- Messages
- 818
- Type of diabetes
- Gestational
- Treatment type
- Insulin
Brains Trust, just after your thoughts. Not needing a medical diagnosis as such and will not hesitate to seek medical advice if needed. But am interested in others thoughts and opinions.
A little background on me:
Currently 32 weeks pregnant with Baby #3. I'm 44yo and was diagnosed with Gestational Diabetes at 28 - 29 weeks. Morning fasting levels are currently around 5.3 - 5.6 mmol up from 5.1 mmol in the first week after diagnosis despite dietary changes to reduce carb intake, so I am on my 3rd day of nightly insulin injections (very low levels for now). Not much change yet.
Day time blood glucose levels are under control if I avoid most carbs. I have had the odd 2-hour postprandial reading of 8.0 mmol - 10 mmol after what I call an 'eating mistake' (eg. chicken nuggets and cheese pastries). Otherwise I am tightly eating eggs for breakfast with avocado and tomato followed by a small slice of homemade sourdough rye bread and a piece of fruit (nectarine, banana, fig) with a tea or coffee and my 2 hour post breakfast readings are usually 5.1 - 6.2 mmol, and my other meals consist of meat / fish and vegetables / salads with carbs being only 1/2 cup of chick peas / lentils/ Cannelli beans or small slice of sourdough rye. Snacks are nuts, teaspn of cacao nibs, and 6 -8 raspberries with tea or hot milk or cocoa; or yoghurt sweetened with Vanilla Bean paste and a bit of fruit. But eating like this has lead me to have the odd carb craving and post meal spike when I couldn't resist or got too hungry. So if I were eating carbs liberally, I suspect I might be given insulin for post meals levels as well, but if my diet is acceptable, I would try to stay lower carb for the remainder of the pregnancy - current estimated date for planned c-section is in 6 week's time at the 38 week mark.
Only other previous relevant history: Baby #1, I was 39yo and at 42 week I was diagnosed with preeclampsia. Failed induction lead to emergency c-section. Everyone survived. My blood pressure has not been the same since. Before babies I was usually 100/60 on average. After babies, 130/80 was more my new normal. So in the next two pregnancies (including this one), I was put on low-dose aspirin to mitigate risk of preeclampsia. GTT blood glucose in first pregnancy was normal. For Baby #2, my OB didn't push me to do the GTT so I had no other diabetes tests between 2014 and 2019, when I was diagnosed with Gestational Diabetes.
After watching some videos from Lily Nichols (registered dietician/nutritionist and certified diabetes educator); and interviews on BioHackers youtube channel with Dr Benjamin Bikman (scientist and expert on metabolic disorders) and Dr Steve Phinney (physician-scientist with a PhD in Nutritional Biochemistry), as well as Jason Fung and Sarah Hallberg of "Diet Doctor", I felt okay about reducing my carbohydrate intake a bit below what my local diabetes dietician recommended to try and lower my Gestational Diabetic blood glucose levels.
Now where I want your thoughts: Ketones in pregnancy. I don't fully understand how the body works in pregnancy. I just know that average medics won't likes seeing elevated ketones in a pregnant woman's urine. So I feel like I broke the rules a little when last night, after a whole day of low carb eating, but filling up on meat, dairy, vegetables and nuts, I tested my ketone levels in a home urine test and got as high as 4 mmol (medium), and again this morning, around 1.5 mmol (weak), but within a very short time, after reading my blood glucose each time (respectively 6.0mmol last night, and 5.2mmol this morning) and then I tested ketones again with a more recent urine output, the levels were suddenly back to Traces only. Only the concentrated urine had these higher levels of ketones from the late evening and the overnight urine samples. But it surprised me to see the darker purple colour coming up so quickly.
Now from what I have read, ketoacidosis is only likely in T1 diabetics with a sustained blood glucose of 14mmol or so and elevated ketones of 1 - 3 mmol. Over 3 mmol and they suggest you go straight to the emergency room to be treated for possible ketoacidosis, especially if you have nausea and vomiting or any of the other symptoms.
I know an average adult probably wouldn't be in ketosis as quickly as a pregnant woman and so I am just wondering if ketones of 4 mmol with blood glucose between 5 - 6 mmol is overdoing the low carb, and should I endeavour just to keep my ketones at trace level and eat a few more carbs?
Does anyone think I should seek medical advice right now after having a fleeting elevated level (4 mmol) of ketones while pregnant with Gestational Diabetes? I don't feel any of the other symptoms of ketoacidosis so I personally don't suspect it's a serious situation, but just think maybe I could loosen up my tight intake of carbs and eat them a little more liberally. Does that sound sensible?
I can easily call my OB and ask these same questions and I suspect I will be told to eat more carbohydrates and then review blood glucose levels and then I expect my insulin doses will be raised and new day time insulin will be prescribed. Which I am okay with. But I am curious about the affects of ketosis in pregnancy and when diet can make it that you don't have to take extra insulin, it seems like a good way to go, except if I really am endangering baby...
I appreciate your feelings about this.
By the way, my husband was not phased. He doesn't think I am endangering the baby and thinks not taking insulin if I can avoid it with low carb in diet is fine. Just wondering how others would react.
A little background on me:
Currently 32 weeks pregnant with Baby #3. I'm 44yo and was diagnosed with Gestational Diabetes at 28 - 29 weeks. Morning fasting levels are currently around 5.3 - 5.6 mmol up from 5.1 mmol in the first week after diagnosis despite dietary changes to reduce carb intake, so I am on my 3rd day of nightly insulin injections (very low levels for now). Not much change yet.
Day time blood glucose levels are under control if I avoid most carbs. I have had the odd 2-hour postprandial reading of 8.0 mmol - 10 mmol after what I call an 'eating mistake' (eg. chicken nuggets and cheese pastries). Otherwise I am tightly eating eggs for breakfast with avocado and tomato followed by a small slice of homemade sourdough rye bread and a piece of fruit (nectarine, banana, fig) with a tea or coffee and my 2 hour post breakfast readings are usually 5.1 - 6.2 mmol, and my other meals consist of meat / fish and vegetables / salads with carbs being only 1/2 cup of chick peas / lentils/ Cannelli beans or small slice of sourdough rye. Snacks are nuts, teaspn of cacao nibs, and 6 -8 raspberries with tea or hot milk or cocoa; or yoghurt sweetened with Vanilla Bean paste and a bit of fruit. But eating like this has lead me to have the odd carb craving and post meal spike when I couldn't resist or got too hungry. So if I were eating carbs liberally, I suspect I might be given insulin for post meals levels as well, but if my diet is acceptable, I would try to stay lower carb for the remainder of the pregnancy - current estimated date for planned c-section is in 6 week's time at the 38 week mark.
Only other previous relevant history: Baby #1, I was 39yo and at 42 week I was diagnosed with preeclampsia. Failed induction lead to emergency c-section. Everyone survived. My blood pressure has not been the same since. Before babies I was usually 100/60 on average. After babies, 130/80 was more my new normal. So in the next two pregnancies (including this one), I was put on low-dose aspirin to mitigate risk of preeclampsia. GTT blood glucose in first pregnancy was normal. For Baby #2, my OB didn't push me to do the GTT so I had no other diabetes tests between 2014 and 2019, when I was diagnosed with Gestational Diabetes.
After watching some videos from Lily Nichols (registered dietician/nutritionist and certified diabetes educator); and interviews on BioHackers youtube channel with Dr Benjamin Bikman (scientist and expert on metabolic disorders) and Dr Steve Phinney (physician-scientist with a PhD in Nutritional Biochemistry), as well as Jason Fung and Sarah Hallberg of "Diet Doctor", I felt okay about reducing my carbohydrate intake a bit below what my local diabetes dietician recommended to try and lower my Gestational Diabetic blood glucose levels.
Now where I want your thoughts: Ketones in pregnancy. I don't fully understand how the body works in pregnancy. I just know that average medics won't likes seeing elevated ketones in a pregnant woman's urine. So I feel like I broke the rules a little when last night, after a whole day of low carb eating, but filling up on meat, dairy, vegetables and nuts, I tested my ketone levels in a home urine test and got as high as 4 mmol (medium), and again this morning, around 1.5 mmol (weak), but within a very short time, after reading my blood glucose each time (respectively 6.0mmol last night, and 5.2mmol this morning) and then I tested ketones again with a more recent urine output, the levels were suddenly back to Traces only. Only the concentrated urine had these higher levels of ketones from the late evening and the overnight urine samples. But it surprised me to see the darker purple colour coming up so quickly.
Now from what I have read, ketoacidosis is only likely in T1 diabetics with a sustained blood glucose of 14mmol or so and elevated ketones of 1 - 3 mmol. Over 3 mmol and they suggest you go straight to the emergency room to be treated for possible ketoacidosis, especially if you have nausea and vomiting or any of the other symptoms.
I know an average adult probably wouldn't be in ketosis as quickly as a pregnant woman and so I am just wondering if ketones of 4 mmol with blood glucose between 5 - 6 mmol is overdoing the low carb, and should I endeavour just to keep my ketones at trace level and eat a few more carbs?
Does anyone think I should seek medical advice right now after having a fleeting elevated level (4 mmol) of ketones while pregnant with Gestational Diabetes? I don't feel any of the other symptoms of ketoacidosis so I personally don't suspect it's a serious situation, but just think maybe I could loosen up my tight intake of carbs and eat them a little more liberally. Does that sound sensible?
I can easily call my OB and ask these same questions and I suspect I will be told to eat more carbohydrates and then review blood glucose levels and then I expect my insulin doses will be raised and new day time insulin will be prescribed. Which I am okay with. But I am curious about the affects of ketosis in pregnancy and when diet can make it that you don't have to take extra insulin, it seems like a good way to go, except if I really am endangering baby...
I appreciate your feelings about this.
By the way, my husband was not phased. He doesn't think I am endangering the baby and thinks not taking insulin if I can avoid it with low carb in diet is fine. Just wondering how others would react.
