GD Check-in 1/6

PikoPiko · January 2015

Hit it, girls!

How many weeks?
Treatment/Regimen?
Any changes, updates, burning questions?
QOTW: What did you aspire to be when you were a kid?

PikoPiko · January 2015

How many weeks? 34 weeks

Treatment/Regimen? Still 4x a day testing, diet

Any changes, updates, burning questions? Been sick. Haven't really been checking my glucose level except for the morning fasting one. I sip liquids throughout the day sporadically. I called the dietitian today, she advise that I start on some carbs like toast, apple sauce, bananas and not worry about the diet til I'm recovered.

QOTW: What did you aspire to be when you were a kid? I wanted to be a flight attendant. We used to fly a lot back then, my dad did business all over the world and he sometimes would take me along if I was healthy enough. Flight attendants back then were way friendlier and would always have treats and toys goodie bags ready for kids. The jet setting lifestyle seemed so glamorous to kiddo me. Now as an adult that travelled internationally monthly, I actually dislike air travel.

DBride2006 · January 2015

How many weeks? 35 weeks
Treatment/Regimen? Diet, texting 4x per day

Any changes, updates, burning questions? Numbers have been really good (one high post-meal number in 3 weeks), but fasting may be creeping up. My nutritionist confirmed I was on insulin by 30 weeks last time, so I'm pretty excited to be at 35 with no insulin. But I have a hunch it may come in the next week or so.

QOTW: What did you aspire to be when you were a kid? A pediatrician or a veterinarian. I spent 5 years doing Market Research and now I manage a Ranch event venue. Not even close.

CatLadyTX · January 2015

Howdy!

34+2

Testing 4Xdaily, glyburide at dinner

My numbers are still a little nuts, but my OB is hesitant to change my medication. I've had a few very low lows, so increasing my meds makes her nervous because she can see that my body can stay low naturally. She doesn't want me to have too many lows, or go too low when I do. Just to be safe, she ran my A1C last week, and it was good. I feel better, and I'm stressing a lot less now that I've talked to her about my concerns and have had more bloodwork.

When I was a kid, I was going to be an astronaut. Specifically, a Shuttle Commander. I even went to Space Camp 6 times (nerd alert:it is where I met my husband). Later, I found out I was too short for the job, so I decided I wanted to be Flight Director. Apparently I had a massive desire to be in charge of everything.

FlutterOfYoshis · January 2015

How many weeks? 34w, 1d
Treatment/Regimen? testing 4x/day & diet
Any changes, updates, burning questions? Baby was breech last u/s. Hoping she doesn't stay that way--she does seem to be flipping. Got a tdap shot yesterday and man does that make your arm sore!
QOTW: What did you aspire to be when you were a kid? I always wanted to be too many things: astronaut, nurse, vet, writer, the next Bruce Lee, etc. It's kinda interesting to me that the things I apparently wanted to be first (age 4: a mom & age 5: a teacher--according to my mom's memory book for me) are the things that have followed through.

EAng · January 2015

33w+3d

Test 4 x's/day. Diet + 500 mg Metformin.

Start weekly BPP's next week. C/s scheduled for 2/19.

CantoDeAmor259 · January 2015

How many weeks? 33 and 2 days Treatment/Regimen? Testing 4xs a day and glyburide before bed Any changes, updates, burning questions? Meh same ol stuff. I found a vanilla Greek yogurt that only has 13 carbs for a 1 cup serving, that pretty much made my day! I stopped writing down all my food, no one ever wanted to look at I so I didn't feel like taking the time to do that anymore haha. Starting to feel like I'm finally hitting the "home stretch" as baby is head down and putting lots of pressure and I'm just overall very uncomfortable now. QOTW: What did you aspire to be when you were a kid? A writer, always had my nose in a book.

Elmo1414 · January 2015

How many weeks? 35 weeks

Treatment/Regimen? Testing 4x a day

Any changes, updates, burning questions? My number have been getting higher, but called my diabetic clinic and they said they are still fine as long as it doesn't seem to be a consistent thing. Also not allowed to reduce my carbs at all as it is causing ketones when I do.

QOTW: What did you aspire to be when you were a kid? I was all over the place. But a vet was one I can think of.

CantoDeAmor259 · January 2015

@Ellteejay‌ it's the dannon light and fit brand, the Greek vanilla has 13 carbs vrs the reg vanilla that has like 19 I think. I bought the big tub, apparently the little cups only have 9 carbs

Apparently they make a carb and sugar controlled one for diabetic people that only has 3 carbs per serving, but I have yet to find it in a store.... https://www.lightandfit.com/light-yogurt/carb-and-sugar-control/strawberries-and-cream

HailsMom · January 2015

35-1

Testing 4x day and glyburide at bedtime

The past 3 mornings my sugar has crashed between 3-5. I wake up and feel shaky and just can't get back to sleep. I finally check it and it's been in the 50's-low 60's. I'm thinking about skipping the pill tonight and seeing how my numbers are in the morning.

I wanted to be a vet until I realized that i wouldn't be able to advise people that they should put an animal down. Then I wanted to be a zoologist. Now I work in a drs office - close enough to a zoo!

CatLadyTX · January 2015

@HailsMom‌ are you having enough protein at snack before bed?

PikoPiko · January 2015

@Hailsmom when you hit a sugar low like that, did your dietitian tell you what to do?

I don't want to give you bad info esp that I'm not on meds, so you should definitely call your dietitian and ask if you guys haven't discussed about how to deal with hypoglycemia. Just to share what's written in the info packet I got and verbally reinforced by my dietitian, I need to consume 15g of fast acting carbs (half a banana, milk, juice etc) immediately and retest in 15 mins to ensure it goes back to the 70-90 range. If it doesn't work, eat another 15g and retest after another 15 mins. I struggled with hypoglycemia in the morning most part of my life, it's not something to tough out on, could be dangerous.

I hope you have better success tonight!

foxslaw · January 2015

I swear by plain nonfat greek yogurt. So good!

HailsMom · January 2015

Well the experiment with not taking the glyburide failed last night. I woke up with my sugar at 94. Once again, just over the line.

@CatLadyTx yeah, I have been doing either string cheese or peanut butter crackers when I take the pill.

@pikopiko I don't have a dietician, but when I spoke with my endocrinologist about the low numbers last week she wasn't too concerned with how low they were - and told me that the glass of milk I have been drinking is a good way to treat the situation. (I knew about milk forhypoglycemia from my medic days)

I guess I will be going back to taking the glyburide, but maybe eating a little more with it. If my number is real low again tomorrow, I will talk to the OB about it at my BPP tomorrow afternoon. The endo, said she thought I might be able to get a 1.25mg pill to cut in half so we could try that instead of my taking half of a 2.5mg one. I will see how tomorrow goes and what the Dr says.

Allie429 · January 2015

PikoPiko said:
Hit it, girls!

How many weeks?
35 + 5
Treatment/Regimen?
diet, checking 2-3 times a day
Any changes, updates, burning questions?
I have an ultrasound to check size then follow up after tomorrow (Thursday). Interested in what hey have to say with my sugars so I shall wait and see!
QOTW: What did you aspire to be when you were a kid?

Teacher

nyclo · January 2015

1. 32+5

2. Testing 4x a day. Experimenting with bedtime snack / nighttime snacking... glyburide now on the horizon?

3. Second growth scan -- fetus is still at 49th percentile (50th 4 weeks ago) and head/abdominal circumferences are fine as is their ratio.

The diabetes/high risk attending this week completely disagreed with the attending last week (who prescribed me insulin for his convenience and his prediction that my numbers would go up). She said she didn't think I needed to be on meds right now, but doesn't quite know what to do with me.

My fasting numbers are a bit high (somewhere between high 80s and high 90s), which she finds surprising because when I took the 3-hour glucose test, my fasting number was fine, but my post-glucose numbers were way up, suggesting it would be the post-prandial numbers that I have a hard time with. But those numbers are always within range, and often well below the upper limit. She suspects that the numbers might be high because I'm breaking down glucose stores in my body, since I do wake up hungry on most nights. But, if I snack at 3am or so, then we aren't getting a "true fasting number" when I test 4 hours later (those numbers are typically high 80s-low 90s, which she says are totally fine for having eaten when I did.). She says she needs a few good fasting numbers to keep me from going on glyburide (she thought the prescription of insulin from the last attending was way off), and suggested eating a "more substantial snack" before bed than my typical Siggi yogurt (14g protein, 13g carb) + small cookie or nuts. I tried that last night, though perhaps too many carbs, and got a fasting number that was on the high end for me: 99.

I guess a question I have for her that will have to wait until next week is, what is the benefit of regulating blood glucose levels at night with insulin/glyburide over snacking, if the numbers I get after snacking are within an acceptable (post-snack, not fasting) range? In other words, is there a level to which blood glucose levels need to drop overnight to be healthy? I'm not opposed to going on meds, I just prefer to understand why.

This experience has really shown me the range of approaches that different doctors take. Moreover, it has reinforced for me the importance of asking questions, and coming prepared and informed to appointments. For example, last week I was given the ok to test 1hr OR 2hrs after meals. But when the doctor came in the room with her statistics from my glucose meter, my 1hr numbers registered as too high (because they are assumed to be 2hr numbers). She had the prescription pad out and ready to go. I asked the her to look at the chart I keep for myself, which indicates time of meal, food eaten, etc. She did, and completely changed her analysis of what is happening with me, saying, no, you don't need to be on anything right now and your daytime numbers are great. She clearly doesn't have all of the answers at this moment... but at least I felt like she was trying to consider my unique physiology and the context of these numbers.

We're playing it week by week...

QOTW: Paleontologist, ballet dancer, Mother Theresa, marine biologist... ended up a teacher and historian.

@ellteejay - that's awesome news! Hopefully the trend will continue!

@pikopiko - feel better! I'm fighting a cold myself and boy does it stink to be sick and pregnant. Glad your practitioner is not stressing diet at this moment, but letting you recover. I'm sure it's hard for you not to stress about it though, as being sick affects numbers (as you know). Sending swift recovery vibes your way!!

To join the yogurt conversation: Siggi's are expensive, but I'm loving the pumpkin spice as a bedtime snack as it satisfies my craving for dessert and protein:carb ratio is pretty good. Otherwise, plain greek yogurt is part of my breakfast, with berries.

PikoPiko · January 2015

Thanks, @nyclo. I'm feeling great today, I think I'm done with this ordeal! My sugar level was low the entire time I was sick just because I wasn't able to eat much. But everything I did eat was carbs! (apple sauce, bread, graham crackers).

Have you tried eating a dinner or snack at night that doesn't have any carbs just to see how you do in the morning? Drink tons of water and wait 10-15 mins before you test?

My sweet fix is hot cocoa. Somehow milk is terrible for me, so I drink coonut or soymilk only. Add some unsweetened cocoa powder and heat it up in the microwave, add some splenda. Tastes almost like the real thing.

nyclo · January 2015

@ellteejay, I'll keep you posted and let you know if I get an answer next week. The nurses have told me that I can test before I snack in the night, but don't have to. I tried it a few times, but found that it stressed me out so much that I couldn't go back to sleep (and increased cortisol levels can interfere with insulin function - yay), so I just stopped. I still definitely have an emotional response related to my testing, but the appointment I had yesterday really put me at ease such that I think I might actually be able to do some middle-of-the-night/before-snack tests without the stress I experienced in the past.

@pikopiko - the nurse told me I needed some carbs in a bedtime snack to jumpstart the insulin. But, I think I'll try your suggestion tonight and see what happens. Thanks. And thanks also for the hot cocoa tip. The cold snap we're having calls for just that kind of thing.

Thanks, ladies!

salbabe79 · January 2015

How many weeks? 35 weeks 5 days

Treatment/Regimen? testing 4xs/day 46 units of humilin at night

Any changes, updates, burning questions? at OB appointment, they recommended induction, scheduling it for 39 weeks but it is still our choice. I have no interest in being induced and hoping he comes before that date...whatever that date is!!

QOTW: What did you aspire to be when you were a kid? vet, still love animals, but would rather do something with training, and pet therapy

PikoPiko · January 2015

@Ellteejay, yeah, I totally hear ya about sick people in Seattle. For some reason folks here are just so fragile. Can't drive in any weather, get sick as soon as the weather turns despite all these North face gear you see around here. They don't seem to understand covering up when coughing and sneezing either. I am currently hiding out, working from home while I'm still weak, so I don't go a 2nd round. Frankly, I don't think I can handle getting sick again!

My only advice to all GD mamas that are sick is to call the folks who manage your diet/glucose. So you know what you can and cannot skip while sick. Far less stressful and so you could be eating the right things to help you recover faster. (I got to eat the BRAT diet, which stands for carbs, carbs, carbs, carbs)

nyclo · January 2015

@ellteejay - so glad you like the Siggi's. My favorites are pumpkin spice (2%), pear spice (2%), strawberry and raspberry (both 0%). Avoid coconut. It says 2% on the front, but that's the milkfat content; the coconut pushes the total and saturated fat content way up.

Minor morning vent: Last night tried having 1 hardboiled egg and celery with peanut butter; downed some water this morning; my number: 97. Arg.

I guess I had more than one: Also, heartburn at night has been a real drag. The past two nights it's woken me an hour or so into sleep and then kept me up for hours on end. I'm pillow propping and apple-cider vinegar swigging, but so many of the other recommendations I've read aren't necessarily compatible with (some of) our GD diet needs: milk at night can make numbers spike, and avoiding a bedtime snack is out of the question for me. I'll try cutting back my water consumption before bed. And I will call the clinic and see what they recommend for this lovely combination of heartburn and GD (would TUMS break the "fast" and does the slowing of digestion that many antacids do affect numbers?). I vaguely recall some of you discussing this, but couldn't find it in any threads. Granted, I was searching at 2am...

Thanks for indulging. Happy Thursday! Stay warm, those of you in cold climes. Brrr!!

foxslaw · January 2015

Had appointment with specialist yesterday! Because I didn't have one bad number in the last month (since I saw them for my initial appointment), my doctor bumped me down to testing 1x per week or as needed! Baby was measuring on track & everything looks good!

PikoPiko · January 2015

That's great news, Foxslaw!!! So happy for you.

foxslaw · January 2015

Yeah, hope you guys are doing well! I will probably still read this thread, but not check in as much to avoid being insensitive!

BabyParker15 · January 2015

I just got diagnosed with GD at my appointment yesterday. I failed one of the four blood draws by five points.

today is my first day of testing 4x/day and then I will see the dietician next week. I haven't craved anything sweet this whole pregnancy. My only downfall is giving up orange juice is going to be rough. I'll do whatever the doctor says to make sure Baby is healthy though! I'm so glad that I can read you ladies' posts! Definitely reassuring as I was quite bummes yesterday!

DBride2006 · January 2015

HailsMom said:

Well the experiment with not taking the glyburide failed last night. I woke up with my sugar at 94. Once again, just over the line.

@CatLadyTx yeah, I have been doing either string cheese or peanut butter crackers when I take the pill.

@pikopiko I don't have a dietician, but when I spoke with my endocrinologist about the low numbers last week she wasn't too concerned with how low they were - and told me that the glass of milk I have been drinking is a good way to treat the situation. (I knew about milk forhypoglycemia from my medic days)

I guess I will be going back to taking the glyburide, but maybe eating a little more with it. If my number is real low again tomorrow, I will talk to the OB about it at my BPP tomorrow afternoon. The endo, said she thought I might be able to get a 1.25mg pill to cut in half so we could try that instead of my taking half of a 2.5mg one. I will see how tomorrow goes and what the Dr says.

I'm curious why your doctor has you on medication instead of insulin. With both my boys, my diet was well controlled, but my fasting numbers hovered between 90-100, so I ended up on a VERY small dose of insulin morning and night. I'm not on it yet this time, but wouldn't be surprised if i needed in the next week or two. I never had any lows with insulin. Just curious why some doctors don't go that route?

PikoPiko · January 2015

Are you ladies getting specialist appointments all the way til you deliver? Just curious of how other doctors/hospitals' policies differ from mine. Mine told me they track up to 36 weeks then I'm done with the diabetes clinic.

HailsMom · January 2015

DBride2006 said:

I'm curious why your doctor has you on medication instead of insulin. With both my boys, my diet was well controlled, but my fasting numbers hovered between 90-100, so I ended up on a VERY small dose of insulin morning and night. I'm not on it yet this time, but wouldn't be surprised if i needed in the next week or two. I never had any lows with insulin. Just curious why some doctors don't go that route?

Glyburide stimulates your body to release more insulin. I'm on the lowest does they can do, unless I can figure out how to cut the pill into quarters.

But you are lucky if you haven't had any lows with insulin, the insulin works the same on the blood sugar if it's produced by the body as it would if it's injected.

CantoDeAmor259 · January 2015

@HailsMom‌ I've been having the same issue with the glyburide as well, getting numbers in the 60's. My fasting are borderline over as well off meds, 95-105. Ugh it's frustrating. I have yet to find the great combination that works and I'm on week 5.

PikoPiko · January 2015

@Ellteejay‌, I'm an eastsider, I go to evergreen. My OB doesn't deal with my diabetes stuff, she only gets recommendations and updates from the dietitians at the diabetes clinic (in the same building). I've been meeting the dietitians every 2-3 weeks since I was diagnosed at 26 weeks.

crabigator · January 2015

foxslaw said:

Yeah, hope you guys are doing well! I will probably still read this thread, but not check in as much to avoid being insensitive!

Just noting that this is also me to some extent. I've worked out a pretty good balance where I don't have many questions or major spikes with my GD, so I'm still reading here and silently supporting you ladies, but I feel weird checking in to just say: numbers still good! every week without being able to add much else.

So just picture me cheering you all on quietly like this every week instead! =D>

I do have a growth scan next week though -- suuuuuper excited to see my baby again!

crispywheats · January 2015

crabigator said:

foxslaw said:

Yeah, hope you guys are doing well! I will probably still read this thread, but not check in as much to avoid being insensitive!

Just noting that this is also me to some extent. I've worked out a pretty good balance where I don't have many questions or major spikes with my GD, so I'm still reading here and silently supporting you ladies, but I feel weird checking in to just say: numbers still good! every week without being able to add much else.

So just picture me cheering you all on quietly like this every week instead! =D>

I do have a growth scan next week though -- suuuuuper excited to see my baby again!

This is the case with me as well.

nyclo · January 2015

HailsMom said:

DBride2006 said:

I'm curious why your doctor has you on medication instead of insulin. With both my boys, my diet was well controlled, but my fasting numbers hovered between 90-100, so I ended up on a VERY small dose of insulin morning and night. I'm not on it yet this time, but wouldn't be surprised if i needed in the next week or two. I never had any lows with insulin. Just curious why some doctors don't go that route?

Glyburide stimulates your body to release more insulin. I'm on the lowest does they can do, unless I can figure out how to cut the pill into quarters.

But you are lucky if you haven't had any lows with insulin, the insulin works the same on the blood sugar if it's produced by the body as it would if it's injected.

Although I am not (yet) on any medication, my fasting numbers are between high-80s and high-90s, so it is likely on the horizon. The doctors I've seen have given me conflicting information. I'll share what I've been told with regards to medication to control fasting numbers - but make no claims that (any of) it is accurate.

Three doctors I spoke with said that glyburide is often prescribed for overnight use because it is slower-acting / longer-lasting and can get a woman through the night, whereas insulin often peaks quickly (One doctor, however, said the exact opposite, referring to Levemir insulin). Glyburide does cross the placenta in small amounts, and while it was thought that insulin did not, the manufactured molecules are apparently small enough now that some studies show it too crosses. No one has been able to tell me about any long-term studies on the effects of either medication on the baby - there is thought to be none. One doctor and one RN said that it can be easier to adjust the dosage using insulin (pen injection), but the others disagreed. One study suggests higher rates of induction and babies born with low blood sugar to mothers on glyburide than mothers on insulin; another study shows the reverse, and a third says the difference is negligible. Perhaps the jury is out on that.

The doctor I saw last week said that she typically presents both meds to her patients, walks them through how they work and are administered, as well as provides them with her recommendation, but ultimately lets her patients decide.

nyclo · January 2015

PikoPiko said:

Are you ladies getting specialist appointments all the way til you deliver? Just curious of how other doctors/hospitals' policies differ from mine. Mine told me they track up to 36 weeks then I'm done with the diabetes clinic.

I go to the diabetes / high risk clinic in the hospital that my doctor is affiliated with. Their policy is to have me meet weekly with a doctor from the clinic to monitor glucose levels and meds, if there are any. This will continue until delivery. They had me do a growth scan at 28 weeks and 32 weeks. Starting at 36 weeks I will have weekly biophysical profiles done, as well as weekly (or twice-weekly, depending on what they decide) fetal non-stress tests. Starting at 37 weeks, based on the bpp, nst, and glucose monitoring, the clinic doctors make weekly recommendations to my OB about my needs for labor and delivery (which could include constant monitoring versus intermittent 15-on/45-off; insulin drip; induction). All of it sounds incredibly over-complicated and over-monitored to me, and I'm tired thinking about the weeks ahead...

DBride2006 · January 2015

nyclo said:

HailsMom said:

DBride2006 said:

I'm curious why your doctor has you on medication instead of insulin. With both my boys, my diet was well controlled, but my fasting numbers hovered between 90-100, so I ended up on a VERY small dose of insulin morning and night. I'm not on it yet this time, but wouldn't be surprised if i needed in the next week or two. I never had any lows with insulin. Just curious why some doctors don't go that route?

Glyburide stimulates your body to release more insulin. I'm on the lowest does they can do, unless I can figure out how to cut the pill into quarters.

But you are lucky if you haven't had any lows with insulin, the insulin works the same on the blood sugar if it's produced by the body as it would if it's injected.

Although I am not (yet) on any medication, my fasting numbers are between high-80s and high-90s, so it is likely on the horizon. The doctors I've seen have given me conflicting information. I'll share what I've been told with regards to medication to control fasting numbers - but make no claims that (any of) it is accurate.

Three doctors I spoke with said that glyburide is often prescribed for overnight use because it is slower-acting / longer-lasting and can get a woman through the night, whereas insulin often peaks quickly (One doctor, however, said the exact opposite, referring to Levemir insulin). Glyburide does cross the placenta in small amounts, and while it was thought that insulin did not, the manufactured molecules are apparently small enough now that some studies show it too crosses. No one has been able to tell me about any long-term studies on the effects of either medication on the baby - there is thought to be none. One doctor and one RN said that it can be easier to adjust the dosage using insulin (pen injection), but the others disagreed. One study suggests higher rates of induction and babies born with low blood sugar to mothers on glyburide than mothers on insulin; another study shows the reverse, and a third says the difference is negligible. Perhaps the jury is out on that.

The doctor I saw last week said that she typically presents both meds to her patients, walks them through how they work and are administered, as well as provides them with her recommendation, but ultimately lets her patients decide.

This was helpful! I seem to vaguely recall researching medication vs. insulin when I was put on it with my first (6 years ago) and I was pretty sure insulin was the "better" option (at least at that time). It makes sense that the research has changed over the last 6 years and I haven't researched it recently (nor discussed it with my doctor). I was always on a slow-release insulin that I only took morning and night (not at each meal) and it worked well for me. I think with DS#1 it was an injection and with DS#2 I had a pen. My fasting numbers will bounce up to 100 for a couple days then come back to 85-93 for a while. I'm almost 36 weeks, so I'm waiting to see if they prescribe it or not (with post-meal numbers in range). I'm definitely in the phase where meals that gave me really good numbers before are borderline now. SO frustrating!

CantoDeAmor259 · January 2015

I read that women on the glyburide (I am) need to stop 2 weeks before delivery. I'm going to ask my ob about this next Friday as I forgot to yesterday. Has anyone else heard this?

Also, who just got over being sick? I woke up with horrible congestion and a cold and so I would love some tips! This is my fist time with gd so I don't know really what to do with being sick and testing and all that fun stuff.

HailsMom · January 2015

@Cantondeamor259 you just keep up with what you are doing. If you have an infection, sometimes that can cause your numbers to be a little higher as can the stress of being sick. As long as it's not a crazy difference, then I wouldn't stress over them too much.

I haven't heard anything about stopping the glyburide prior to birth though.

CatLadyTX · January 2015

@CantoDeAmor259‌ I read that, too. I asked my OB about it and she said it wasn't necessary.

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