GD check-in 9/15

nopegoat · September 2014

OK another newb question. Is it normal to be diagnosed with GD and sent directly to an endo or usually does that come later?

My appt. Thurs is with an endo and I thought it was a normal nutrition/monitor appt. but a girl on an off board mentioned it might be more?

bowlwoman · September 2014

I never got sent to an endo with GD. I went after I got my type II diagnosis, but then my regular family doctor handled everything after that appointment.

I only went to the perinatologist/MFM when pregnant.

Cheekers2010 · September 2014

kdm06c said:

OK another newb question. Is it normal to be diagnosed with GD and sent directly to an endo or usually does that come later? My appt. Thurs is with an endo and I thought it was a normal nutrition/monitor appt. but a girl on an off board mentioned it might be more?

I'm not sure what's normal because I was sent to a nutritionist for my first appt, but IMHO the endo is much better. They can give you all the info you need and monitor you the best.

nopegoat · September 2014

OK so my OB could just be just being proactive right? I am seriously so confused now and completely kicking myself for not asking more questions when I called.

bowlwoman · September 2014

It may also depend on your OB's preference/training and what resources are available in your area. In Austin almost all of the OBs send their GD patients to the same perinatology group.

Cheekers2010 · September 2014

kdm06c said:

OK so my OB could just be just being proactive right? I am seriously so confused now and completely kicking myself for not asking more questions when I called.

Probably. Honestly, I think it's best. I had to wait for weeks before I could see the nutritionist to get my monitor and then she was so unhelpful. It was a major pain in the butt and in the meantime, I just floundered around not knowing what the heck I was doing. I'm sure it doesn't mean anything as far as your results. No doubt it's just how your OB likes to do things.

bowlwoman · September 2014

Do those of you going to an endo also go to a MFM/perinatologist? We have one stop shopping there, for nutrition counseling, nonstress tests, ultrasounds, etc.

BdblZ · September 2014

@bowlwoman or @erein (or anyone else with previous GD experience) - Any ideas on why my fasting morning sugars are high (target of 90, but can't seem to get below 100), but by 2hr post meal readings so far seem to be fine (under the 120 target)? I'm not eating anything crazy for my evening snack either. I've only been testing for 3 days so far, and am not due to send my numbers in until Monday for feedback from the doc...just looking for ideas of what I could do in the meantime.

#lovingmyplacentalhormonesrightnow

bowlwoman · September 2014

BdblZ said:

@bowlwoman or @erein (or anyone else with previous GD experience) - Any ideas on why my fasting morning sugars are high (target of 90, but can't seem to get below 100), but by 2hr post meal readings so far seem to be fine (under the 120 target)? I'm not eating anything crazy for my evening snack either. I've only been testing for 3 days so far, and am not due to send my numbers in until Monday for feedback from the doc...just looking for ideas of what I could do in the meantime.

#lovingmyplacentalhormonesrightnow

@BdblZ I'm having the same problems with my fasting numbers, and mine only have to be 95 or below. They're running 98-105, currently. The dietician last week said it could be because I'm not eating enough of a bedtime snack, so overnight my body is surging and dipping too much, which makes my fasting numbers high. And yes, if I eat enough to count for a full meal at bedtime, then my fasting numbers are usually ok, but then the rest of my numbers are off for the day, especially breakfast. With DD2 I had to go on meds to keep my fasting numbers down, so that looks like what I'm headed for this time. I wish I had better advice for you, because then I'd have my shit all figured out too.

BdblZ · September 2014

@bowlwoman - Thanks! I'll try eating a bit more, and see how the rest of the week shapes up.

bowlwoman · September 2014

BdblZ said:

@bowlwoman - Thanks! I'll try eating a bit more, and see how the rest of the week shapes up.

During my her pregnancy, my best friend was type II and had to have an insulin pump connected 24/7. She had to set her alarm at 3am every night to wake up and eat something to keep her numbers from getting wonky. I'm so thankful I don't have to go that route.

BdblZ · September 2014

bowlwoman said:

BdblZ said:

@bowlwoman - Thanks! I'll try eating a bit more, and see how the rest of the week shapes up.

During my her pregnancy, my best friend was type II and had to have an insulin pump connected 24/7. She had to set her alarm at 3am every night to wake up and eat something to keep her numbers from getting wonky. I'm so thankful I don't have to go that route.

@-) Oh dear! I couldn't even imagine! Although on my sugar charts, there is a column for a 3AM reading, which I think they have you do if you go on meds. I really, really, really hope I don't need to do that. I have a hard enough time waking up at my usual 6AM!

bowlwoman · September 2014

BdblZ said:

bowlwoman said:

BdblZ said:

@bowlwoman - Thanks! I'll try eating a bit more, and see how the rest of the week shapes up.

During my her pregnancy, my best friend was type II and had to have an insulin pump connected 24/7. She had to set her alarm at 3am every night to wake up and eat something to keep her numbers from getting wonky. I'm so thankful I don't have to go that route.

@-) Oh dear! I couldn't even imagine! Although on my sugar charts, there is a column for a 3AM reading, which I think they have you do if you go on meds. I really, really, really hope I don't need to do that. I have a hard enough time waking up at my usual 6AM!

It may just be insulin, because I was on glyburide during both girls' pregnancies and never had to get up to eat in the middle of the night. Or maybe just because my numbers were fine on the initial dose of glyburide (2mg) and I never had to increase it to keep my numbers ok.

erien · September 2014

@BdblZ‌ Having fun yet? Ditto what Bowlwoman said. Fasting numbers are the most difficult to control but eating more carbs at bedtime can help. I've heard ice cream works great:-) I'm on metformin so I have never had fasting issues. Women who go on meds often do because of their fasting numbers, not post meal numbers. Like I said, it's difficult to control.

aksue22 · September 2014

bowlwoman said:
Do those of you going to an endo also go to a MFM/perinatologist? We have one stop shopping there, for nutrition counseling, nonstress tests, ultrasounds, etc.

I've only been to the MFM doctor. They never sent me to an endo. MFM monitors my levels every week.

CandaceC1020 · September 2014

Hi ladies!

I'm technically not GD since I passed my bloodwork, but I had an appointment with my midwife today where she told me that my numbers were higher than they would like them to be and she wanted me to switch to a DG diet to be safe.

I'm currently 27w5d. I've only gained 11 pounds so far in my pregnancy. I don't eat a lot of sweets, but I haven't paid attention to the carbs and sugars in each food. Since I'm not technically GD, I won't have medicine or a machine to monitor my blood sugars and will not have visits with a nutritionist.

Has anyone found a good website that has a good run down of the rules and guidelines? I've been searching this am but everything that I find has a little of this and that, but not completely comprehensive.

bowlwoman · September 2014

@CandaceC1020‌ I'll see if I can find my diet info. It's been so long that I'm not sure where the paperwork is.

CandaceC1020 · September 2014

@bowlwoman - That would be awesome if you can find it!

bowlwoman · September 2014

@candacec1020 Still looking for the diet. I know I had scanned it in from before on my old computer, but I can't find the power supply for it. I'll see what I can come up with, though.

Well, they did decide to put me on meds, so no big surprise there. I don't have to start the weekly NSTs and BPPs until 32 weeks, though, so another month until I'm going every week.

nopegoat · September 2014

Had my endo appt. today. They are sending me to a nutritionist in the next week or so. I got my meter today though and have to stick myself 6 times a day and keep a food log which is faxed in once a week. Oh man this is fun stuff.

bowlwoman · September 2014

@kdm06c Six times a day. Sucks. Sucks. Sucks. What are the six times? Most of us only have to do four times: waking/fasting, then two hours after each meal. Do you have to do a bedtime test as well?

The food log isn't that bad, honestly. I downloaded an app on my iPhone that is pretty awesome. It cost me $6, but it's worth it, and I can generate a report that sends all my food intake, exercise, and sugars out in either a spreadsheet or PDF. If you're interested, I can send you the info.

nopegoat · September 2014

@bowlwoman‌ she said to check it before and then 1hr after each meal (breakfast, lunch, and dinner) so 6 total checks.

Sure! What's the app called? I have an android, but will see if they have it for my phone. They gave me these "fancy" handwritten charts and honestly they are embarrassing lol.

bowlwoman · September 2014

@kdm06c Here's the website of the company:

https://www.coheso.com/diabetesmanagement-app

I use the other one, the Diabetes in Pregnancy app, but it looks like it's only available for iPhone. This one, from the screen shots I could see, looks to be more or less the same as the one I'm using. There may be a few different functions, but it looks almost identical.

There were a few times that the food I wanted wasn't in the database, so I just added it from the labels. And, on my app, there isn't a way to input ingredients for an entire recipe and then give you the nutrition info for just a serving, so I used the MyFitnessPal app for that and then just input the 1 serving size information into the diabetes app.

nopegoat · September 2014

Thank you @bowlwoman‌ checking it out now.

Emilysan16 · September 2014

Just got my results back. Failed.

I'm 25.2 weeks along.

I pick up my meter tomorrow and was told I would prick myself 5 times a day.

Honestly, I have felt great. Some heartburn,but that's it really lately.

I do have a question about my test results. Did anyone have a higher 3rd hour reading than at the 2nd? My 3rd draw was 13 higher than the previous. Just seeing if I'm a freak or other people had this happen!

GTKY- I'm a FTM, so this is all new to me. I have issues processing sugar before baby, so I'm not surprised that I have trouble now, though.

bowlwoman · September 2014

@Emilysan16 Sorry you failed, but welcome to the thread. For DD1 my numbers followed the curve of fasting: normal, 1 hr: super high, 2 hr: super high, 3 hr: normal. For DD2, they were fasting: high, 1 hr: super high, 2 hr: higher than 1 hr, 3 hr: normal. Needless to say, I failed both times. I didn't take the test this time because I am type II.

Emilysan16 · September 2014

@bowlwoman My fasting was okay. 1 hr 202, 2 hr 167, 3 hr 180. When I got the call, I asked why I jumped up on the 3rd. She just acted surprised I asked and said my body was abnormal. I just get frustrated with the office. I didn't know about making sure you ate carbs 3 days before until I started looking online. They didn't mention it at my appointment. I feel very ignored there. BUT thank you for letting me know that someone had their number drop then raise!

nopegoat · September 2014

OK so probably a stupid question but I have a hard time sticking to a schedule, eating 3 full meals, and then snacks. Anyone care to share their eating schedule?

Also she told me to test before and after every meal. But if I throw in a snack between meals won't that mess up the number before? I had a glass of milk as a snack today and my starting number was a little higher than it was suppose to be.

So many questions. Sorry.

ETA: I also got my actual numbers from my 3hr. Fasting-86 1hr- 216 2hr-194 3hr-94.

erien · September 2014

@kdm06c‌ My schedule is breakfast at 6:45. Snack at 9:15 (often a second one at 10:15). Lunch at 12:00. Snack at 3:30. Dinner at 6:00. Snack at 9:00.

I've never monitored before all meals but its just more "data points" if your levels are high. For example, you mentioned a higher premeal number today. If your post meal number were abnormally high for what you ate you could contribute that to your levels being elevated prior to the meal. But, honestly, I've never heard of testing 6 times a day. If the trend continues, you'll need to either space out your snacks and meals more or alter your snacks. But milk is a good snack so don't change that.

Don't skip snacks!

nopegoat · September 2014

Thanks @erien‌!

My Dr said that my before meal numbers should be between 60-90 and 1hr after should be less than 120.

So far today before lunch was 81 after was 114. Had a cup of milk about 45mins-1hr before dinner and my numbers were 93 before and 99 after. So not too far off.

My serving size/carb count was off though. Dang pasta. We are going grocery shopping tomorrow for more GD friendly meals so I am hoping the diet gets a little easier for me.

bowlwoman · September 2014

@kdm06c‌ That protocol seems very strict to me, IMO. Almost all women I know who have had GD follow the 4x testing protocol and the numbers need to be 120 TWO hours after meals. Usually if you test one hour after, it's supposed to be 140.

Your doctor is making the call, but just FYI in case you get questioned about it.

nopegoat · September 2014

I have never been through this before @bowlwoman‌ and I thought it was a bit much. I have a follow up in 2wks so I am going to continue to try and do what she said for now, but I will probably ask about it then.

Another question. How many grams of carbs are you allowed per meal and snacks?

bowlwoman · September 2014

@kdm06c‌ @CandaceC1020‌

Here's my diet breakdown:

Breakfast: 15-30g carbs, 1-2oz protein (no fruit before lunch)

Morning Snack: 15g carbs, 1-2oz protein (no fruit before lunch)

Lunch: 45-60g carbs, 3-4oz protein

Afternoon Snack: 30g carbs, 2oz protein

Dinner: 45-60g carbs, 3-4oz protein

Bedtime Snack (eat within an hour of bedtime): 30g carbs, 2oz protein

Carbs I have to count toward my allotment:
all grains
all fruit
corn, potatoes, sweet potatoes, beans, peas, carrots and beets over 1/2 cup
milk, yogurt, ice cream, cottage/ricotta cheese
all sweeteners (honey, agave, sugar, maple syrup)

CandaceC1020 · September 2014

@bowlwoman - YOU ARE AWESOME!! Thank you for posting this. This reinforces the information that I found yesterday while searching the interwebz for GD info.

bowlwoman · September 2014

@CandaceC1020‌ You're very welcome.

oh, and serving sizes: generally 1/2 c of grains, veg, and fruit = 15g carbs.

Exceptions to equal 15g carbs:

1 c dairy
1/3 c rice
1 c berries
1 c cut melon
1 med/fist-sized uncut fruit (apples, oranges, peaches, pears, etc)
15 grapes

erien · September 2014

I have similar carb/protein targets but I have to eat more protein than that to be satisfied. And I need two morning snacks which I ok'd with my dietician.

My target last pregnancy was 120 one hour after meals. That is very strict and explains why I got very overwhelmed with the diet and occasional high numbers. I am much better educated this time and realize how strict that was. At the same clinic this time its 130 after one hour or 120 after two hours. I try to stick to the one hour target.

bowlwoman · September 2014

I generally eat more protein too. Those are the max carb and min protein values, basically, that you need to stick to to keep the sugar absorption as even as possible And fats aren't really even addressed, which also help slow down the absorption of carbs into your system.

Oh, and no fruit before lunch. Which means I eat a lot of weird veggies for breakfast because I don't like eggs and the gluten free alternatives for breads and stuff usually spike my sugars.

nopegoat · September 2014

Thank you so much @bowlwoman‌.

My endo said 30g of carbs for meals and 30 for snacks. Smaller portions and balanced plates.

I'm hoping I get a little more direction with the nutritionist soon.

bowlwoman · September 2014

kdm06c said:
Thank you so much @bowlwoman‌.

My endo said 30g of carbs for meals and 30 for snacks. Smaller portions and balanced plates.

I'm hoping I get a little more direction with the nutritionist soon.

Good luck, and I hope the nutritionist loosens up the reins a bit.

bowlwoman · September 2014

Well, the meds seem to be working. My fasting this morning was 85.

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