Adventures in GD, Part II

[FeistyMom]

I'm back with my 2nd GD pregnancy! This time I managed to avoid the panic and despair that I felt when it happened the first time, but now I'm feeling kind of silly.

My doctor gave me the option to skip the dietitian appointment and just start doing food journal and blood sugar testing 4 times a day (morning fast & 1 hr after each meal). I still had all my testing stuff from last time (2 yrs ago), so I said SURE!

First, the kit that I had been given previously has mismatched brand for the glucometer and the finger prick thingie (Can you tell I am NOT a medical professional and don't know the real names?), so even though my OB's office called in prescriptions for supplies, I have the wrong lancets. But no problem - I still had a few left from before.

Next, I go to do my first prick and test this morning. I felt so proud of myself for only taking 10 minutes to remember how to get the lancet inside the pricker, but then it took me another 10 minutes to actually be able to push the button (HUGE fear of finger pricks, was sooo relieved when it didn't hurt at all; if blood hadn't appeared almost instantly, I would have thought it hadn't have pricked at all!)

Feeling a bit sheepish about being a coward, I proceeded to completely fail at using the glucometer. First I pricked and dabbed the strip BEFORE inserting it, and inserted the bloody side first. I kept trying to insert it that way even with the machine clearly giving me an error. By the time I figured it out, the strip was too dry, and I had to reprick. Best part of the experience? My fasting number was 85.

At this point I realized I wasn't sure if that was good or not. I was pretty sure that was a good fasting number, so I wrote it down and had some breakfast. Kids were late to school, I was running like crazy, got to my office PAST the 1 hr mark, went to do the test anyway and... Battery dead error. It had just enough life left to taunt me.

Happily the battery has been replaced and I managed to take my 1hr test after lunch. I got a 142. At this point, I realized - I honestly have no freaking idea if that is a good number or not. So, I head to google! Did you know that googling all kinds of variations of 'blood sugar levels during pregnancy' with or without including the term 'gestational diabetes' results in lots and lots of links with absolutely ZERO useful information? Sure, if you want to know the expected results from the 1 hr challenge or the 3 hr tolerance test you can find them, but I could not find the expected/safe ranges!

So to sum up: boo @ GD, but yay for painless finger pricker; boo @ wrong lancets but yay for fresh batteries; and last but not least, what the heck is the right range for fasting and 1hr marks?

 

[jem77]

You sound like you are in good spirits about this! Wish I was.... I actually cried at my appt yesterday because I am so upset about having GD. Although, I am feeling a bit better about it today....
Anyway, fasting number should be under 95, and 1 hr after each meal should be under 135 according to my Dr. Not sure if different Dr.s have different ranges.

 

[rayraykay]

I love your attitude. I wish I could say I was being that positive about it. I still struggle with the diagnosis big time. I had my 36 week ultrasound today and my baby is estimated at 6 lbs 9 ounces already, which is bigger than normal. Her tummy looked huge too.. although the ultrasound tech wasn't able to tell me anything... I meet with my OB tomorrow. My numbers have all been in range and I am diet controlled only. I am feeling so down about it.

My fasting needs to be 95 or under, 1 hour post meal needs to be 140 or under.

Can I ask how your first GD pregnancy went? How were you able to deliver your baby? Were you diet controlled? What did the baby weigh if you don't mind me asking? Thank you!

 

[FeistyMom]

Thanks for the infos guys!

With my first GD pregnancy, I was completely devastated. Cried *soooo* much, and definitely felt incredibly sorry for myself. I had to cut 2 of the things I had enjoyed the most (mid-morning cocoa break which had helped me deal with daytime nausea, AND chocolate ice cream).

I think because I know more of what to expect, and because honestly I expected to fail this time around, that I can take it more in stride. I'm still such a total weenie about the finger pricking, but I remember that by the end of last pregnancy it didn't seem like a big deal.

My GD pregnancy was pretty uneventful. He came a little early (10 days, and exactly on his sister's bday!), but was my smallest baby to date. It was a normal labor and delivery, water broke on its own, no drugs were necessary. I was able to stay diet controlled throughout, especially when I added walks after lunch and dinner. It got a bit harder towards the end - even with the same exact diet, my numbers were creeping up. LO was 7 lbs, 8oz. His blood sugars were just a little off at first, but we were able to get him regulated with just colostrum, so within 24 hours his readings were normal. I went ahead and did the full 2 day allowed stay though, so they could check him again before we left for my own peace of mind

Hang in there ladies - give yourselves time to freak out a little and stress and quite frankly grieve for the 'normal' pregnancy that you won't quite get to experience. The folks on these boards usually have tons of great advice, and that is really what drew me to bnb in the first place So after you get through this initial period of shock and grief and just all around crumminess, we'll all be here to support each other through the day-to-day details of just dealing with things!

 

[rayraykay]

That's awesome, that gives me so much hope. My levels are also controlled thru diet alone. Thank you for sharing. Also- did the GD go away completely and fairly soon after you delivered your first?

 

[FeistyMom]

Rayray - yes, the GD disappeared completely for me by the time I got home from the hospital. I tested myself a few times afterwards, but the OB didn't even bother with a follow up test. He did warn me that given that I had GD, and also given that I previously had had issues with hypoglycemia (low blood sugar), I had a significantly elevated risk for developing type II diabetes in a few years (I think he said around age 50).

I have been on a rollercoaster with my blood sugars! For the most part my fasting numbers (the first thing in the morning test) have been right on track and below 80. But my after meals have been a yo-yo. I tend to take a long time eating, and it makes a big difference if you are testing an hour after you START your meal, or an hour after you FINISH it. The first week, I tested roughly an hour and some change after I started, and my numbers were all low. This week, I have been testing an hour after I finish, and holy cow these are high numbers for me. I hit 165 twice in one day.

To be fair, I have NOT really adjusted anything about my diet at this point. I wanted to get a sense for how my 'normal' eating habits were impacting my blood sugar levels. I really am swinging high and low as crazily as my hubby suspected. He correlates my sugar levels with my... let's say 'crazy' or 'aggressive' moments. Seems like either extreme and I am a bit unpleasant to be around, even witchy if you will.

Today I have switched up my breakfast to my old staple from last pregnancy: oodles of peanut butter over a single slice of whole wheat bread or sandwich thin. Once in a while I put a dab of sugar-free jelly on too (the kind with sucralose, NOT aspartame, which gives me nasty headaches). So far so good - numbers nice and low. After breakfast yesterday was a whopping 165, but today a lovely 107. I may attempt a 'normal' lunch from the sandwich shop downstairs.

For folks in the U.S., who's going to do a special Thanksgiving diet, and who's going to say 'well it is only one day...' and throw caution to the wind? I'll probably end up somewhere in the middle, in part because I'm not doing the cooking this year and I feel very odd asking/suggesting any alternatives, and also in part because I absolutely love stuffing and I love pumpkin pie and I'm not sure I can survive without at least one serving of each. Or a few bites. mmmm pie.

 

[jem77]

Feistymom, I plan on enjoying my Thansgiving! I'm not going to cut much, if anything out of my diet that day. I have been working so hard to control myself, I think one day will be fine!

I had 3 fasting #'s of 95 and one 100 this week, but it was my first week, and Dr is already threatening to put me on nightly pills. Is this what hey normally do? I'm not happy about that. This morning was 88, so hopefully I can stay around that.... I really hate this!

 

[FeistyMom]

Jem - sorry took so long to respond, was out of town with family for Thanksgiving and then had to transition back into 'work' mode this week. Crazy.

Those are high fasting numbers (you are looking for under 80, generally), and yes - they will immediately go after medication if the fasting number is high, as it sets the stage for your entire day, and is more related to your own internal sugar regulation than directly related to what you are eating. Bedtime snacks that have a good amount of carbs can help with the high morning numbers, but often it really does help to have some kind of med on board to get those fasting numbers down.

For instance, my fasting number is usually 75-78. If I skip bedtime snack (although sometimes I just eat dinner so late it doesnt matter), those jump to 85-89. Since those fasting numbers are fine, the fact that I had TWO instances of 165 didn't raise the medication flag with my OB, just made him remind me to make better food choices. He knew that I was mainly just experimenting though, and reminded me that this early on, we really want to be on the low side after meals (so <120) because the numbers do creep up as the pregnancy progresses.

I was able to remember from my last go round that a gob of peanut butter on whole wheat was a good stabilizer for me in the morning. I totally forgot about the importance of snacks though, so I think part of my highish lunch readings I have been getting is because I haven't been doing a mid-morning snack. If my memory serves me right, daytime snacks were best if they were nuts, seeds, and cheese based but bedtime snacks needed to be more specifically carb related. So I'm adding frozen yogurt bar to my bedtime snack (found one from weight watchers that looked reasonable and is working so far for me).

So far the most disappointing thing for me this go around (besides the whole not gorging on donuts and ice cream and chocolates...) has been the finger pricks. I hate finger pricks as a general rule. The anticipation is so awful. But last time, after only a few times I seemed to become numb to the problem and really didn't have difficulties. I even felt foolish for having been worried about it. This time, I didn't worry about it but I have had a horrid time! I freeze up, often taking up to 10 minutes to actually push the little trigger to do the prick. I have started anticipating it so much, that my finger will pull back too early, and I don't poke deep enough to get enough blood and have to poke AGAIN! And when I do successfully poke, IT HURTS. So annoying! I really thought it would be smooth sailing since I was so 'experienced' at it now. Ha.

In happier news, my Thanksgiving numbers were actually superior in general to my 'normal' numbers. I did forgo the extra pie, but managed one piece of pumpkin on Thursday, and one piece of cran-apple on Friday. Turkey is apparently a really great protein to pair with some of the carb heavy foods (stuffing, mashed potatoes), and all the extra activity surrounding cooking and cleaning and moving kids around must have burned off the pie.

How is everyone else doing?

 

[Whitesoxfan41]

Found your post Mel! So glad to have the extra information!

For everyone else, I was diagnosed with GD at 28 weeks but couldn't see the doc or dietician until 30 weeks (Monday of this week) because we were out of town for my husband's job. I just started monitoring sugars and following the GD diet they gave me. I've followed nearly to the letter but still have high fasting numbers (120-130) and having problems with my hour after breakfast numbers (today was 161). . .lunch and dinner have been fine. I have to report my numbers to the doc tomorrow and am pretty sure she will put me on something for the fasting number.

So far I've measured right on track size wise. . .I have another appointment on Monday, then I go in 2 weeks later at 33 weeks for an ultrasound to check weight and fluid levels.

 

[FeistyMom]

I think metformin is the most common initial drug they try, but I've also heard some docs go straight to an overnight insulin. It seems like it gets more complicated once you add drugs, because while it should be significantly easier to keep the numbers out of the high range, then you also have to worry about lows.

Kellie I hope they get you fixed up! I have been very happy with my morning numbers so far, but I actually had a complete meltdown last night at home on my poor husband because I had burnt the onions while cooking dinner, which I started late because I unexpectedly picked up the kids, and I was actually really upset because I can't eat anything anymore, and normally we would have just grabbed fast food or I would have heated something up but I can't eat any of that junk now. So I just kind of sobbed in the kitchen for a few minutes after yelling at him.

I am somewhat at a loss for this busy season. Ideally, I know that the best bet is for me to cook pretty much every dinner, and then use the leftovers for lunch the next day. However, it is Christmas season, I have 3 kids 6 and younger, in-laws visiting in less than 2 weeks, and I work full time. I was frustrated when I had an Italian meal and ended up at 135 (I KNEW I shouldn't eat that piece of bread, but it had garlic baked inside!!!), but yesterday I was completely DEVASTATED when I hit 161 after what I thought was a sensible Thai selection (I picked a seafood combo that had a soy-based sauce, and used a smaller portion of rice than usual, and went with brown rice instead of jasmine). So, I can't eat deli sandwiches, I can't eat hot sandwiches unless I get the bread JUST right, I can't eat pasta, I can't eat Thai... What the heck am I supposed to eat for lunch? *boggle* Or do I throw in the towel next week and just beg for insulin? Since my fasting numbers are normal, I'm not sure the doc would go for that just to appease my crappy eating habits. I'd go with just salad, but I can't even just eat salad, because not ENOUGH carbs or protein to be satisfying.

I'll tell ya what - this is WAY easier in the summer, even if it did mean forgoing ice cream and watermelon. Just the fact that summer was less busy for me meant cooking wasn't a problem, and hubby loves grilling so had plenty of lean, delicious grilled meats and lots of leftovers. This holiday + diabetes stuff is killing me!

 

[Whitesoxfan41]

I've had GREAT numbers with lunch and a salad. I have been doing a spinach mix, a hard boiled egg, some chicken or steak, cucumber, peppers and some cheese, ranch dressing. Sometimes avocado as well. I usually eat 4 multi grain crackers with it (15 carbs) and I try and stuff some cottage cheese down as well. I'm SUPER full trying to get enough carbs in and I rarely do. They want 45 carbs for lunch and dinner and it's nearly impossible. Potatoes, pasta and rice throw my sugars way up. My 1 hour the last couple days after that lunch has been like 112. I usually cheer. Too bad nobody is here to enjoy my antics huh?

My biggest problem with the diet they gave me is getting fruit exchanges in. It's NOT in season and I'm just not a huge fan either way. I like berries but not unless they are fresh. Unsweetened apple sauce was recommended so maybe I'll try that, just seems like extra sugar to me, but it would up my carbs a bit.

 

[FeistyMom]

Kellie, for your fruits do you like/tolerate dried fruit? I had eliminated prunes at first because I was afraid I would end up too high, but I'm adding them back in. I eat 3 prunes a day if I want to avoid backing up Plus it gives me the added carbs but doesn't seem to explode my numbers.

Doc looked at my numbers, is happy with my fasting numbers (avg 78), felt I had done well to drop my dinner numbers (avg 120), but my lunch numbers were less than stellar, so I'm on weekly monitoring for now. Lunch avg is about 140 for me. He guessed immediately that I eat out most lunches. I am going to try very hard to do leftovers/make lunch for myself, but I am honestly not organized enough to do that right now.

My diet is utter crap at the moment. I am eating worse now than I did during first tri, although admittedly I'm eating less processed carbs Somehow fresh fruits and veggies are almost non-existent in my meals, in large part because the rush of the holidays and home improvement projects and work and kids has me so flustered I haven't done proper meal planning in weeks (since before THanksgiving). My in-laws arrive next week, and it'll be another string of eating out for almost every meal.

LO is measuring a tad bit on the big size now - already 4lbs 2oz, and I'm only 30 weeks, so could be in for another largish baby (first two, non-GD were over 8 lbs; last one w/ GD was under 8...), so I really do want to get this stuff under control.

For me the current positive is that I made a curry dish with quinoa last night, and my numbers were great. So brown rice is pretty much out for me, but quinoa is in. That gives me potatoes (but not fried), whole wheat pastas, and quinoa for big carb sources, and that is something I can definitely work with.

 

[FeistyMom]

Another happy update: Zantac is helping me with the heartburn/reflux, which IS helping me with appetite and nausea seems way down. Still can't handle the thought of peanut butter (ICK), but I had success with dinner last night and breakfast this morning so feeling better about life.

It is amazing how a bit of quality sleep can change your perspective!

 

[Whitesoxfan41]

That is fantastic Mel! Pepcid is my FRIEND big time.

My numbers are just pissing me off. 162 after lunch today, plus fasting is STILL high. I'm seeing insulin in my near future. Grrrrrr

I get better numbers when my carbs are lower, they keep telling me I'm not getting enough carbs and that's why my ketones are so prevalent. It's lose/lose.

 

[FeistyMom]

That stinks Kellie

Just keep reminding yourself - you do need carbs, and you aren't personally failing to do anything if eating the right amount of carbs is causing high blood sugar, it is your placenta! When in doubt, blame the placenta, that way it is equally your partner's fault At least that's what I've told my husband!!

 

[Whitesoxfan41]

HAHAHA. . .I love it! Blaming the placenta!

 

[FeistyMom]

I'm being a bad girl... I ate Frosted Flakes for breakfast two days in a row! First day it was only half a bowl and numbers were fine. So I did it again today but a full bowl, and then.... FORGOT TO TEST. I have no idea how bad/normal it was.

And, to top it off, I'm having McDonald's for lunch. Not exactly good life choices, I know, but it is the routine the kids are used to - go to the doctor, be on good behavior, get McDonald's afterwards. That was DD2's treat after being swabbed for strep yesterday, and this morning when DD1 woke up with a sore throat she only showed any enthusiasm when she said at least she'd have McDonald's for lunch. When I implied that we wouldn't be going as she didn't have to go to the doctor and we'd just pick up her meds, she was nearly devastated. So of course I caved and DH is bringing home the fast food. So I'm going to HAVE TO remember to test this time, but I won't know for sure if my numbers end up high because of the actual meal, the fact I didn't do a snack, or because I gorged on Frosted Flakes.

I swear, I used to be a smart woman who could make good life choices. Can I blame the placenta on my irrational and childish decision-making??

Anyone with GD (or any type of diabetes) also find themselves making bad choices?

 

[Whitesoxfan41]

Awe. . .I'm all about blaming SOMETHING else!

It's REALLY hard and honestly, I'm having a harder time following the diet so strictly when it doesn't seem to be making that much of a difference. Life DEFINITELY gets in the way. If I had younger children to take care of, I'd be having a much harder time as well. Heck, if I were WORKING it would be much harder. You're pretty much super woman!

 

[FeistyMom]

Thanks for the encouragement I just feel super tired most of the time, but hopefully I'm holding it together well enough to be a decent example for my kids and they'll remember the good parts and not be scared for life by my shrieking harpy impression that happens occasionally.

 

[Ganton]

Can I ask how you girls first knew that you had GD? Did you have any symptoms or did you just get the GTT as standard? We don't get the GTT in the uk, unless we'be had a previous large baby or some other risk factor. My first baby was over 9lb, but that's not big enough to get the test.

However, I've started to feel nauseous about half an hour after each meal o the last couple of weeks and am becoming increasingly thirsty. By the end of my last pregnancy, I had a take a bottle of water everywhere with me as I had sudden bouts of thirst that made me feel really sick. I'm struggling to keep my weight gain under control this pregnancy, so the midwife has said that she'll keep an eye on my fundal height and refer me for growth scans if it's on the large side, but I was wondering if GD could be a possibility?