Gestational Diabetes diagnosis

SpursGal

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Hi, only just discovered this site following googling some stories and advice regarding Gestational Diabetes. I'm 27 years old and 6 months pregnant. I also have a 9-year-old son, plus no-one in the family with diabetes.

Some weeks ago, I was asked to do the Glucose Tolerance Test to determine whether I have GD. Upon finding out the drink involved, I had to refuse as I suffer from a very sensitive bladder condition and 99.9% of the time I can only drink water. Other drinks flare up my condition, and those with sugar in are just a plain no-go for me.

Last week I attended an anti-natal appointment with a diabetes specialist midwife at my local hospital to be shown how to do the pin-prick test. I was told I had to do it before every meal, an hour after every meal and then once just before bed. I've done the full week and it's absolutely caned my fingers. I've got a low pain threshold, I can't stand the sight of blood. hate needles, plus I suffer from Raynauds syndrome especially in the winter. Despite warming my hands for a few minutes beforehand, I must've had 10 failed attempts to draw blood for the test, plus the 49 recorded scores and all my fingers are bruised at the end and are so sore despite cream to help soothe them. How do people cope with doing this so much?

Today I had a phone appointment with the midwife to give her my results. I was told "it's probably the start of GD" and I've now got to do another week of testing. I gave her some additional info regarding some of my higher scores and she seemed to take it into account somewhat, but thinking back on it for the past 9 hours I've been wondering if she didn't that much. She didn't strike me with too much confidence today when she brought up that because I'm a stay-at-home Mum, I'd "probably be sat at home watching television all day". I lead a fairly active lifestyle despite suffering from chronic bladder pain, IBS, an anxiety disorder and Reynauds, which all limit me but I try to battle on and following putting on a load of weight from medication a few years ago I was losing weight at a healthy pace until conceiving and had shed around 6 stone since coming off the tablets 18 months prior. I'm currently ~15 stone (which is the same as when I became pregnant) and 5 and a half foot. I don't diet and I don't sit there eating ****, I just cook lots of healthy food, have lots of vegetables and usually don't overeat. Pregnancy is causing me to overeat here and there but I can stop myself more often than not.

Do these scores seem true to what my midwife said?

Before breakfast - 4.6, 5.1, 4.6, 4.6, 5.1, 5.0, 5.4
One hour after breakfast - 6.1, 7.7, 5.8, 6.7, 6.7, 8.2, 6.7
Before lunch - 4.2, 6.1, 4.7, 5.8, 3.7, 5.2, 4.6
One hour after lunch - 7.1, 5.7, 6.9, 5.9, 5.8, 7.2, 8.2
Before teatime - 4.3, 4.4, 5.2, 5.5, 5.2, 6.4, 4.3
One hour after teatime - 6.8, 6.6, 6.1, 7.7, 8.8, 7.7, 10.2
Before bed - 6.1, 5.4, 5.2, 5.4, 6.6, 5.3, 9.5

- Only had final meal 90 minutes before bed, washed down with a large mug of Horlicks 60 minutes before bed, following doctor's orders due to severe leg cramps at night!

- I'd had two big bananas this day, random urge, one between lunch & teatime and the other together with my tea. Heard that this can affect things.

Other factors that may or may not have affected things?
- Also had to do blood pressure testing for the same week, had to end it as the machine was squeezing me so much and it caused a lot of stress.
- Been sleeping really badly due to bad leg cramps, been crying out in pain and nothing's seemed to help, so that's had me stressed.
- This past week I've been having my 'breakfast' at around 11am, my 'lunch' usually around 6pm when I finally feel like eating. My final meal was often between 11pm and midnight and then I'd head to bed between 1am and 2am. I don't always eat at these times but I think maybe the lack of sleep plus other things happening in the day have thrown things out of kilter a little.
- My 'breakfast' was often a sandwich with or without moderate snack, my 'lunch' was homecooked meals like lasagne (7.1 score one hour after) or roast chicken with all the trimmings, plenty of veg (6.9). My 'teatime' was almost always cereal, if not then a small toastie.

With everything else that I have to contend with, I really don't want another condition but I'm starting to feel I just have to face it, if it turns out the midwife was spot on. Her questionable comments make me want to get a second opinion, even if it turns out she was correct and the diagnosis is confirmed. Sorry if I've waffled but there's just been so much on my mind. Thanks in advance to anyone who might be able to offer their opinion on my scores, or just give general advice.
 

azure

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I can't give a medical comment as I'm not a medical person, but looking at your blood tests I think you have some good results there mainly, but a few higher ones mixed in. Your midwife or doctor should give you targets if you do have GD. Then you'll know what you're aiming at before and after meals.

Just a few things - for your blood tests, it makes a big difference what 'finger pricker' you use. One with an adjustable depth is best. Set it at just deep enough to get the blood you need to test. Wash your hands in warm water, and you can also try shaking them down a bit, if that makes sense, to try to 'shake the blood to the fingertips'. Prick the sides of your fingers not the pads, and work through the fingers using each side so your not using the same finger too often.

I'm sure you realise this anyway else you wouldn't have mentioned it, but keeping more traditional times for meals could help. Many people with diabetes find that their blood sugar can go up in the morning if they eat late. Also, eating too late at night isn't good for most people. So more regular meal times might help your results too :)

If you test after meals, you may find that certain foods don't 'suit' you because they make your blood sugar higher than you'd want. So then you can avoid those and, again, keep good control :)

I'm moving your thread to the GD section. Have a look round there and ask any questions you want.

Well done on your weight loss, by the way :cool:
 

SpursGal

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3
Thanks for the reply and advice.

So far, all my midwife has said it that it is about portion sizes more than anything. I'm going to see my GP next week and see what they say, plus I'll be hearing from the midwife again later in that week.

Luckily, I've got the hang of drawing blood now, it was the first couple of days I was hitting trouble but I ended up setting the lancing device to 1, warmed my finger adequately and held it horizontal. Hardly any issues since, apart from the pain afterwards.

Yesterday I ate at more normal times, had a 6.7 one hour after tea and then a 5.2 before bed. This morning it read as 4.6 which seems a common score for me at that time of day. However, for breakfast I had a small bacon sandwich, in a granary breadcake, followed by an Activia yoghurt. One hour later my score is up to 9.5 and it's really upset me. Earlier this week, I'd eaten my last meal much later on Sunday, had a same-size bacon sandwich on white bread for Monday breakfast, followed by yoghurt. My 'before meal' score was 4.6 and afterwards it was 6.7. How can it be so different now? Same food, more time inbetween eating, more suitable bread... I'm getting the feeling now I'm going to be confirmed with GD.

Thank you once again.
 

azure

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You're welcome :) As pregnancy progresses, insulin resistance increases, so if you do have GD you may find that you have to work harder as keeping your blood sugars in range as the pregnancy goes on.

That could be why you had that yoghurt issue. You may also find that certain foods just don't suit you, so may decide to swap to others eg I like the Activia yoghurts too, but find a plain Greek yoghurt easier to deal with. I have dollops of it on berries for dessert.

Keep us updated with how you get on, and best wishes for the rest of your pregnancy :)
 
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SpursGal

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Hi again, and a belated thanks for your response.

It's been a challenging time since I last posted. I finished a second week of testing with very similar scores to the ones above. Before week 1 of testing I'd been given a guideline of having a score below 6 before a meal, and below 8 for one hour after a meal. On the few occasions where my score was above these limits in week 2, I'd either
- overeaten following going too long without eating due to being busy or not feeling hungry
- eaten a snack within an hour of performing a 'before meal' test (one time it was very close to testing)

When speaking with the diabetes midwife at the hospital following all this, I was given false understanding first, followed instantly by robotic responses and personal jibes. Because I'm a stay-at-home mother, I am "likely to sit there watching television all day and not doing anything". Whenever mentioning the reasons that could have caused the high scores, she agreed, said "yeah that's probably it" but then classed them as typical scores for someone with GD and basically this means I need to keep testing.

In the end, I stopped testing as my fingers couldn't take any more. I reluctantly booked in for a GTT at my local GP surgery but I had to cancel today due to my bladder condition being really, really bad so far this week. I was already worried before this week as to whether my bladder, which basically has no lining, could handle a sugary drink when all I've drank for years is water otherwise it feels like passing glass when I go to urinate. Anyway, following cancelling the GTT, I called the diabetes clinic in the antenatal department and informed them of this and asked where to go from there. More robotic responses came my way saying "your past scores here indicate you've had high blood sugar levels on several occasions without any reasoning". This infuriates me as I've had contact with these people 5 times now, I speak to someone different every time and nothing I've discussed with them is ever noted down on record, and I even get told every phone call that I "have GD because your GTT showed high levels", which to leads to me having to informing them again that I have not done a GTT, why I haven't done a GTT and that my pinprick results are mostly fine. I take in what they tell me - well, whatever isn't deliberate scare-mongering - but they take in nothing from me. It's had me upset all day.

To add to this, I've been booked in for numerous appointments, combining extra scans with trips to the diabetes workshop which, combined, they say easily could last over 2 hours each hospital trip. And I only find this out by accident over the phone, and they made the appointments over a week ago. The first of these is in 12 days and I'm feeling extremely pigeonholed by medical professionals up there. I had a really bad first birth and really don't want them to force me into being induced or having a c-section with my second boy.

I'm not sure what I could achieve by posting this here, but I needed to let it out. Apologies for sounding so full-on. Just not convinced I have GD. My eating habits haven't changed throughout really, and I don't eat ****. Currently 27 weeks and 4 days and I'm now exactly the same weight as I was when I fell pregnant. Had numerous urine & blood tests recently and there's never anything like sugar found.

Overall, I've really, really enjoyed my pregnancy until the possibilities of GD have come along, combined with those people at the hospital. It's saddening that I now feel like I could skip the rest of my pregnancy and fast-forward to my boy being here with us.
 

azure

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@SpursGal Sorry you've had such a bad time : ( Yes, it's very frustrating when people don't listen and just reply without thinking about what you've said or your particular circumstances. All I can say is don't let them get you down or make you stressed. Treat dealing with them as though it was a business thing or as though you're doing it for someone else, if that makes sense. Don't let them upset you - or ruin your enjoyment of your pregnancy. It'll go all too fast.

Obviously I can't say whether you have GD or not, but I do know the NHS is trying to make sure they spot more cases and testing more. I quite understand why you didn't want ths GTT with your bladder issue. I'd be very nervous too in those circumstances.

No one can force you into being induced or having a section. I'm not sure that they induce GD ladies anyway (they tend to if you have established diabetes not GD). The last GD lady I read about (on a pregnancy forum) had a natural birth :) Remember you are in control of the birth. I had a good book to relax me as my 2nd delivery was awful (had my 3rd baby last year). Reading that was empowering. I also spent a few minutes every day doing breathing and relaxation exercises. I felt very calm in my last pregnancy.

I know you don't like testing, but if it was me I'd keep doing it if only for my own peace of mind. You obviously know what foods you can eat, so carry on taking care of your diet. That's half the battle. Even if you don't have GD, eating well and sensibly is good.

Keep us updated - and please don't let all this spoil your pregnancy. Take care xx