GD/Diabetes check in/support 4/30

zande2016 · April 2018

Eeeek I didn't realize it had been over a month since the last check in. I don't think we've had any new GD diagnoses since the last thread, but figured I'd start this and see if anyone is needing some support.

How far along are you?

Management method (diet/exercise, insulin/other medication):

Upcoming appointments:

Any questions, things you are struggling with and need support on, or rants/raves?

Feel free to share some meals/foods/recipes that are working for you, or foods you found you have to avoid:

zande2016 · April 2018

How far along are you?
29+3

Management method (diet/exercise, insulin/other medication):
Diet/exercise and metformin. Probably starting insulin this week.

Upcoming appointments:
MFM tomorrow to review my logs and see if I need insulin. He actually called me last week after I faxed my log, and said he wanted to start a bedtime insulin for my fasting numbers, and I told him in the 2 days since I faxed my log, they had gone back down. He said we'd monitor another week and I'd come see him and we'd discuss. Since then the fasting number stayed down a couple days, shot up for a couple days, then went back down today. Meanwhile my breakfast and lunch have been slowly creeping up too, and I can only get a good breakfast number if I skip carbs with breakfast. Today I had 2 eggs and one piece of toast w/ peanut butter (15g carbs) and was at 151 after an hour. So now I am wondering if he'll prescribe bedtime insulin and also breakfast insulin.

Any questions, things you are struggling with and need support on, or rants/raves?
Re what I was saying above...does anyone know if bedtime slow acting insulin for fasting would also help the breakfast number? Just trying to mentally prepare myself. Also wondering if there's anyone out there who had GD in a prior pregnancy, was well controlled on insulin, and was able to go past 40 weeks. Seems like a rare unicorn situation but I am really hoping my body can go into labor on its own this time and I feel like insulin is going to put a nail in that coffin.

Feel free to share some meals/foods/recipes that are working for you, or foods you found you have to avoid:
Quinoa is the one grain that's been working well for me. Rice and potatoes haven't been great, though last night I had a small hand full of fries with dinner and I was okay. Ice cream still works pretty well, thank god. Starting to get really bored with my snacks, I won't be sad if I never see another string cheese again after this pregnancy.

zehcnasella · April 2018

How far along are you?
30w6d

Management method (diet/exercise, insulin/other medication):
diet

Upcoming appointments:
So far I just have my routine checks every two weeks. And a nurse calls me for my numbers once a week

Any questions, things you are struggling with and need support on, or rants/raves?
Nothing now. I feel pretty in control

Feel free to share some meals/foods/recipes that are working for you, or foods you found you have to avoid:
potatoes and white rice are the only things I have found to spike my sugar

zande2016 · May 2018

Glad your numbers are under control @zehcnasella! I just back from the MFM and surprisingly he decided not to start me on insulin. I've been going back and forth between normal and slightly high fasting numbers, and he said since my growth scan was perfect he'd rather leave things the way they are for now. Of course subject to change at any time so I guess my daily anxiety over the morning number will remain for now. He said try to exercise more - yes, easier said than done when walking causes such bad sciatica pain.

Sarafuss · May 2018

I’m just jumping in but don’t have much to contribute at this point. I’m 27+4 today and I failed my glucose test yesterday and they started checking my blood sugar in the hospital (see GD testing thread if you missed why I’m here). My fasting was 93 and after breakfast was 133 so a little higher than I’d like to be. We’ll see how this next week goes but I expect to end up on insulin before this pregnancy is over.

Sarafuss · May 2018

@zande2016 I’m glad to see you’ve avoided insulin for now! Your MFM sounds pretty reasonable.

zande2016 · May 2018

@Sarafuss I was really glad to see him going by how the baby is actually doing as opposed to just my numbers, just hoping the baby is still growing normally at my ultrasound next week. So far he's 50%, which is what my son always was too. Re your breakfast number, my goal is below 140 so that seems okay to me, but also consider you're in bed right now not moving around a lot, so maybe once you're out of the hospital it will improve.

Sarafuss · May 2018

My MFMs like my fasting 90 or below and meals 130 or below. But I’m sure you’re right that sitting here doing nothing doesn’t help anything! Fasting and breakfast have always been my struggle so I’m not surprised. But those numbers aren’t really considered “high” either. My lunch was 113 but I barely ate any of it. Hospital food is so bland and gross!

zande2016 · May 2018

It's funny how different doctors rely on different standards. Mine is looking for fasting below 95 and one hour after meals below 140. I think that might be what the ACOG follows but not really sure. Same as you with the fasting and breakfast though. I seem to be on this every other day schedule with fasting....I'll get an 84, then a 108, then an 88, then a 107, etc. He was like, well if you're elevated 50% of the time but doing well with growth, let's not start insulin. Then my 80's would become 70's and 60's which he doesn't want either. And I basically can't have carbs with breakfast anymore, I think part of the problem is I have to eat in the car on my way to work, which is an hour drive, so I can't be active after breakfast. And I hear ya on the hospital food...except right after I had my son, I was SO famished, I gobbled it all up and it actually tasted good to me.

Sarafuss · May 2018

@zande2016 does milk work for you in the
morning? In previous pregnancies the carnation instant breakfast shakes were good. They have regular and sugar free. I did okay for awhile with the regular ones. But they were easy for breakfast in the car on the way to work.

zande2016 · May 2018

I actually haven’t tried milk...except yogurt, which does work as long as there’s not too much sugar. That might be worth a shot since I am so sick of hard boiled eggs that sometimes I literally gag as I choke them down.

zehcnasella · May 2018

@zande2016 glad your MfM seems to be reasonable.
My fasting needs to be 90 or below and that never seems to be a problem. And my meals are 140 or below. It is weird how different doctors use different standards. @Sarafuss milk hasn’t really affected me. But I usually drink it night. It happens to be the like one thing I viciously crave. Which is weird because I haven’t really drank it in like 10 years. I was on almond milk for a long time.
I need to increase exercise too!!! But there are so many things to do after working a full time job and prepare for a baby. Ha.
I haven’t really gained any weight since the diagnosis. I have my regular OB appointment tomorrow. We shall see how that goes.
Keep up the good work ladies :-)

WorkinWeezel · May 2018

How far along are you?
32 weeks

Management method (diet/exercise, insulin/other medication):
Diet/Exercise

Upcoming appointments:
Just an U/S at 37 weeks, and I have to send in my logs on Monday morning

Any questions, things you are struggling with and need support on, or rants/raves?

Guys, I'm at a loss. I was not overweight prior to getting pregnant. I've gained only 10 lbs this pregnancy so far. I'm a healthy eater and I exercise regularly, including Beachbody workouts, walking, and running. I burn a ton of calories daily. I failed only the 1 hour marker on the 3 hour GTT. The dietitian told me to change nothing, except to increase my protein before bed and test my blood sugar 4 times per day. The Perinatologist, a week later, cut me down to 2 times per day and said "well, you're not really diabetic, just with the standards of the Axia practice with failing one marker". A week later I email my logs on Monday morning (last week). By Wednesday the dietitian is emailing me saying I have to be put on insulin; my numbers were definitely wonky from being sick, and my fasting were high by 1-5 points. By Friday (yes, 5 days later), the Perinatologist's office is calling me threatening insulin as well. My numbers aren't even bad!!! This past week I've been extremely careful, and I've been drinking my protein shake before bed. Last night and this morning are the ONLY two numbers that are high- last night I was at 131 (they want me between 60-120) but I think I tested too early. This morning I was at 99 (they want my fasting under 95). I have no explanation as to why.

I know I'm very lucky that my issues are minimal, but it's driving me crazy. I do NOT want to be eating more and I just don't see how I can be eating even more carefully than I already am at this point. It's so frustrating. My two other kids were big at birth- 8 lbs 15oz and 9 lbs 12 oz both born vaginally and both 4 days late. I have an ultrasound at 37 weeks to check the weight of the baby. Any other suggestions? I"m happy to copy/paste my logs if you want to see specific numbers to give me better insight. I'm new to all of this (luckily) and I just don't know what else to do.

Thanks girls! Sorry for the book!

zande2016 · May 2018

@WorkinWeezel that's really frustrating! You aren't actually even diagnosed with GD based on the criteria, and now they want to put you on insulin...it seems pretty extreme to me. Definitely feel free to share your logs, but I will say, I've had plenty of high fasting numbers since my diagnosis around 10ish weeks ago, and my MFM doctor still decided to hold back on insulin based on baby's normal growth and the fact that some of my fastings are in the 80's and insulin would bring them too low for his liking. Over the past week my fastings have been mostly 98ish with a couple 90's, so I might be prescribed insulin tomorrow for fasting, but I've been given a lot of leeway and time to try other things before getting to that point. Also, I was sick once with a bad cold and once with the flu, and both of those times I noted it on my log as an explanation for high numbers. That is completely a valid reason for high numbers, and if they go back down after you're better, should not be a basis to start insulin.

Are you testing one or two hours post meal? Sounds like your doctor is more strict on post meals than mine, I just have to be under 140 an hour post meals. If you only had two high numbers, and those numbers aren't even that high, I'd be seriously pushing back and asking for more time to monitor. My doctor is much less concerned with the occasional high post meal number that I can explain by something I shouldn't have eaten, as opposed to fasting which is really out of your control.

ETA also might want to ask if they are willing to try metformin before insulin...it's up to you if you'd want to try metformin, but there are pros/cons to both from what I've researched. Insulin just seems to bump you up to a higher risk category than metformin for some reason.

AlwaysMrsS · May 2018

I just got my 3 hour results last night. I failed 3/4 draws. I’m waiting/hoping for my dr’s office to call with some type of instructions.

How far along are you?
28w 5d

Management method (diet/exercise, insulin/other medication): I’m hoping diet and exercise is enough, but we’ll see.

Upcoming appointments:
I have my 30w appointment next Tuesday

Any questions, things you are struggling with and need support on, or rants/raves?
I feel like my brain is going to explode.

Sarafuss · May 2018

@WorkinWeezel how many high post meal numbers do you typically have in a week? My MFM's guidelines are typically more than 6 high post meal numbers and 3 fasting before they are concerned. But even then they ask if the numbers were because of poor meal choices or some other factor. If your numbers were high from being sick I would definitely ask for another week of numbers before starting insulin. As @zande2016 said, my MFM isn't as concerned about post meal numbers being a little high because you can change what you're eating to try and modify them (and if that doesn't work they may try meds).

Are you trying different bedtime snacks? Maybe your protein shake isn't working for you anymore. How many carbs are in the shake? One thing that worked well for me at bedtime was greek yogurt. Are you keeping a food log also to know what types of foods are giving you high numbers? I would try and not get caught up on the glucose test and only failing one number at that time. In my last pregnancy, I had the same thing happen and eventually did end up diabetic since it gets harder to control as pregnancy progresses.

As far as meds go, I never saw any help with my numbers on metformin but I did try glyburide in prior pregnancies. That seems to be a step below insulin. I prefer insulin because glyburide would occasionally drop my numbers too low. But if you're concerned about being risked-out of a certain birth center or something like that, maybe that is something to ask about.

WorkinWeezel · May 2018

@Sarafuss thank you! I think it's my fasting numbers that are most concerning. I'll try to post screen shots. I actually did try greek yogurt last night instead of my protein shake and my fasting was the lowest it's been since I started all this!!!
*OK when I tried to copy/paste it was a complete mess! Let me try this:

week of 4/23:
I had 7/8 fasting numbers too high
No after-meals were too high

week of 5/1:
I had 1/7 fasting number too high
1 after meal too high (dinner)

Sarafuss · May 2018

@WorkinWeezel It does seem like it was due to illness unless you completely changed your bedtime snack this week (for the whole week). Have they seen the numbers for the week of 5/1 yet? If they are suggesting insulin after seeing those that's kind of crazy.

zande2016 · May 2018

I saw the MFM today and one thing she mentioned was, if I notice higher fasting numbers on days after I didn't eat as much, I might try consuming more calories and see if that helps. I've been losing weight so possibly I am getting a caloric deficit and my liver is making up for it overnight by releasing sugar. I have noticed more hunger lately so I will try increasing my calories, but with proteins and fats and extra snacks as opposed to lots of carbs. She said to try to look for patterns to see if I can figure out why I'm getting the highs. We're not at the point of insulin yet, with half of my fastings being a little high, half being normal, and perfect growth.

WorkinWeezel · May 2018

@zande2016 and @Sarafuss thanks girls. Both the peri and dietitian emailed me back to say they are happy with the past week, just be careful with carbs at dinner bc they will carry over in to the next day. Noted! I'll do the Greek yogurt again tonight to see how that affects tomorrow's fasting.

zehcnasella · May 2018

@WorkinWeezel sorry you are having a rough time. Tell your docs concerns if it comes up again. Or switch docs. They seem to be really strict.

My docs said if there are 2 or more high readings in a week she would look at medication. But my “high” numbers are only 11-15 points higher and she isn’t too worried about those.

My fundal height is measuring big though and I have a growth scan Friday. I’m at 32 Weeks today. I guess we will see.

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GD/Diabetes check in/support 4/30

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