Hello - 2 x GD pregnancies and now in limbo

[angusglens]

Hello! I have been stalking, and decided that it was better to be present and ask rather than mis-educate myself! A bit of history, I am a mum to three, with my second baby in 2016 I was diagnosed with Gestational Diabetes at my booking in appointment at 8 weeks, they found glucose in my urine. Initially the GD was controlled with Metformin, however as I progressed through the pregnancy I was prescribed Long Acting Insulin to help keep my BG levels down which worked well. After the pregnancy, life got in the way, I was breastfeeding therefore the GTT that I was instructed to take at 6 weeks post-partum gave a false reading. Fast forward a couple of years and I fell pregnant again in 2018 and started to become aware of feeling odd, I still had some test strips and found that my BG levels were beyond the limits I had been given by the Diabetic nurse during the previous pregnancy and immediately raised my concerns. The upshot was that due to the record keeping that I’d maintained and the food diary that I’d kept I was put on Novorapid before each meal, and Long Acting Humilin again to control my levels. I was monitored every couple of weeks and the dosage units increased every two weeks up to . I had a healthy baby 8 months later following an induction due to the GD.

Whilst being under Consultant care for the pregnancy, there was much discussion around my case – I am overweight, but managed to control that through both pregnancies, I ate a very controlled diet and exercised, however the very early diagnosis in both pregnancies they felt pointed to something, but it was never investigated further. I was just instructed to request a blood test post-partum, and when I had finished breast feeding. I duly did what was asked of me, and just before Christmas last year I phoned up my surgery and asked for a GTT which was as instructed by the surgery’s previous letters to me. I arrived on the morning on the test, having fasted overnight to be told that they no longer did GTTs, the nurse would take my bloods to get a blood glucose reading from the labs, and I was sent on my way. When I phoned up for my results I was told that it was higher than expected at 7.4mmol for fasting and was called back for an HbA1c test on Christmas Eve. The results of the HbA1c came back at 48mmol/L or 6.5% - right on the limit line. I discussed my history with the surgery’s specialist diabetic nurse and she was very understanding, gave me the literature around low carbohydrate diet and exercising and told me to stop testing my blood glucose, come back in three months and I would have an HbA1c again and take it from there.

Since that last appointment obviously COVID-19 has hit and the surgery when I phoned this week are not conducting any routine blood tests, therefore I cannot book in for an HbA1C and feel at a bit of a loss. Since before Christmas I have been checking my BG levels and monitoring them myself – whether or not this is wise I’m not sure. The nurse at the surgery asked me not to. However I have used up the stash of test strips that I did have, and have subsequently purchased some more for my own piece of mind rather than anything else.

Going by the advice on the website that for a normal healthy person, fasting BG levels should be between 4.0 & 5.4mmol/L and up to 7.8mmol/L 2 hours after eating, since I resumed testing at the end of November, my lowest readings on waking have been 6.9mmol/L up to 10.0mmol/L (on a very rare occasion). More often than not they’re somewhere between 7.2 & 8.0. I do watch what we eat as a family, all meals are cooked from scratch with a good portion of proteins and I have reduced the volume of carbohydrates that I eat. I have been running three times a week for the last ten weeks, however I don’t seem to be able to lose any weight. If I have binged on something, or had a very carb heavy treat, I have found myself feeling very ‘spinny’, if I’m lying down its as if I can hear my pulse thumping around me. I drink a lot of water and am frequently visiting the loo. At times I do wake up through the night to pee, however I’m also a very very deep sleeper, however as soon as I wake I have to go to the loo as feel desperate. I’m also now aware of being particularly tired through the days, which previously I put down to being a busy Mum and working full time – who knows! I also experience hunger at times not long after having eaten, and can wake in the night needing the loo, then struggle to return to sleep because I’m hungry!

I’m not really sure what I’m after, and until I manage to book another HbA1c I guess I don’t really know where I’m at. Any words of wisdom would be gratefully received!!

 

[Resurgam]

What would your levels be after eating one of those carb heavy meals?
The hunger is your BG dropping from high to low under the influence of lots of insulin.
Having had two children and GPs and dieticians who pushed me to eat carbs because they believed them to be healthy, I know just how draining they are, and can only suggest that a diet lower in carbs, higher in proteins and natural fats will give you more energy, more restful sleep and less urgency first thing in the mornings.
If you are moving to type two your morning readings are of little consequence really, it is the difference in level between just before beginning to eat and two hours later which seem to be the most relevant - if there is a big increase in those two hours then you have overdone the carbs and spiked your glucose levels.
I went many years when feeding the family doing an extra few veges or having a salad for myself to replace the higher carb part of family meals. Whenever pushed to having less fat more carbs less red meat, my weight would go up, then I'd escape from notice and do low carb and lose again, and feel better every time. I am really sensitive to carbs so used to crash in the afternoons after eating lunch - I used to set an alarm but was notorious for being late at the school gate until one particular weight conscious GP moved on and I did not have a weekly session of being shamed and shouted at.