Endo advice conflicting with OB - GD related

vrt235

I've been testing my sugars twice a day for 3 weeks now. They are almost always slightly high. Fasting is between 95-105 and 2hrs after a meal is between 120-135 My Endo did not put me on a diet. He is not concerned about my numbers at all (talked to him today) and says to continue as is. My OB thinks I borderline need insulin and he is making me go to a nutritionist on thursday so I can start a better diet. The endo thinks I do not need to see a nutritionist and I am fine. Whose advice do I follow here?

jenns123

The diet is a healthy diet so it can't hurt you.  Would your ob be okay with you doing the diet for a week or so to see if your sugars go down before starting insulin.  I think that is what I would want to do.

juliane2004

Your numbers look fantastic to me. I think insulin would/could make you drop too low. I'd stick with the Endo, since that's there specialty.

dennice79

juliane2004:

Your numbers look fantastic to me. I think insulin would/could make you drop too low. I'd stick with the Endo, since that's there specialty.

 

I disagree your numbers do not look that good and your ob is right to be concerned. Do you need insulin? that I can't tell you - but you definitely need to start controlling with the diet as your numbers need to be under 95 for fasting and under 120 2 hours after meals. It tends to be the farther you get along in pregnancy the worse the hormones effect the numbers. How where your glucose tests?

ilenegrace

Wow this is interesting for me to hear because my OB won't refer me to an Endo bc he says they are insulin crazy and always push it pretty hard. Although in the same appt my OB prescribed me insulin . When I asked about it he said the Endo would have me on it 4+ times a day and my OB 1-2 times per day. Anyways I agree that you should attempt to control your numbers with your diet first if your OB will let you. And also I am not 100% sure but I think once you are referred to an Endo they are supposed to manage your GD and your OB takes care of everything else. Maybe you should have your dr's clarify this since there is a conflict. GL!

jlh123

I'd follow the advice of your OB but let your OB know how they differ from the endo so maybe they can explain more as to why.  But from my knowledge, with regular diabetes, your numbers are fine.  But with GD, they want them even lower.  Not sure as to why but that's what was told to me by the dietician, peri and OB.

jen5-03

From what I've read, the numbers are fine for you, but maybe not good for controlling the baby's size.

As much as I hate the GD diet, I would go talk to the nutritionist. It's just a diet.

If it was a question of insulin/no insulin I would be more worried about the conflicting advice. And it's not like the endo would be worried if your numbers were a bit lower, and your numbers are just a tiny bit high from what my targets are (my GD targets are under 90 fasting and under 119 at 2 hours)

SuwaneeGirl

I'd be most inclined to follow your endocrinologist's advice since they are experts in diabetes management.

BUT... you do not need to be a referee. Have the two doctors do a case conference about your situation. That is their professional obligation.

Does your health insurance offer or sponsor a pregnancy management plan, where a nurse calls you to check on you during your pregnancy? If so, report this disagreement to the nurse. They can also organize a case conference on your behalf.

Bottom line is that the doctors need to arrive at an agreement at how to treat you.