2/29 GD/Diabetes Check In

Monicagail1

Gestational Week:

Successes:

Challenges:

Recipe/Tips:

Questions:

allaire314

Gestational Week: 33 - only 7 more to go!

Successes: Made it through the baby shower with no issues with my numbers! I made relatively smart choices, but I wasn't about to miss out on cupcakes! I had over 120 carbs for dinner (didn't mean to go that high over the recommended 45-60, but oops!) and two hours later my reading was 120! Granted that is the highest it's ever been... but it was still right where is was supposed to be... with double the amount of carbs! 

Challenges: My fingers hurt... all the time... I'm only at a 2 on my device in terms of how far the needle goes - any lower and I'm not sure I'll draw enough blood for the reading.

Recipe/Tips: Open face fried egg sandwiches were my go to for breakfast - simple, fast, and oh so yummy! Don't knock it til you try it, but I make mine with melted cheese on the egg, sliced dill pickle and ketchup... sounds SO weird, but I ate it this way pre-pregnancy.

Questions: At my appt last week I didn't see my regular OB, just one of the NPs in the practice. I asked about the possibility of reducing my testing since my numbers have been so good... and she said it wasn't very likely since we are so close to the end... has anyone else had really successful numbers and no leeway on testing?? I'm hoping when I see my regular OB next week and ask the same thing, she'll let me reduce, but that's another week and a half of 4 times a day... I'm so over it! **Sorry that turned into kind of more of a rant than a question!**

Jheaps

Gestational Week: 32 - 

Successes:  No glyburide or insulin!  Yay!  I also was pretty religious about getting out for my 30 minute walk post-dinner, even though it was routinely 9pm or later and really cold.

Challenges:  We generally eat dinner late, so it's been a challenge to stay up for the two hours after dinner to check my sugars.  Twice in the past week I had dinner at 10:30! Also, random food sometimes spikes me sugar if I don't have enough protein.  I had roasted chicken with broccoli and yucca the other night and my sugars were high from the yucca.  Same thing when I had 1/2 a sweet potato with my steak and veggies.  I guess no starches for me.

Recipe/Tips:  Walking after dinner is the key to good fasting numbers for me.

Questions: I'm definitely on board with reducing testing!  My post-meal numbers are almost uniformly good.  Anyone else have issues with different fingers testing drastically different?  This morning I tested a 96 fasting, so I pricked another finger and it was 108.  WTH?  Any idea why my pinky on my right had would test differently from my left, even when I just washed my hands?

allaire314

@Jheaps  any finger on my right hand routinely tests lower than my left.

Jheaps

@allaire314: my are consistently testing differently, but sometimes right is higher than the left.  Frankly, this is my saving grace from going on drugs.  No way am I interested in being medicated based on test results that can vary so widely.. 

allaire314

Jheaps said:

@allaire314: my are consistently testing differently, but sometimes right is higher than the left.  Frankly, this is my saving grace from going on drugs.  No way am I interested in being medicated based on test results that can vary so widely.. 

Preach! Oh I get so frustrated with it sometimes! 

Sienna516

Hey ladies, I'm lurking from May with GD. I noticed some of you said you test after 2 hours. My dietitian has me doing my blood sugar checks after an hour of starting my meal (which is hard for me since I'm a slow eater, so I feel like I'm trying to wolf down my meal, so I can start processing it).

Was the 2 hours something you progressed to, or from the start of your GD diagnosis? Also, if you don't mind sharing what ranges do you have to fall within?

I feel like I have kind of tough limits compared to the standards for gestational diabetes on NNDIK's gov website..theirs listed are: fasting: under 96, 1 hour: under 141, 2 hour: under 121. My dietitian's standards are fasting: under 91, 1 hour: under 121. My numbers have been pretty good over all so far, even with the standards she has me using. 

shtjustgotreal

Gestational Week: Week 33 

Successes: once I was FINALLY able to get a glucometer from the hospital after several failed attempts filling the scripts or having them filled at a phatmacy, all but one of my readings since Friday have been well under the guidelines. Today was a bit high but also the first time I tried to have anything with any sort of red sauce on it. Man they weren't lying when they said red sauce was a big source of carbs! So no more spaghetti or anything with marinara on it from here on out for me. Small price to pay when I've had to make such few changes to my normal diet!

Challenges: Went in for my first NST on Friday and was having contractions already about 5-8 mins apart. I guess it was enough of a scare to admit me and have me sent up to L&D to be monitored for a few hours and checked to see if I'm dilated. Was sent home with some simple instructions on keeping an eye out for preterm labor. But otherwise I guess contractions that strong are normal at this point? Not being dilated yet was a huge relief, but the contractions to the point ofstopping me mid sentence when I'm talking hardly seems nothing to worry about. 

Recipe/Tips: none really. Like I said I haven't had to change much other than avoiding red sauce like the plague. 

Questions: anyone else having signs of preterm labor during their NST?

allaire314

Sienna516 said:

Hey ladies, I'm lurking from May with GD. I noticed some of you said you test after 2 hours. My dietitian has me doing my blood sugar checks after an hour of starting my meal (which is hard for me since I'm a slow eater, so I feel like I'm trying to wolf down my meal, so I can start processing it).

Was the 2 hours something you progressed to, or from the start of your GD diagnosis? Also, if you don't mind sharing what ranges do you have to fall within?

I feel like I have kind of tough limits compared to the standards for gestational diabetes on NNDIK's gov website..theirs listed are: fasting: under 96, 1 hour: under 141, 2 hour: under 121. My dietitian's standards are fasting: under 91, 1 hour: under 121. My numbers have been pretty good over all so far, even with the standards she has me using. 

For me testing 2 hours post meal has always been the recommendation from the GD Specialist and my OB, so that's what I've done. In terms of numbers, I'm supposed to be <95 fasting, and <120 two hours post (start of) meal. Have you asked your dietitian why he/she is more strict with your numbers?

korpatch

Jheaps said:

Challenges:  We generally eat dinner late, so it's been a challenge to stay up for the two hours after dinner to check my sugars.  Twice in the past week I had dinner at 10:30! Also, random food sometimes spikes me sugar if I don't have enough protein.  I had roasted chicken with broccoli and yucca the other night and my sugars were high from the yucca.  Same thing when I had 1/2 a sweet potato with my steak and veggies.  I guess no starches for me.

My doctor specifically told me that eating after 7:00 at night causes your cortisol levels to skyrocket and likewise your insulin absorption to go down. If you have a job where you must eat late (I had a job for most of my pregnancy where I had to eat dinner after 9:00pm because I didn't get home till then or later), I would totally stay away from what you said. Starches and added sugars (anything with honey, sugar, molasses, etc...) would send me over the top. But if for some reason your able to eat earlier, that's when I would eat those!! 

korpatch

Sienna516 said:

Hey ladies, I'm lurking from May with GD. I noticed some of you said you test after 2 hours. My dietitian has me doing my blood sugar checks after an hour of starting my meal (which is hard for me since I'm a slow eater, so I feel like I'm trying to wolf down my meal, so I can start processing it).

Was the 2 hours something you progressed to, or from the start of your GD diagnosis? Also, if you don't mind sharing what ranges do you have to fall within?

I feel like I have kind of tough limits compared to the standards for gestational diabetes on NNDIK's gov website..theirs listed are: fasting: under 96, 1 hour: under 141, 2 hour: under 121. My dietitian's standards are fasting: under 91, 1 hour: under 121. My numbers have been pretty good over all so far, even with the standards she has me using. 

Your story really reminds me of my own!!! I was told I had to test seven times a day after finding out I had GD at 28 weeks. Fasting and then one hour after every meal and snack. I felt like that's all I did was prick my soar fingers and prep snacks and meals. The lady said it had to be under 90 for fasting (mine is always in 60s and lower 70s) and under 120 for an hour which was very stressful. Then I moved states.
The nurse I started going to in KC said the lady in Cincinnati (Christ hospital) was crazy for having me do that. Not even someone without diabetes always has a blood sugar under 120 an hour after a big meal. (Not that we get to eat big meals anymore...) I was changed to testing 4 times a day. Fasting and 2 hours after any meal. Under 95 for fasting. Under 120 for two hours after a meal. I felt free! If I were you and your numbers have been good, I would call your OBGYN and tell them what the dietitian has you doing and see if maybe you need to see someone else. Having lived it, I can tell you that what she has you doing is not only crazy, but potentially be harmful to your baby... This is why. Is she having you check for Ketones every morning? Ketones are basically the by product of your body breaking down fat. When I was on the "crazy trying to keep it under 120 an hour after eating diet", I wasn't getting enough carbs, my body turned to my fat stores. Ketones can pass to the baby and "might" cause lower IQ. They think it takes constant high quantities of Ketones to cause a problem. When I was on that diet, I think I only really ever had only a few (but I'll never know cause the crazy dietitian never mentioned it!) So, if you're dietitian didn't even mention that to you, you might want to ask for a referral elsewhere and pick up some ketone testing strips at Walgreens (they are pretty cheap).
Again, I'm not trying to scare you! But just saying I've been in that boat of ambiguity and am so thankful for my new GD group of ladies (Dietitian, nurse, and perinatologist) who have set both me and my baby on the right path in managing this random thing! 

korpatch

@allaire314 How was your baby shower!!?!! Mine was wonderfully and overwhelming! I likewise ate cake, but I was prescribed it by my GD team (they all said I must have cake at my baby shower and that a one time spike would not hurt the baby). So happy your numbers stayed down. 


Gestational Week: 35. (AHHHHHH!!! I need to finish the nursery! )
Successes: My perinatologist thought my numbers were so good after last weeks check in she lowered my testing to only twice a day! Fasting and then two hours after a different meal everyday. I must admit... I still always check dinner and sometimes lunch if I haven't had it before... But I usually just check fasting, dinner and then choose one of the other meals to test after unless it's my only fasting and dinner day! It has been quite freeing and @allaire314, I have no idea why your team won't reduce it for you if your numbers are good all the time. That is really frustrating! They should be able to notice a trend in the testing numbers even if you become more insulin resistant. Maybe soon? I wasn't bumped to two times till week 34.

As I only had to test twice a day... I may have strategically skipped testing after my baby shower. There really wasn't time anyway and I did eat only a really tiny piece of cake and was REALLY good about paring it with a protein. 
Challenges: Not with GD thankfully. Just in general with all the aches and pains! This baby will be out in the next five weeks!!! He still hasn't turned and spends most of his time in transvers and breech. It's starting to bruise up my sides whenever I have a Braxton hick... and I have MANY of those every day since week 22. @shtjustgotreal I have a ton of pretty strong Braxton hick contractions everyday. I have no idea about preterm labour except my mom always gives me a funny look when I hold my hand on my belly and make the "mild pain" look. I don't think they would be painful at all if this kid was faced the right way!!! When I mentioned it to my ob at 30 weeks, she didn't seem to be worried and just said I was a "great contractor". She's going to check my cervix this week and I have a sneaking suspicion I might be on bed rest after that appointment... but we'll see.
Tips: Keep up the good work!!! We're almost there!!!! And then most of us can have a cookie in one hand and our baby in the other right after labour! I'm requesting toffee nut from panera.

allaire314

@korpatch The baby shower was awesome!! (I should really post some pics on the thread). Amazing to see how loved this little girl is already! 

Hooray for reduced testing!! Oh what a relief that must be (even if you are voluntarily testing more)... just the thought that you don't HAVE to is awesome! My next appt is at 34 weeks (and with my regular OB) so fingers (sore ones at that) crossed I get to follow suit! I'll keep you posted!

As for our tip... babies' first photo!?! Cupcake is obviously for mama
 

Monicagail1

Sienna516 said:

Hey ladies, I'm lurking from May with GD. I noticed some of you said you test after 2 hours. My dietitian has me doing my blood sugar checks after an hour of starting my meal (which is hard for me since I'm a slow eater, so I feel like I'm trying to wolf down my meal, so I can start processing it).

Was the 2 hours something you progressed to, or from the start of your GD diagnosis? Also, if you don't mind sharing what ranges do you have to fall within?

I feel like I have kind of tough limits compared to the standards for gestational diabetes on NNDIK's gov website..theirs listed are: fasting: under 96, 1 hour: under 141, 2 hour: under 121. My dietitian's standards are fasting: under 91, 1 hour: under 121. My numbers have been pretty good over all so far, even with the standards she has me using. 

When I had GD with my first pregnancy, my practice used the fairly standard fasting <95, two hour post meals <120.  When I started researching at that time I thought 120 at 2 hours post meal was crazy strict, as goals for regular non-pregnant diabetics were higher than that, but I managed with careful diet selection and strategic exercise.

This time (approx. 6 years later) they are using fasting <90, 1 hour post meal <120 for all diabetic OB patients. And I thought that was crazy strict too, lol.  I do take meds this time (now I'm Type 2, not GD), but have been managing well.  And honestly, I kind of like testing at the one hour mark, versus two.  It was kind of a pain in the butt to wait around for two hours post meal, sometimes, especially if I had a later dinner.

Monicagail1

Gestational Week: 32 weeks

Successes:  After a couple of adjustments my fasting numbers are back down in a good range.  It's so crazy that for this whole pregnancy, my fasting numbers were great until the last couple of weeks.

Also, had a pretty good first round of NST/BPP/AFI screening today.  Baby is head down, which is super important to me, as I had a breech baby last time and am trying for a VBAC.

Challenges: Baby's ultrasound size estimate jumped from 50th percentile at 28 weeks to 70th percentile at 32 weeks.  The doctor was kind of nonchalant about it, and said they'd measure again next month, but it still has me worried based on my delivery goal of VBAC and hoping to avoid a delivery before 39 weeks.  My first baby (vaginal) wasn't tiny, probably around 80th percentile (8lbs at 40 weeks) but my second (breech, c/s) was a whopper at 9lbs at 37w4d, and most of her rapid weight gain and size increases occurred between 34-37 weeks, based on u/s estimates.

And I know, lots of people say that U/S weight estimates are notoriously inaccurate, but in my experience they've been pretty close for my babies.

Recipe/Tips: Taking a break from boring tuna I've found a pretty yummy curry chicken salad recipe.  Mix mayo, chopped celery, and curry with shredded chicken (I get pre-shredded from the deli because I'm lazy).  I put it in lettuce wraps, but you can use bread or other sandwich/wrap vehicles

Questions:

Monicagail1

allaire314 said:

Challenges: My fingers hurt... all the time... I'm only at a 2 on my device in terms of how far the needle goes - any lower and I'm not sure I'll draw enough blood for the reading.

Questions: At my appt last week I didn't see my regular OB, just one of the NPs in the practice. I asked about the possibility of reducing my testing since my numbers have been so good... and she said it wasn't very likely since we are so close to the end... has anyone else had really successful numbers and no leeway on testing?? I'm hoping when I see my regular OB next week and ask the same thing, she'll let me reduce, but that's another week and a half of 4 times a day... I'm so over it! **Sorry that turned into kind of more of a rant than a question!**

@allaire314

I've definitely been through the sore finger routine.  Are you rotating fingers for testing?  Using both sides of the finger (and not the pad, which will be more sore) on both hands?  Now I have almost the opposite issue though.  Several of my fingers are so callused from constant testing that I can hardly get any blood unless I use a super deep setting

Given that I'm now type 2 and on insulin for this pregnancy, there's no hope for me reducing the number of times I test (and I have the added bonus of 4 shots per day in the stomach, plus 4 finger pokes, lol).  However, even when I was GD in my first pregnancy, and had really good control with diet and exercise, I was never allowed to reduce my testing.  Stayed at 4x per day for the whole third tri.

Monicagail1

@shtjustgotreal

I'm glad that everything's ok, that you're not dilating, and your doc doesn't seem to be concerned about the contractions.  Personally I've not experienced any contractions except for BH before going into labor, and definitely nothing that would take my breath away.  So I can't say that I know it's normal or not.  But FX for you that all remains well!

Sienna516

Thanks for all the responses!!

@korpatch yeah i"m doing ketone testing 4 times a day. That has been negative for the most part (occasionally "trace" amounts). I see my dietitian this Thursday so I will bring up the levels to her. I didn't realize mine was so strict until I read this thread of other people testing after 2 hours and then I searched online and found that website I linked and was confused after I put all of this together why mine seems so strict. I can't imagine testing 7 times a day! Yikes! 
I wish I could do 1 hour after I finish eating my meal, then I wouldn't feel so rushed to eat.

allaire314

Monicagail1 said:

allaire314 said:

Challenges: My fingers hurt... all the time... I'm only at a 2 on my device in terms of how far the needle goes - any lower and I'm not sure I'll draw enough blood for the reading.

Questions: At my appt last week I didn't see my regular OB, just one of the NPs in the practice. I asked about the possibility of reducing my testing since my numbers have been so good... and she said it wasn't very likely since we are so close to the end... has anyone else had really successful numbers and no leeway on testing?? I'm hoping when I see my regular OB next week and ask the same thing, she'll let me reduce, but that's another week and a half of 4 times a day... I'm so over it! **Sorry that turned into kind of more of a rant than a question!**

@allaire314

I've definitely been through the sore finger routine.  Are you rotating fingers for testing?  Using both sides of the finger (and not the pad, which will be more sore) on both hands?  Now I have almost the opposite issue though.  Several of my fingers are so callused from constant testing that I can hardly get any blood unless I use a super deep setting

Given that I'm now type 2 and on insulin for this pregnancy, there's no hope for me reducing the number of times I test (and I have the added bonus of 4 shots per day in the stomach, plus 4 finger pokes, lol).  However, even when I was GD in my first pregnancy, and had really good control with diet and exercise, I was never allowed to reduce my testing.  Stayed at 4x per day for the whole third tri.

I was rotating fingers until I discovered the difference between my right and left hands... my left hand is consistently 20 points higher than my right (the right hand numbers seem WAY more reasonable due to what I ate), so I switch sides and fingers, but I have stuck to my right hand almost exclusively because 20 points is a HUGE difference. I guess I shouldn't look a gift horse in the mouth that I don't also need meds... gotta keep it in perspective!

AEG84

Huh, I guess I'm the oddball here - my OB office told me very specifically that the 2 hours starts from the time I take my last bite, not from when I start eating. I wonder why the difference? @Sienna516 maybe you can clarify that with your doctor as well?

Gestational Week: 33

Successes: numbers are still looking good. Dr didn't even look at my log last appt, just asked where my numbers are falling. Everything has stayed consistent (high 70s/low 80s for fasting, 80s after breakfast, usually around 100 after other meals), so even though baby is measuring pretty big she didn't seem concerned.

Challenges: It's actually a lot harder to remember to test consistently only twice a day, since the times rotate!

korpatch

I know the two hours from the first bite is pretty standard, but that is based on eating only taking 20min total. I asked my GD nurse what if I take longer... Like at a nice restaurant? She said I should try to eat within a 20mib period and on the rare occasion I can't, I can base the time on 20 min before the last bite... But I've never heard of two hours from the last bite!

@sienna516 I'm glad they are having you check ketones! Although I was told the only time it was accurate was first thing in the morning. It's amazing how all of this info everyone is getting is sooooooooooo different! I guess it all boils down to do we trust our doctors and believe they have us and our babies best interest in mind. I love my new OB and GD team! If you love and trust your team, stick with it... But I guess I would ask them why they do it the way they do. They might have a great answer and you can share it with us confused!

Sienna516

@korpatch I actually don't care for my OB that much, she was ok in the beginning, but certain things have bothered me about her along this pregnancy. I feel like she doesn't pay enough attention to details.
Just a couple of examples: Last time I was there she kept saying I was 28 weeks, and I was like no, I'm 30 weeks and then she told me he was measuring fine at 28 weeks and I corrected her again, but she said said he was fine and it was normal. Then she said she would order an ultrasound for the 10th to check growth. The thought just crossed my mind that maybe she looked at my birthdate (5/16) instead of my due date (5/6) which would have been 28 weeks instead of 30. She also told me I needed to get my DTAP shot and I told her I had already gotten that and then she saw that in my file after I told her..
she also seems really pushy towards induction and I really want to avoid induction if possible. I'd almost rather do a c-section than induction. The dietitian had seemed ok, but I'm a little irked about the strict numbers. I don't like that I have to phone call in my numbers for the week. I think they should have some online or email thing.
I'll definitely ask both my OB and the dietitian when I see them about the differences and let you guys know what they come up with for reasoning.

korpatch

Yes. I email my numbers every week, but some offices don't have a "secure" account to do that with.

Gosh. OB seems kind of scatterbrained or really busy! I know my OB recommends getting the dtap again at around 35 weeks or so even if you've had it recently because then it actually covers the baby when they are born. But again... I guess every office is different and I haven't had mine since I was 18... So I'm definitely due! Get it Thursday...

Sienna516

I had it the shot a little less than 2 weeks before that appointment.  Before that I was 13 lol, so I was way overdue prior to getting it. Idk what her deal is tho. Most appointments she seems really busy. Last time she was about to scoot me out the door and I was like wait I have questions for you! 

Sienna516

I talked to my dietitian today and asked about why their blood sugar ranges were so strict. She said they were actually going to be increasing their 1 hour test to be 130 & below as acceptable. She was very happy with my meals' blood sugar testing & said I had averaged around 100. She said we didn't need to meet anymore, but I still need to send in my blood sugar results. She said I could do by email if I preferred, which was nice. I asked if at any point I could go down to 2 blood sugar tests a day and she said that would be up to my doctor, asked who I had, and then said that my doctor wasn't one that typically allowed that . 

korpatch

Well... I guess keep the mantra of "only ----- more weeks" left. And it's worth it for the baby. I'm almost there!