Any athletes with GD? Or LADA?

[Londonwriter]

Hi,

I'm 28 weeks into my second pregnancy currently. I thought something was a bit weird around three weeks ago and bought a blood glucose monitor, and took the monitoring results to my consultant who sent me for a OGTT on Tuesday.

I have no risk factors for GD except age (this is, apparently common), but - over the last three weeks - have developed GD so severely that I currently can't eat anything except the Atkin's Diet Induction Phase 1 (as in 10-15g of carbs per meal), which I'm sticking with (with my consultant's approval) until I see an endocrinologist on Monday. My OGTT result after 2 hours was 10.9.

There are lots of women who don't have risk factors, but I'm obviously perplexed about the situation. I am still exercising up to 3 hours a day at nearly 29 weeks pregnant - and not minor league exercise, such as walking. Instead, I'm cycling long distances, running with the dog, doing dance aerobics 4 times a week, and heavy cardio lifting exercises. I'm using the exercise to manage my blood glucose, which doesn't really go down on its own. My diet was low-GI before I became pregnant, and my BMI was around 22.

Husband and I are particularly perplexed by my glucose monitoring results. He has a sister with Type I and 48 hours ago started managing my blood sugar like Type I. So we're literally counting carbs and then matching them to my activity level. It appears that 10g of carbs cause my blood sugar to rise by 1 point and there seem to be no or limited homeostatic process controlling my blood sugar. Yesterday, I sat for three hours on the bed reading, measuring my blood sugar every hour (this was after cycling for two hours to take my son to and from nursery, and 45 minutes of dance aerobics - so I was legitimately tired, okay)... and it never moved from 5.5. This doesn't seem normal for ladies with GD who are advised to snack regularly to keep their blood sugar up (!?).

I have grandparents with Type II, which they developed in their 60s (they were classic Type II - high BMI and not much exercise). I also had an insulin resistance test that showed my fasting glucose was similar to my fasting insulin (so borderline and suggestive of Type II). In addition, I have an undiagnosed autoimmune disease that seems to be linked to my subfertility (this baby was IVF) and which was severe enough to take me off work for several years. Due to the symptoms, and damage to my hands (from poor circulation), we assume it's a connective tissue disease of some type, but I've never shown any real signs of organ or tissue damage, no suggestive antibodies of RA/lupus, and only have a low-titer ANA.

My husband and I are wondering if I actually have LADA exacerbated by pregnancy, due to the autoimmune problem, but I don't know if I'm kidding myself and it's possible that someone of 39 who exercises up to 3 hours per day at 29 weeks pregnant can get GD this badly and be at serious risk of Type II post-pregnancy? Anyone else with that experience?

Also, did anyone get diagnosed with LADA during pregnancy and does the 'static blood sugar' sound familiar? I posted on a support group for ladies with GD and they didn't understand what I was talking about. They said it was impossible to control blood sugar using techniques for Type I and that, due to hormones, there was a limited correlation between carbs in food and a lady's response to the sugar. They told me I had to get better at pairing carbs with fat/protein to release glucose more slowly and experiment with lots of different carbs until I could find one I could tolerate (which I was already doing - the glucose built up to the level in my blood you'd expect from the carb count of the meal, but slower with a slower GI carb than a fast one, and regardless of whether I ate green beans, tomatoes yoghurt, porridge, quinoa, Nairn's oatcakes, or rye bread).

Anyone have a similar experience?

I'm going to ask the endocrinologist for an antibody test on Monday, but feel a bit of a prat/a bit precious if there are lots of women with GD like me and it's just 'one of those things'...

 

[Londonwriter]

I should add that I also did a private scan when I suspected GD and my baby was already on the 93rd-98th percentile for his stomach at 27 weeks. Hence my desire to Atkin's Diet the situation until I can get better medical help!

 

[Millie74]

Hi,

I'm 28 weeks into my second pregnancy currently. I thought something was a bit weird around three weeks ago and bought a blood glucose monitor, and took the monitoring results to my consultant who sent me for a OGTT on Tuesday.

I have no risk factors for GD except age (this is, apparently common), but - over the last three weeks - have developed GD so severely that I currently can't eat anything except the Atkin's Diet Induction Phase 1 (as in 10-15g of carbs per meal), which I'm sticking with (with my consultant's approval) until I see an endocrinologist on Monday. My OGTT result after 2 hours was 10.9.

There are lots of women who don't have risk factors, but I'm obviously perplexed about the situation. I am still exercising up to 3 hours a day at nearly 29 weeks pregnant - and not minor league exercise, such as walking. Instead, I'm cycling long distances, running with the dog, doing dance aerobics 4 times a week, and heavy cardio lifting exercises. I'm using the exercise to manage my blood glucose, which doesn't really go down on its own. My diet was low-GI before I became pregnant, and my BMI was around 22.

Husband and I are particularly perplexed by my glucose monitoring results. He has a sister with Type I and 48 hours ago started managing my blood sugar like Type I. So we're literally counting carbs and then matching them to my activity level. It appears that 10g of carbs cause my blood sugar to rise by 1 point and there seem to be no or limited homeostatic process controlling my blood sugar. Yesterday, I sat for three hours on the bed reading, measuring my blood sugar every hour (this was after cycling for two hours to take my son to and from nursery, and 45 minutes of dance aerobics - so I was legitimately tired, okay)... and it never moved from 5.5. This doesn't seem normal for ladies with GD who are advised to snack regularly to keep their blood sugar up (!?).

I have grandparents with Type II, which they developed in their 60s (they were classic Type II - high BMI and not much exercise). I also had an insulin resistance test that showed my fasting glucose was similar to my fasting insulin (so borderline and suggestive of Type II). In addition, I have an undiagnosed autoimmune disease that seems to be linked to my subfertility (this baby was IVF) and which was severe enough to take me off work for several years. Due to the symptoms, and damage to my hands (from poor circulation), we assume it's a connective tissue disease of some type, but I've never shown any real signs of organ or tissue damage, no suggestive antibodies of RA/lupus, and only have a low-titer ANA.

My husband and I are wondering if I actually have LADA exacerbated by pregnancy, due to the autoimmune problem, but I don't know if I'm kidding myself and it's possible that someone of 39 who exercises up to 3 hours per day at 29 weeks pregnant can get GD this badly and be at serious risk of Type II post-pregnancy? Anyone else with that experience?

Also, did anyone get diagnosed with LADA during pregnancy and does the 'static blood sugar' sound familiar? I posted on a support group for ladies with GD and they didn't understand what I was talking about. They said it was impossible to control blood sugar using techniques for Type I and that, due to hormones, there was a limited correlation between carbs in food and a lady's response to the sugar. They told me I had to get better at pairing carbs with fat/protein to release glucose more slowly and experiment with lots of different carbs until I could find one I could tolerate (which I was already doing - the glucose built up to the level in my blood you'd expect from the carb count of the meal, but slower with a slower GI carb than a fast one, and regardless of whether I ate green beans, tomatoes yoghurt, porridge, quinoa, Nairn's oatcakes, or rye bread).

Anyone have a similar experience?

I'm going to ask the endocrinologist for an antibody test on Monday, but feel a bit of a prat/a bit precious if there are lots of women with GD like me and it's just 'one of those things'...

I had gestational diabetes in both my pregnancies. My boys are 12 and 13 now. I was on insulin through both pregnancies. At the time I was teaching A Level Dance in a college and was very active. It was a shock. 13 years on in January I was diagnosed with Type 2 diabetes. Hba1c 96mmol. With very low carb and metformin I got down to 52 mmol, but no lower. I still teach dance and have a BMI of 25. I was very frustrated with my results. I asked GP for GAD test and am LADA. He said that I had 1700 antibodies and under 5 is normal. I fear I have been undiagnosed for a while as have background retinopathy. He said at least 6 week wait for endocrinologist referral.

 

[Antje77]

I'm not pregnant, nor an athlete, so not the best person to answer your questions.
A couple of thoughts, though.

and it never moved from 5.5. This doesn't seem normal for ladies with GD who are advised to snack regularly to keep their blood sugar up (!?).

Many women with GD need insulin. Without insulin going low is usually not an issue.

48 hours ago started managing my blood sugar like Type I. So we're literally counting carbs and then matching them to my activity level.

That's closer to how a T2 would manage, although it's part of the factors a T1 has to take in as well.

it's possible that someone of 39 who exercises up to 3 hours per day at 29 weeks pregnant can get GD

GD is possible for anyone, regardless of exercise, weight or diet.

can get GD this badly

Why would you say you have it "badly"? You're seeing numbers in the 5's without insulin. Your OGTT was 10.9, which for someone with diabetes isn't particularly high (for instance, I would expect something like 20 or higher should I try it, and that's with my basal insulin).

For now, would it be an idea to concentrate on the GD and this very much wanted pregnancy? With GD, they're quick to start you on insulin when your bg shows you need it, so treatment wouldn't be different, regardless of developing diabetes of whatever type afterwards.
Some do develop diabetes after GD. It can be soon or it can take years or it may never happen. It can be any type.
I don't think your doctor will be happy to have you testing for antibodies at this moment, when the important thing is to keep your bg healthy during your pregnancy.

I wish you a very happy pregnancy and the best baby in the world!

 

[Londonwriter]

Antje, Millie, thanks for the replies

A couple of thoughts, though.

Many women with GD need insulin. Without insulin going low is usually not an issue.

That's closer to how a T2 would manage, although it's part of the factors a T1 has to take in as well.

Thanks for this I've now spoken to my sister-in-law, who has Type I diabetes, and she said many of the same things as you!

Unfortunately, the first place I asked for advice was a GD support group who said carb counting wouldn't work because some ladies with GD can spike with lettuce if they're intolerant to it, and that ladies with GD need to snack three times a day to avoid their liver dumping glucose into the blood stream.

My sister-in-law thinks that's all b****t too. However, without knowing much about GD, we assumed I had really quirky GD as I don't need to snack and the carb counting approach was working for us.

GD is possible for anyone, regardless of exercise, weight or diet.

Although statistically that seems to be the case, the NHS guidelines and advice to newly-diagnosed GD patients doesn't give that impression

Why would you say you have it "badly"? You're seeing numbers in the 5's without insulin. Your OGTT was 10.9, which for someone with diabetes isn't particularly high (for instance, I would expect something like 20 or higher should I try it, and that's with my basal insulin).

My SIL said that too The NHS guidelines are quite strict (fasting below 5.3: my fasting is ~6.1) and many ladies with GD seem to be able to eat a low-GI, moderate-carb diet without medication - so I assume I have severe GD (even if not bad diabetes).

For now, would it be an idea to concentrate on the GD and this very much wanted pregnancy? With GD, they're quick to start you on insulin when your bg shows you need it, so treatment wouldn't be different, regardless of developing diabetes of whatever type afterwards.
Some do develop diabetes after GD. It can be soon or it can take years or it may never happen. It can be any type.
I don't think your doctor will be happy to have you testing for antibodies at this moment, when the important thing is to keep your bg healthy during your pregnancy.

Unfortunately, this pregnancy only exists because I concentrate on possible autoimmune disease I have an undiagnosed disease that causes chronic fever, joint pain, brain fog, rashes, severe Raynaud's with tissue damage, etc. and which seems to stop me getting pregnant. I've had it treated off-label/empirically twice and, each time, I've become pregnant. I've been treated throughout the pregnancy (just gone into remission) and am due to see an immunologist after the birth. So, obviously, it would be helpful to know if I have autoantibodies to my own pancreas. However, with having a family history of Type II in old age (two grandparents and an uncle), it might be unconnected, of course.