April 2016 Moms
Monicagail1
member
GD/Diabetes Check In
Monicagail1
member
GD/Diabetes Check In
Gestational Week:
Successes:
Challenges:
Recipe/Tips:
Questions:
Love: 8.10.99
Marriage: 12.18.04
DD1: 5.19.10
DD2: 4.11.12
Marriage: 12.18.04
DD1: 5.19.10
DD2: 4.11.12
#3 EDD 4.23.16
Re: GD/Diabetes Check In
My my numbers have been all over the place for the last week or so, so my insulin was upped again. I was somewhat relieved to know that I am still on the low end of the spectrum with my dosages though.
Marriage: 12.18.04
DD1: 5.19.10
DD2: 4.11.12
Little bit of a rant...I had my GD consult with the nurse practitioner at my OB's office yesterday. It was horribly unhelpful. They gave me this sample menu of what is supposedly a "perfectly balanced" day, which included 3 cups of skim milk, multiple servings of bread with margarine (?!?), and only 2 servings of vegetables. They also did not give me a range of carbs to shoot for in each meal even though I specifically asked for that - just a giant list of food equivalents (like, one bread is equivalent to 1/4 bagel, or a 6" tortilla). I just feel like the consult was useless. I spoke to a nurse at Cigna and she was more helpful, but couldn't give me carb ranges. I need to reach back out to my OB's office and push for better guidelines. On the plus side, the nurse practitioner said most likely I will just need to carefully monitor for a few weeks, and then if everything looks ok, I can just spot check from there. Really hoping that will be the case!
I might be in the minority regarding my supplies. They have been covered 100%. They are subject to the deductible on my plan, but after that I have no cost. The hassle so far has been getting the correct amount when I refill. My plan will cover me to test 4x per day, which is what my dr wants, but the supplier always hassles me about it. Eventually it gets worked out, but it's irritating.
I'm sorry your OB wasn't helpful with info on managing your diabetes. Can they refer you to a diabetes education class? We have one for GD through the hospital I'm delivering at, and it was covered by my insurance.
Regarding the the carb counts, while I'm certainly no certified diabetes expert, having survived a GD pregnancy and now living with type 2, I feel pretty confident offering some basic info.
-start paying attention to carb counts on labels and serving sizes of packaged foods.
-as a starting point, 45-60g of carb per meal is probably a good range. You can make adjustments as you go, based on your post meal numbers
-in my experience sometimes early in the day you need to stick with lower carb counts (breakfast 30g for example) but can go to the upper limits later in the day, especially if you've worked in some exercise during the day.
-do try to work in 2-3 snacks per day, to help keep your blood sugar steady. 15ish grams of carb per serving is what was recommended to me.
-the American Diabetes Association website is a decent place to do some research on choosing foods when you have diabetes.
You might want to track what you eat and how many carbs in the beginning so you can see which food combos are giving you good results or bad results. Also, my dr and dietitian told me, both when I has GD and now with type 2, that the goal isn't to cut carbs out completely. You need some carbs, hopefully healthy ones. If you get to a point where you're eating a moderate amount of carbs and your numbers are high, don't feel bad about taking meds to help.
Marriage: 12.18.04
DD1: 5.19.10
DD2: 4.11.12
When you were diagnosed with GD, I suspect you were probably counselled about the future risk of diabetes mellitus (please correct me if I am wrong). However, once you were diagnosed with GD or PE, were you also counselled about the future risk of cardiovascular events?
The reason I ask this is because I am part of a "Physician Mom's Group" on Facebook, with over 45K physician mommies, and this was asked there. I was surprised to see that the FAR majority of women who were diagnosed with GD or hypertensive disorders of pregnancy were completely unaware of future cardiovascular risks and what to do to prevent it. And this is a group of PHYSICIANS! So I wondered how this information is being disseminated among mommies out there. I'm a preventive cardiologist, and just got a grant to do a research project in this area, hence my interest in this topic. Curious to see what your counselling has been like, and happy to share information if needed.
@thaisac1 This is my second GD pregnancy. I was told in the class I went to that I had an increased risk for type 2, and that there is nothing I can do to prevent it (i.e. continuing a GD type diet). I was not given info about a cardiovascular risk or preventative measures. I would be interested in how to prevent cardiovascular problems if you have it!
*** NOTE: I am not writing this to scare anybody!!! This is purely to pass on important information and help you make good decisions about your health.***
Long story short, women that have a history of gestational diabetes or hypertensive complications of pregnancy (i.e.: Pregnancy hypertension, pre-eclampsia and eclampsia) have a higher risk of cardiovascular events (i.e.: heart attack, stroke…) later in life, and are often affected prematurely (most women don't have heart attacks or strokes until well after they're 60; while women with these pregnancy conditions often have it earlier). For GD, risk increases by about 25% (specific risk for heart attack is 92% higher). For pre-eclampsia, risk is two-fold higher (100% higher). Women that have a history of severe pre-eclampsia actually have a 10-fold increase in risk.
There are a few theories about this increase in risk, although no one theory is known to be the right one… One theory is that the development of hypertensive complications of pregnancy or gestational diabetes actually causes damages to blood vessels, starting a cascade that culminates with atherosclerosis later in life. The other theory is that women who develop these disorders in pregnancy may already have an intrinsic predisposition to cardiovascular disease, and pregnancy is truly the first 'stress test' women go through in life… Therefore, the physiologic stress of pregnancy may uncover an already abnormal cardiovascular system. Maybe it is a combination of both theories… No one knows 100%.
Why do I think it is important for all of you to know this? Because when it comes to cardiovascular diseases, prevention is of utmost importance. If you know that even though you've had your baby and your gestational diabetes/ pre-eclampsia are now resolved, you are still under a higher cardiovascular risk for the many next years to come, then you can put your best efforts into prevention. On the other hand, if you don't have this knowledge, you may think that the issues are 'behind you' and go on with life as usual….
My advice is to really focus on a healthy lifestyle, and keep close tabs on your cardiovascular risk factors for the next many years to come. Keep a healthy weight, eat a balanced diet without the extra fats and sugars, exercise on a regular basis, keep your blood pressure and cholesterol low, treat your diabetes to perfection if you have it, and if you were a smoker pre-pregnancy, never, ever, EVER touch a cigarette again (well, this advice is valid for anyone
Stay healthy, girls!!!
Edit: A robust reference on GD and CV events if anyone is into the science: https://www.cardiab.com/content/15/1/15
I have references for pre-eclampsia too if needed.
Fortunately for me, I know my family history of diabetes and heart problems and I was pro-active so they were able to intervene before it effected my DS.
This time around, I passed the GD test, but my 1 hour was boarder-line. My doc said she wanted me to check it twice a week, since I have my little home testing kit, but unless something comes up during my home testing, they wouldn't test for it again. Which I find annoying since my number was literally the <= number.
Marriage: 12.18.04
DD1: 5.19.10
DD2: 4.11.12