RH in pregnancy

[Rachwoo8]

Hi.

Wondered if anyone had experience of having reactive hypoglycaemia in pregnancy?

I was treated as gestational diabetes in first pregnancy after a raised GTT. I was having frequent hypos, always had a normal Hba1c, no risk factors and a post natal GTT which showed a hypo. Second pregnancy no highs but still hypos, not under a team. I had self diagnosed with RH in the meantime, as symptoms were on going, and I've had hypo symptoms as long as I can remember. But with worsened symptoms in pregnancy.

I'm now in my third pregnancy and having a terrible time with hypos. My 2 hour GTT was 2.3. Been seen by endocrinology who think it's likely RH, but not having further tests until I'm not pregnant and stop breastfeeding. Seen a dietician who was very helpful but not come across RH before.

Was started on metformin, and felt worse. After reading on here (thank you!) I have now made big diet changes and it's much more controlled, even off metformin. Not having the highs due to splitting meals into 2 sittings an hour apart, low GI carbs, adding peanut butter or hummus, frequent snacking when I can. But I'm still having hypos and feel pretty terrible, especially if any snacks delayed.

I feel a carb free diet would probably make me feel better, but this isn't recommended in pregnancy.

Any advice on how to manage in pregnancy and breastfeeding welcome! As well as any snack ideas please. Really struggling to find time to prep or eat with a busy job and 2 young children! I'm finding I need to eat something every hour to avoid a hypo but cannot sustain it, and am not hungry!

Thank you!

 

[Brunneria]

Hi and welcome!

Congratulations on getting the handle on things that you have!

i can understand their reluctance to subject you to more glucose tolerance tests until after you have given birth. But that does leave you in a tricky situation.

You definitely need to listen to your healthcare team because they are the ones who know your test results and your health history, but if you have been reading the RH section of the forum then you may well have seen me repeating over and over that keeping carbs to a minimum works best for me.

So I’m wondering if you can tweak things... spread your carbs out more? Switch to lower GI versions (I know you mentioned you are already low GI, but maybe some fine tuning) or smaller portions? Increase the fibre and fat in your meals (an easy test to see if the f&f thing works is to add coleslaw to meals, or have a glass of water with 1 teasp of psyllium husks stirred into it with your meals). All of those may steady your bg out a little more.

have you tested/made notes to find out which foods, in which portions, are causing the hypos?
It took years, and this forum, before I was able to work out that my food intolerances were causing RH reactions to certain carbs. I do far better tolerating sugar than I do anything containing gluten. Maybe if you kept a food diary you may spot a particular food, or group of foods that cause more problem than others?