GD check-in 10/6

paigep8 · October 2014

Yesterday was my first day on the diet and today I am totally depressed. I feel afraid for the next 73 days of pregnancy and what other things could pop up. I am not feeling satisfied with the food they have me eating. I met with a nurse practitioner, who I feel doesn't have extensive knowledge about GD. I am going to see a nutritionist to get additional information. They have me eating for my snacks a piece of fruit in the morning and the afternoon snack is 1 starch/bread, 1 fruit, 1 milk. I have noticed many of you are having peanut butter and celery or crackers, cottage cheese. Any other snack ideas? I am usually hungry in the afternoons so I would love suggestions on what others are doing.

Also, do your plans have a lot of milk on them? Mine has FIVE servings of milk a day! I drink almond milk and find this to be a challenge. I can sub yogurt for milk, but no other ideas are listed. That seems like A LOT of milk and yogurt to me.

bowlwoman · October 2014

@paigep8 Are they counting milk as one of your carb allotments for meals/snacks, or are they just trying to ensure that you get enough calcium? I rarely drink milk, but I eat cheese, use Greek yogurt in place of sour cream, and have some ice cream occasionally as a treat after meals. You don't have to count regular cheese as a carb, but you do have to count cottage cheese, ricotta, milk, and yogurt.

Definitely go to a nutritionist. S/he will be able to help you fine tune your diet for your lifestyle and baby's needs.

JKentW · October 2014

Feeling okay about this, nutritionist said I was being really strict with myself. Now just to get a hang of the meter.

pchung · October 2014

@paigep8 Wait say what?!? My NP told me that I cannot have milk. I am a big milk drinker since I gave up coffee. I almost cried in her office. I was told to only drink milk if and when I have to go on insulin and only when I have a low of below 70.

I am not liking that different practices are saying different things.

paigep8 · October 2014

I agree! I feel like there is WAY too much difference between one person's GD diet and another's. I am shocked there are no standard meal plans in place that we can't go by. Yes, FIVE servings...that is a ridiculous amount to drink on a daily basis. Yesterday, I skipped one serving and had two plain, lowfat yogurts, but two yogurts and two milks is still a lot.

paigep8 · October 2014

Two questions for all the GD ladies:

-do you know how high the fasting numbers have to be for them to consider meds? I do realize this will differ a little between practices.

-have any of you STM with GD experienced any of the listed side effects, such as pre-e, GD that turns into type 2, maybe that is too big or suffers from breathing issues after birth? Are these things more what can happen if it goes undiagnosed/untreated? TIA

erien · October 2014

@bowlwoman‌ I think you can best answer paigep8's questions:-)

bowlwoman · October 2014

@pchung That's kinda weird that your NP said you can't have milk. My office says if I'm below 60 (for any reason) to get some SUGAR sugar in my body ASAP. Like, candy, juice, soda, etc. No milk except on insulin and only under 70 seems very odd, to be honest.

We're encouraged to have three servings of milk/cheese a day, to make sure we're getting enough calcium. We just have to count any dairy that has milk sugar as a carb, so 1 cup of milk, 1 cup of yogurt, 1 cup of cottage/ricotta cheese = 1 serving of carbs (15g). But, don't forget that these dairy items also count as protein for meals/snacks. So, a cup of cottage cheese and an apple would be a perfect 30g carb snack, because you get the needed protein from the cheese. Same with a cup of milk and a graham cracker. Or a cup of yogurt with a bit of fruit or granola.

Are you seeing a nutritionist? This is the type of stuff that you need to see a nutrition specialist for. Most doctors/medical professionals don't really do a great job in this area, IMO.

@paigep8 Yes, I agree that there is too much latitude between the diets given out by different practices. I've used the same diet for all three of my pregnancies, and all my babies were perfect in terms of size and blood sugars after birth. Also, the practice I go to is happy to have you experiment to find out what your body can tolerate and eat based off more your own body's cues than strict adherence to a diet, if you can tolerate it.

For your questions:

Fasting numbers and meds depends on what your office's cutoff is. Mine is 95, but a lot of the other women here have to keep theirs below 90. Your doctor's protocol on meds may also be different. Some practices do metformin, some do glyburide, and some do only insulin.

This is my third pregnancy with diabetes. I have PCOS, and I've been on metformin since 2005 to treat those symptoms. PCOS also makes me twice as likely to develop GD during pregnancy, which I did with both girls (8 and 6 years ago). I had no problems with blood pressure, pre-e, etc. Other than the GD, things were great. I was induced with both girls because of the GD, and delivered both vaginally with no complications, and they were both just at 7 pounds. About two years after DD2, I had a high A1C and fasting blood glucose (128), so my doctor declared me type II and I went on some injectible meds that had just come out. Since then, I've just been on the metformin, and all of my blood sugars and A1C tests have been completely normal. So, technically, I'm one of those who did develop type II after pregnancy, but I also had some mitigating factors (PCOS, back to back pregnancies, etc.)

bowlwoman · October 2014

erien said:

@bowlwoman‌ I think you can best answer paigep8's questions:-)

Yes. I know way too much about this stuff.

pchung · October 2014

@BrittP10 I am hoping it is hormones because I have had the same issue with eating the same thing and testing different the next day.

erien · October 2014

@paigep8 Wow, that's a lot of milk! Cow's milk spikes my sugars too much so I only do one glass per day and that's usually at bedtime. Unsweetened almond milk wouldn't have the carbs but I could never drink that many glasses in one day! Most of my calcium comes from cheese and yogurt. And I need more variety than being forced to eat 5 servings of the same thing every single day! I hope your nutritionist agrees you can have more variety in your diet to get the recommended calcium/dairy.

I do not know what my doc's cutoff is for fasting. I have been in the 70's my whole pregnancy so it hasn't been an issue. 90-100 seems to be typical.

Along with Bowlwoman, I am also a GD vet. The only thing that could have possibly been related to GD with my first is high fluid level. Not alarmingly high to cause concern for the baby's health but I was definitely measuring big and uncomfortable. My fundal height is measuring normal this time so that's why I attribute the high fluid level to GD. I have been controlling my diet this time around since the late first trimester. From what my doctor told me, GD patients can have higher than normal fluid levels because the sugar concentration in the amniotic fluid is high so the body adds more fluid to dilute the sugar.

My son was born at 37w5d. Given my GD diagnosis, I was concerned about what I had read about lung immaturity, especially in boys. However, he didn't have any problems. And like you mentioned, many "complications/side effects" are more prevalent with uncontrolled diabetes. I delivered vaginally with no blood sugar issues for either of us after delivery.

bowlwoman · October 2014

@BrittP10 Yes, that happens to me quite frequently. My MFM said it's most likely hormones. Or, it could be other factors such as not enough sleep, stress, adrenaline, etc. My nutritionist said they take those types of things into account if you have a weird one-off number. It's a systemic problem or pattern that they tend to look for, not a weird one-time spike due to something weird.

bayareagirl2011 · October 2014

paigep8 said:

Yesterday was my first day on the diet and today I am totally depressed. I feel afraid for the next 73 days of pregnancy and what other things could pop up. I am not feeling satisfied with the food they have me eating. I met with a nurse practitioner, who I feel doesn't have extensive knowledge about GD. I am going to see a nutritionist to get additional information. They have me eating for my snacks a piece of fruit in the morning and the afternoon snack is 1 starch/bread, 1 fruit, 1 milk. I have noticed many of you are having peanut butter and celery or crackers, cottage cheese. Any other snack ideas? I am usually hungry in the afternoons so I would love suggestions on what others are doing.
Also, do your plans have a lot of milk on them? Mine has FIVE servings of milk a day! I drink almond milk and find this to be a challenge. I can sub yogurt for milk, but no other ideas are listed. That seems like A LOT of milk and yogurt to me.

I also had low papp-a in my first tri screening. Didn't realize there was a correlation between the two, but the low papp-a has me freaked out already. Our genetic screening also came back fine. I thought I got GD because my dad and grandma have it.

It will get better - the first week or so was ROUGH for me. I haven't been super emotional this pregnancy but I swear I cried a few times and pretty much felt just kept sorry for myself. The second week gets better. A few things I've enjoyed - whole wheat waffles (trader joes has some good ones) with peanut butter, the so delicious mini ice cream sandwiches I can have as well as a treat, steel cut oatmeal with nuts, cinnamon and almond milk. It will take some time to get used to it, but just keep telling yourself that it's temporary! Once you get it down, it's not horrible.

JKentW · October 2014

1st fasting reading this morning 101. Hope this gets better

paigep8 · October 2014

Thanks for your suggestions! @bayareagirl2011‌ How are your growth scans? Is the Papp-a acting up? I think it's funny that I'm being monitored for a small baby and now a bug baby. Jeez.

bayareagirl2011 · October 2014

paigep8 said:

Thanks for your suggestions! @bayareagirl2011‌ How are your growth scans? Is the Papp-a acting up? I think it's funny that I'm being monitored for a small baby and now a bug baby. Jeez.

paigep8 - I've gone to the MFM every month since I was 18 weeks for growth scans. Baby has always measured about a week or so ahead, up until about 27 weeks. Now, she's measuring closer to 1.5 weeks ahead. I was concerned it was GD, but my MFM doesn't think it is, since all 3 measurements (abdomen, head, and femur) are measuring the same. She said that a big abdomen measurement, but short femur or smaller head was somewhat common in GD babies. Agreed, it was definitely a change, worrying my first and second tri about IUGR, and then my 3rd about having a baby too big. Thank goodness we are towards the end!

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