I had no problems with injecting insulin, though I couldn't face injecting it into my pregnant stomach.

Overall, I'd say try not to worry too much: diagnosis this late in pregnancy means you're likely to have GD and nothing else, and if you cut out the really high-carb foods (sugar, sweets and sweet things) you probably couldn't get your BG high enough for long enough to harm your baby even if you tried.

The only caveat is if your readings are really high: are they just a bit above the recommended levels or way up? If it's the latter, I'd suggest you treat yourself as a long-term diabetic and cut down drastically on carbs or insist on insulin.

And finally, I'm not a doctor, and I suspect your doctor/nurse/dietician will give you very different advice. Then all you can do is research as much as you can (lots of good info on this website luckily!) and make up your mind.

Best of luck,
Kate

thanks, I plan to try and see my doctor on Monday to discuss it all. Was just quite shocked at the attitude of the nurse from the diabetic clinic I spoke to. Was just looking for advice and got a mouthful of sarcastic comments.

 

[azure]

Hi @Jajamcp I hope you get a nicer nurse next time! Have you seen a dietician? They may be more helpful.

I have Type 1, but a friend had GD and I believe she found that eating regularly kept her blood sugars better. I think she also had a small snack at night. I don't know what she ate, but she said that that helped her blood sugar to not go high in the morning. I know nothing about that as I have Type 1, but I'm mentioning it as it may be something you want to ask your consultant about.

The high morning sugars could be your body putting extra glucose in your blood ready to start the day. If it is that, it may be hard to control without medication (although you could ask about the snack idea I mentioned earlier). Many woman take Metformin in pregnancy. I can understand why you're worried, but I hope your consultant will put your mind at rest.

Another thing you could try is getting up as soon as you wake up and eating straightaway. Again, the idea is to stop your body dumping glucose in your blood.

If you do need medication, remember it won't be for long and it's nothing you did wrong. Some women have GD and can manage by adjusting their diet, but others need some extra help from tablets or insulin.

 

[Jajamcp]

Hi @Jajamcp I hope you get a nicer nurse next time! Have you seen a dietician? They may be more helpful.

I have Type 1, but a friend had GD and I believe she found that eating regularly kept her blood sugars better. I think she also had a small snack at night. I don't know what she ate, but she said that that helped her blood sugar to not go high in the morning. I know nothing about that as I have Type 1, but I'm mentioning it as it may be something you want to ask your consultant about.

The high morning sugars could be your body putting extra glucose in your blood ready to start the day. If it is that, it may be hard to control without medication (although you could ask about the snack idea I mentioned earlier). Many woman take Metformin in pregnancy. I can understand why you're worried, but I hope your consultant will put your mind at rest.

Another thing you could try is getting up as soon as you wake up and eating straightaway. Again, the idea is to stop your body dumping glucose in your blood.

If you do need medication, remember it won't be for long and it's nothing you did wrong. Some women have GD and can manage by adjusting their diet, but others need some extra help from tablets or insulin.

Thanks, I did wonder about a snack at night that's why I wasn't sure when the nurse told me to not eat anything after my main meal at night. Will give it a try

 

[azure]

Thanks, I did wonder about a snack at night that's why I wasn't sure when the nurse told me to not eat anything after my main meal at night. Will give it a try

Experiment with the content - ie carbs, protein, fat. You may find an ideal mix of those helps.

Good luck

 

[kesun]

Thanks, I did wonder about a snack at night that's why I wasn't sure when the nurse told me to not eat anything after my main meal at night. Will give it a try

It sounds as if they did give you a meter, so experimenting will be relatively easy.

I suffered from an unpleasant DN when I had GD: she said that since my blood sugar was still high I must be lying about following the (healthy plate) diet. I remember feeling helpless and panicky because the diet was the only tool I'd been given and it didn't work. The only thing that kept my sugars down was not to eat - but I was worried that would harm the baby. She also said that the reason my ketones were high was that I was failing to drink enough water - annoying since I was continuously thirsty and gulping down pints of water.

Fingers crossed for a more patient-friendly nurse at your next appointment.
Kate

 

[heavenly]

Hi. Gestational diabetes is hormone driven. Hormones are highest during the night, and as your pregnancy progresses your body will become more resistant to the insulin that your body produces. This is a normal process. It's probably nothing that you are doing that is causing the higher fasting readings. You may require some long-acting insulin to reduce your fasting readings. Do you have an appointment with your diabetes team to discuss? Out of interest what are your fasting readings? The 1 hour post-breakfast readings are normally the ones that most struggle with but your diabetes team should be able to discuss these with your diabetes team. Also look at hidden sugars in foods like yogurts, baked beans, fruit, drinks etc.

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