GD thread AGAIN - sorry :(

[going_crazy]

Hi all..... I did post about my GTT results coming back as 8.3 instead of 7.8. After a lot of thought, I feel that this wasn't a fair test:
* I was eating (chocolate etc) at 11:30pm the night before the test (my fault)
* I was told to fast for 8 hours, although I've since found out I was supposed to fast for 10-14 hours
* For the last 2 weeks I've not been able to exercise as I had injured my coccyx (ouch) and could barely walk and I've found out that this could affect my GTT result
* I saw my results being 8.3 which would usually mean test again in a couple of weeks, BUT the diabetic midwife wrote down it was 8.9 This means I would have to monitor my levels every day for the rest of the pregnancy!
* I have found out that I'm not classed as having GD, I've just got an 'impaired result' - ther is a HUGE difference!


So my question is this:

Do I have a right to ask for another GTT?

And can I refuse to see the diabetic midwife, and just carry on seeing my community midwife?

In my opinion she didn't listen to a word I said, just went ahead and gave me the glucose monitor, told me what I can and can't eat and shoved me out the door!!!!!

I took my own GTT this morning - I fasted for 12hours, then checked my levels before (5.3), had 394ml Lucozade Original, tested my levels again after 2 hours and they were 6.9!!!!! - Perfect result!!!


Any opinions (good or bad) grately appreciated!

Thank you so much for reading my rant!! xxxxxxxxx

 

[belladonna]

I took my own GTT this morning - I fasted for 12hours, then checked my levels before (5.3), had 394ml Lucozade Original, tested my levels again after 2 hours and they were 6.9!!!!! - Perfect result!!!

Not so perfect I'm afraid, it should be the result after one hour not two! And after an hour it should be less than 7.0 mmol/l. Your fasting result is on the high side too as the max should be 5.5, mine are usually 4.5.

Carry on seeing both midwives- the diabetic one will probably just check you, not the baby and make sure you have the extra scans so they can check the growth of the baby.

Also just to let you know (but it may be different at your hospital) that if your levels are higher than 7.0 more than 3 times in a week they will probably put you on insulin. If you keep your levels under control through diet you won't have anything to worry about.

 

[going_crazy]

Not so perfect I'm afraid, it should be the result after one hour not two! And after an hour it should be less than 7.0 mmol/l. Your fasting result is on the high side too as the max should be 5.5, mine are usually 4.5.

Hi hun, thanks for your reply

Wow! You had the result read after one hour? I've done quite a bit of research and I've never seen it say after one hour! Maybe we were given different drinks?
I'm going by the information I was given at the hospital and with the Freestyle lite booklet - anything under 7.8 is fine...... I assume we've been given different info, as I was definately told that after after 2 hours it should be under 7.8.
I found this online which also seems standard???

Fasting Blood Glucose
Glucose Level .....................................Indication
From 3.6 to 6.0 mmol/L .................... Normal fasting glucose
From 6.1 to 6.9 mmol/L .....................Impaired fasting glucose
7.0 mmol/L and above ...................... Probable diabetes

Oral Glucose Tolerance Test (OGTT)

Sample taken 2 hours after a 75-gram glucose drink.
Glucose Level ........................................Indication
Less than 7.8 mmol/L ........................Normal glucose tolerance
From 7.8 to 11.1 mmol/L ....................Impaired glucose tolerance
Over 11.1 mmol/L ............................. Probable diabetes

It came from this website: https://www.labtestsonline.org.uk/understanding/analytes/glucose/test.html

I'm thinking I will make any definate decisions after another GTT - at least then I will know either way!

Thank you for your reply xxxxxxxxxxxx

 

[JynxPhD]

What would it hurt to carry on as if you were (which I think you are) diabetic? I've had GD twice and I am about to be put on insulin. I look forward to getting my sugars under control since diet alone can't do it. I mean checking your sugars and following a diabetic diet will only benefit your baby. Isn't that a good thing? It really isn't that bad. I know if can seem scary and irritating at first but it gets easier.

What is it that you are so bothered with? Maybe I can help with my past experiences.

 

[going_crazy]

What would it hurt to carry on as if you were (which I think you are) diabetic? I've had GD twice and I am about to be put on insulin. I look forward to getting my sugars under control since diet alone can't do it. I mean checking your sugars and following a diabetic diet will only benefit your baby. Isn't that a good thing? It really isn't that bad. I know if can seem scary and irritating at first but it gets easier.

What is it that you are so bothered with? Maybe I can help with my past experiences.

I'm not 'bothered' with anything really, I had the GTT because if diabetes in the family, but the diabetic midwife told me that was irrelevent and it was because my BMI was boderline - I weigh less now than I did when I was pregnant with my other children, and I never had the GTT with them (I was never offered it?) But the midwife also gave me no information whatsoever about the risks to me or baby of having GD.... There are so many conflicting things online that I have been left confused!

I would like to have another GTT to give me a better idea of my 'normal' levels - as I have said, I am not bothered to be proved wrong, but I really really don't think the 1st test was fair (through my own fault) and I would appreciate another one done whilst I hadn't been pigging out on junk food (not normal diet for me @ 11:30pm..... I'm normally in be by this time anyway!! )

I'm also concerned that I've kept to my 'normal' diet (white bread, childrens cereal etc) over the last 2 days and my levels 1 hour after food have not been above 6.8???? Surely that's 'normal'? Hence me asking for a further GTT......... I may very well be wrong, but I just have that 'gut feeling' that I do not have GD and I'm more than happy to be proved otherwise

Thank you so much for your reply - I hope that if I have another GTT and it proves I do have GD I can get some info from you? xxxxxxxx

 

[lolly25]

Hi hun,
I too have to have a gtt done after 20weeks, because of bmi on boarderline. I think it would do no harm in following the diet until you have another gtt, that way if its high again then you've kept to the diet, and if its ok then youve done no harm either x

 

[belladonna]

Hi hun, thanks for your reply

Wow! You had the result read after one hour? I've done quite a bit of research and I've never seen it say after one hour! Maybe we were given different drinks?
I'm going by the information I was given at the hospital and with the Freestyle lite booklet - anything under 7.8 is fine...... I assume we've been given different info, as I was definately told that after after 2 hours it should be under 7.8.
I found this online which also seems standard???

Fasting Blood Glucose
Glucose Level .....................................Indication
From 3.6 to 6.0 mmol/L .................... Normal fasting glucose
From 6.1 to 6.9 mmol/L .....................Impaired fasting glucose
7.0 mmol/L and above ...................... Probable diabetes

Oral Glucose Tolerance Test (OGTT)

Sample taken 2 hours after a 75-gram glucose drink.
Glucose Level ........................................Indication
Less than 7.8 mmol/L ........................Normal glucose tolerance
From 7.8 to 11.1 mmol/L ....................Impaired glucose tolerance
Over 11.1 mmol/L ............................. Probable diabetes

It came from this website: https://www.labtestsonline.org.uk/understanding/analytes/glucose/test.html

I'm thinking I will make any definate decisions after another GTT - at least then I will know either way!

Thank you for your reply xxxxxxxxxxxx

Looking at that site it doesn't really mention GD, just to say you are tested if you have glucose in your urine- I never have. Luckily my hospital tests all women- not just the 'high risk' ones. I think the information above is really for the other types of diabetes. With GD its best to keep the levels lower to avoid the baby becoming too large due to the extra sugar they are getting.

The NHS recommend:

If it is safely achievable, women with diabetes should aim to keep fasting blood glucose between 3.5 and 5.9 mmol/l and 1-hour postprandial blood glucose below 7.8 mmol/l during pregnancy.

Have a look at the bottom of page 1 here: https://www.nice.org.uk/media/E5D/8C/2008021DIP.pdf

This link is more useful though: https://www.nice.org.uk/nicemedia/pdf/CG063Guidance.pdf

HTH

 

[going_crazy]

Hi hun, thank you for the link, I appreciate any information right now as the diabetic midwife kinda rushed through everything and shoved me back out the door!

I also appreciate having someone to chat to!

If it is safely achievable, women with diabetes should aim to keep fasting blood glucose between 3.5 and 5.9 mmol/l and 1-hour postprandial blood glucose below 7.8 mmol/l during pregnancy.

^^ This is the same as what I was told - for testing one hour after I've eaten. I'm sorry, in your original post I thought you meant your levels were tested 1 hour after the GTT.....

I am really struggling to find any information about the glucose levels of pregnant women one hour after they've eaten (just to compare with mine really - just being nosey ) Do you know where I can find that info?
I'm also finding very conflicting information on the real risks to mum+baby - some websites say things along the lines of having a big baby, increased risk of c/section and some jaundice problems, other websites mention much more risks such as stillbirth, problems with breathing after birth, haemoraging(sp) etc which is all rather scary tbh I really wish the diabetic midwife had given me a leaflet or something !

Sorry for the rant again and thank you for your reply xxxxxx

 

[belladonna]

I know, I haven't been able to find any results apart from the recommendations in the NICE guidelines.
Its terrible that the midwife didn't give you any info- how often do you have to see her? Have you had an appointment with a consultant yet? I have to go every week to see the diabetic team (which is midwives and dr) and also have scans and see the obstetrician at 30, 32, 36 & 40+ weeks. Also have you seen a dietician yet?

The possible effects for baby are very serious and include the things you have listed, but also the chance of pre-eclampsia is higher. Someone has put some really good links to leaflets on one of the other GD threads, I think she is a midwife (I can't remember her name)

What part of London are you in? Which hospital are you going to?

 

[going_crazy]

I know, I haven't been able to find any results apart from the recommendations in the NICE guidelines.
Its terrible that the midwife didn't give you any info- how often do you have to see her? Have you had an appointment with a consultant yet? I have to go every week to see the diabetic team (which is midwives and dr) and also have scans and see the obstetrician at 30, 32, 36 & 40+ weeks. Also have you seen a dietician yet?

The possible effects for baby are very serious and include the things you have listed, but also the chance of pre-eclampsia is higher. Someone has put some really good links to leaflets on one of the other GD threads, I think she is a midwife (I can't remember her name)

What part of London are you in? Which hospital are you going to?

Hi!

I have got to see the midwife again on 11th June and she said a dietician will be in touch but didn't say when! I'm very disappointed so far as I've not really any idea what form of diet I'm supposed to be following - For example I didn't know I couldn't eat pastry until tonight when I had a pie for dinner and my reading after 1 hour was 10.2 my 1 hour reading after food has never been more than 6.9!!!
I had to look online to see if pastry could've caused it and found that pastry is one thing I should definately avoid! I also spoke to the labour ward who were extremely helpful and told me not to worry unless I had several readings that high!

I saw a consultant 4 weeks ago (before I was diagnosed) and she signed me off! I suppose I'll get an appointment with her again? I really don't know much as I've had no info whatsoever!!!!
I already had a 34week scan booked as my last daughter weighed 9lb 8oz (I didn't have GD though as far as I know, and she was fine at birth) but no one has mentioned any other scans

I'm having weetabix for breakfast as someone mentioned this was good? so far white bread has been ok with me, but I also love crackers so I may just have them for lunch in future - I'm hoping this is ok and I think my dinners are just going to be trial and error!!!!!!!

Do you know what the glucose levels need to reach before they put you on insulin?

I might phone the midwife on Tues to see if I can get an earlier appointment as I really don't know what I'm doing! I really thought I didn't have GD because of all my 6.9 readings, but since the pastry incident I'm not so sure!!

Thanks again for your help xxxxxxx

Oh, btw I'm going to University Hospital Lewisham and they're normally really good there but just this time I don't feel looked after xxxxx

 

[belladonna]

11th June! Thats a long time to wait!
I was really lucky- I had the fasting test on Tuesday, had letter to confirm GD on Thurs and had the appointments with diabetic midwife, consultant and dietician on the following Tuesday.

They told me if I have 3 or more readings over 7.0 in a week then they would put me on insulin (normal level is 7.8 unless BMI is over 30) My average reading after dinner is about 6.0 after lunch is 5.5

The diet is really easy

• No white bread (includes pitta, naan & wraps)- have wholemeal.
• Limit fruit (can make levels high) AVOID fruit juice! Have lots of veges though
• AVOID processed potatoes- have fresh
• White rice should be fine- basmati is the best
• AVOID squash, fruit juice and fizzy drinks - SOME diet drinks are ok, some make levels go crazy
• Any thing with white flour is a
• Yogurt should be OK if it has less than 10g of carbs per 100g
• Watch any processed food basically, as they seem to hide sugar in everyting!

It will be trial and error though as it all depends on the individual and how fast you can process the sugar.

For example I had homemade paella tonight and my reading was 5.7 which is really good. Last week I had lamb kofta kebabs (from sainsburys) with salad and brown pitta and the reading was 7.7 forgot about all the stuff mixed in with the mince.

Definately contact your midwife to see if you can get more info- its really bad that they have left you to deal with it with no help. If you have no joy with them perhaps contact your GP who may be able to find out more for you.

You are entitled to the following care:

28 weeks
Offer ultrasound monitoring of fetal growth and amniotic fluid volume.
Offer retinal assessment to women with pre-existing diabetes who showed no diabetic retinopathy at their first antenatal clinic visit.
32 weeks
Offer ultrasound monitoring of fetal growth and amniotic fluid volume.
Offer to nulliparous women all investigations that would be offered at 31 weeks as part of routine antenatal care.
36 weeks
Offer ultrasound monitoring of fetal growth and amniotic fluid volume.
Offer information and advice about:
•timing, mode and management of birth
•analgesia and anaesthesia
•changes to hypoglycaemic therapy during and after birth
•management of the baby after birth
•initiation of breastfeeding and the effect of breastfeeding on glycaemic control
•contraception and follow-up.
38 weeks
Offer induction of labour, or caesarean section if indicated, and start regular tests of fetal well-being for women with diabetes who are awaiting spontaneous labour.
39 weeks
Offer tests of fetal well-being.
40 weeks
Offer tests of fetal well-being.
41 weeks
Offer tests of fetal well-being.

I have managed to keep it under control by diet only and at my 36 week scan they estimated that the baby was 7lb6oz already but baby is breech at the mo so have been booked in for an ECV on friday which I'm getting nervous about already.

I had a look at your hospitals website and unfortunately couldnt find anything useful on there. I'm so glad I moved away from London, I used to live in Walthamstow and the hospital there is Whipps which is rubbish!

 

[costgang]

ive got to monitor coz ive got gd again, and my levels are meant to be less than 6 before meals and less than 7 2 hours after, havnt been able to control mine with diet so now on metformin and insulin 4 times a day

 

[going_crazy]

ive got to monitor coz ive got gd again, and my levels are meant to be less than 6 before meals and less than 7 2 hours after, havnt been able to control mine with diet so now on metformin and insulin 4 times a day

Hi, thank you for your reply
I am very new to GD and have not been given any info - the info I have found online etc is very conflicting....!
Is is hard taking insulin? xxxxx

 

[going_crazy]

I have managed to keep it under control by diet only and at my 36 week scan they estimated that the baby was 7lb6oz already but baby is breech at the mo so have been booked in for an ECV on friday which I'm getting nervous about already.

Good luck with that hun, I hope it goes ok and is not painful or anything xxx

Just one more question from me......
Is it ok to monitor my levels BEFORE I eat?? I'm just interested if my levels are constantly high or if certain foods stay in my system for longer etc - for example, this morning I had 1 weetabix as recommended by the midwife, but an hour later my levels were quite high at 7.4, so didn't know if this will affect my lunchtime reading??? Oooo... and are snackajacks ok for a snack??? I'm finding it hard in between meals

Sorry for the bombarding of questions.... I'm hoping to get an appointment with the dietician soon and I'll go with pen and plenty of paper!

xxxxxxxx

 

[sarafused]

Personally Id bin the snack-a-jacks, its just rice! Try to think lower carb and higher protein.

Part of it is also trial and error to see what you get on with best.For snacks what about some grainy ryvita with marg or low fat cheese spread? Carrot sticks and humous or a low fat yogurt.

Id suggest you test your sugar levels before breakfast. In my last pregnancy I found that after I had been awake a little while my sugars would go up before I had eaten.

I think 1 weetabix isnt very much for breakfast! In Finland we are recommended to have 2 dl of (made up) porridge or 2 slices of full corn bread (we get heavy rye) and then some suggestions of toppings or extras to go with it.

 

[serenitylove]

iv been told to test every day as my random test was noted down as a fasting test which it wasnt but im obese so dont mind the extra care i have the home tester thing and have been told to call if my resluts are befor food over 5'5 mmols and 1hours after food over 7'5mmols iv gone over twice so go back next week to see nurse and dietician good luck x

 

[belladonna]

Did you test as soon as you got up, before breakfast? Only test first thing in the morning- theres no need to before each meal. What did you have with the weetabix?

 

[going_crazy]

Did you test as soon as you got up, before breakfast? Only test first thing in the morning- theres no need to before each meal. What did you have with the weetabix?

I tested before brekkie and it was 5.3 (not bad I suppose) I had 1 weetabix with a little milk and my level an hour later was 7.4 I have done a bit of research on the net (not sure if it's a good or bad thing really!) and I've found that following a low GI diet can be beneficial for GD.....? This would mean that weetabix is a no go - I suppose it is different for each person, but I thought I'd give it a go until I see the dietician/consultant/diabetic midwife again!

Oh, and I also found that on the GI diet, snackajacks are a definate no-go - which would explain why my levels an hour after lunch were 10.4!!

After dinner tonight my reading was 7.2 which is lower than I thought it would be but still on the high side?


Anyway - how's you? xxxx

 

[belladonna]

Yeah I had heard that low GI foods were good, but I have been fortunate that I can still eat most carbs. I don't eat breakfast usually but I have been having those new belvita breakfast biscuits and an apple or banana and get a reading of about 6. I started to have brown toast for breakfast and would be about 5.5.
I don't really snack during the day, but if I do I will have fruit or a packet of crisps ( make sure they are kettle chips/ walkers) or a couple of digestive biscuits.
Don't assume that its your food that are pushing your levels up- it may be what you are drinking.

 

[going_crazy]

I thought about drinks, but I mostly drink water through the day, a VERY occasional small cup of water and I've also had drinks of pepsi max - this has zero sugar zero carbs and I was told this was ok by the midwife?

This is hard work to begin with, I'm hoping with more info it'll get a lot easier! xx