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GD+ & Low weight gain

Kylynara SunKylynara Sun member
in High-Risk Pregnancy
I haven't participated on here in forever, and I'm getting worried about something and am hoping to get some answers.  The short version is that I'm on a very restricted diet right now due to several complications and I'm losing weight.  I'm 30 weeks along and I had gained 9 lbs, but since I've had to change my diet a couple weeks ago, I've lost 4.  

Long version, When my older DS was born, my placenta came out white and that gave them the clue they needed to find what was wrong. My triglycerides were off the scale, so somewhere over 4000.   I also had pancreatitis and gall stones.  Some of the doctors thought that the gall stones caused the pancreatitis which in turn caused the high triglycerides.  One thought that it was more likely I had high triglycerides that caused the pancreatitis and gall stones.  I had my gall bladder out 4 months postpartum.  About 11 months postpartum, following a cholesterol check (once I wasn't pregnant my numbers dropped and remained normal.) they found that I had elevated liver enzymes.  They haven't determined the cause, but they were just borderline high.  They dropped again a few months later.  That was all in 2011.

Now I'm pregnant (30 weeks as stated above) with my second one.  We found in December that my triglycerides are going up again.  (They were almost 400 in November and nearly 700 a month later in December.)  I was put on Niacin, which is the only thing you can use to treat high triglycerides during pregnancy.  At the end of January I had my GTT and failed.  Before I could do the class on GD (about 2 weeks after the test) I had a monthly liver enzyme check come back high.  It's believed that the Niacin is causing the liver enzymes to elevate, so I've been taken off the Niacin.  I've been on the GD diet for about 2 weeks now.  I was already eating low fat due to the triglycerides and have continued.

I started my pregnancy about 4-5 lbs. overweight at 144.6.  I lost 8 lbs in first trimester, gained 17 back for a net gain of 9 since the start of the pregnancy, but I've now lost 4 of those again.  I'm up about 5 pounds for the whole pregnancy.  Any ideas on how to gain more weight?  The only thing I can eat more of is vegetables, and only at mealtimes, and I'm already finishing mealtimes feeling absolutely stuffed to the gills.  I can't cut exercise since it's needed to help control the GD and triglycerides.  I can't add fat, protein, or most carbs because it would interfere with the balance I need for the GD/triglycerides.  I know it's horribly dangerous to be losing weight at this point, or to end my pregnancy with such low weight gain.  I just don't know how to fix it.

I see the perinatologist Wednesday morning and will certainly ask him and his diabetes nurse about it then, but I don't feel right doing nothing in the meantime.
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Re: GD+ & Low weight gain

  • angelsnightangelsnight member

    I really know nothing about your other issues with the triglycerides, but it's fairly common to lose weight on the GD diet.  Granted I was about 60 pounds overweight prepregnancy, but I've lost 10 lbs since my BFP due to the diet (I was diagnosed early) and morning sickness.  I have since gained back about 8 of those pounds, but I am still under my BFP weight, so at almost 37 weeks, I've gained nothing.

    I think you'll be fine till you see your peri on Wednesday, and if they don't give you the answers you're looking for, I would see if you can visit the nutritionist again.  But from what I have heard, the baby will take what it needs from you....I don't think you need to worry about your baby not getting the nutrition it needs, and again, I am not familiar with your situation, but I wouldn't say it is horribly dangerous to lose weight at this point unless you were too thin to begin with, which it doesn't sound like the case.

    Lilypie - (fm2j)

    Lilypie - (YesX)

     My Pregnancy/Parenting BLOG TTC since 5/2011, BFP #1 12/3/11, M/C 12/7/11 @ 4wks 2d. Began seeing RE Sep 2012. October 2012 Metformin 1500 mg= ovulation on CD34 BFP#2 11/14/12 9DPO, EDD 7/26/13, DX Gestational Diabetes @14 wks, our angel born sleeping 3/24/13 @ 22wks 2d. BFP #3 7/4/13 8DPO EDD 3/22/14, DX Gestational Diabetes @14 wks. started insulin @16 wks.  Our rainbow, born 3/19/14 @ 39wks 6d., we're so in love!

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  • RrrrrachelRrrrrachel member
    Yeah I'm wondering if your doctor is concerned about weight gain or you're just worried about it. Unless you started underweight I suspect it's not a big deal and I wouldn't worry too much about it.

    And the gd diet sucks enough on it's own, I can't imagine combining it with your other issues!
    Mama to a little girl born July 2011 and a little boy born April 2014! Baby Birthday Ticker Ticker
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  • stephl3055stephl3055 member
    Are you testing for ketones?  I had to test for about a week after my GD diagnosis.  Once I stopped seeing a positive number on the strips I was allowed to stop testing.  My dietitian told me they did not want me losing weight, but wanted to control the rate and amount I did gain.  I was diagnosed at the typical 28 weeks.  I gained 19 total, but I'm guessing I lost some at the beginning like most people do.  

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    LO then (2 days) and now (1 year)     Baby Birthday Ticker Ticker
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  • ah625ah625 member
    They weight you're losing is fat reserves because of the low carb diet plus you're active. That's totally expected. 
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    Lilypie Second Birthday tickers
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  • haziedazehaziedaze member
    How is baby's growth? Honeslty it sounds like a very complicated/difficult balance to obtain so if your doctor's at all worried you should really be seeing a nutritionist regularly who can help you meal plan, etc. Why do you have to limit protein? That seems like the one thing that would help both diagnoses and give you some good nutrition. I'm loving having shakes for a bedtime snack. We do some with coconut milk and others with part skim cottage cheese. You'd have to watch the fat content, but that might be a way to pack in more protein/calories if you can.
    BFP#1 9/14/10 (EDD 5/21/11); no fetal pole 6w6d, 7w4d, d&c 10/8
    BFP#2 3/16/11, beta 138; 4/12 Baby/HB DS born 9/10/11 at 29w4d due to partial abruption and PTL
    Lilypie Third Birthday tickers
    BFP#3 8/19/13 Another boy! 17P, modified bedrest and Nifedipine helped us have a termie! DS2 born 4/19/14 at 38w5d.
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  • Kylynara SunKylynara Sun member
    edited February 2014
    Thank you all for your comforting responses.  I saw the doctor today and he said that it was normal and common and they aren't concerned.  He said unless I'd started the pregnancy weighing 90 lbs or something ridiculously skinny it's not a concern and people lose weight on the GD diet all the time.  They are already watching the baby's growth and weight gain closely, because of the GD, so they'll know if the baby is not growing as it should be.  Also he said because my numbers have been good and I'm getting hungry before meals I can have an extra half carb at morning and afternoon snacks.

    I know that a lot of general pregnancy stuff I've read has said that it's dangerous to gain less than 15 lbs. during your pregnancy and that is why I was concerned.  Some Googling told me that it can result in low birth weight babies and pre-term labor is the danger.  Also my OB, had expressed some concern with my weight gain earlier on.  She was happy with how I was doing weight-wise at my last couple appointments, but the GD stuff has all happened since I last saw her.  (I see her again tomorrow.)

    As far as limiting protein, that's a kind of a process of elimination thing.  The GD diet info they gave me says 7-10 oz. per day.  It also specifies 1-2 servings per meal and 1 at each snack.  The vegetable information says 5+, fill up on as much of these as you want, so I took that to mean they don't want me getting too much protein.  Also, it's difficult to find protein that has neither fat nor carbs in it.  And to cram in more protein without disrupting the other things, I'd have to have something that is non-fat, non-carb.

    They did not have me test for ketones. However they have been very happy with how in control the diabetes is for me.  I'm finding that in a lot of ways the GD diet is something of a relief for me.  It's enough work to keep my mind from dwelling too much on my other worries and it's something where they know what they are dealing with and how to treat it and I can just follow orders.  The other stuff is unknown waters for everyone.  The Perinatologist (who's nearing retirement) said he's only seem maybe 5 cases in his career with the cholesterol issues.  It's too rare for there to even be much research on it let alone any consensus on how or even if to treat it.  It's really quite scary and having something where I know what to do and can focus on doing it, has really been a blessing in an odd way.  I've been on a low fat diet for 3+ years now, so I'm pretty good at substitutions, healthy fats, finding low-fat/fat-free options.  I'm specifically counting my fats now because I feared I was going too low (and I am usually).  I'm having to do some tweaking to get the right balance.
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