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Gestational Diabetes #65


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#1 ~A2~

Posted 27 April 2012 - 11:07 AM

Hi all

New thread time

Previous thread

Regards

Ali


#2 Chelara

Posted 27 April 2012 - 11:15 AM

And isn't it very, very cruel that eB keep putting those profiteroles, cauliflower fritters, Anzac bikkies and red velvet cupcakes on show.

Please be advised so soon, wow 4 weeks to go and I feel like I've done nothing but focus on bloody food! Fingers crossed it all goes well for you.

I have my growth scan on Tuesday, I sort of feel like its a bit of a test to see how well this diet is going... Hoping they can't see my slice of pizza and occasional chocolate in there lol. This is my first scan since the morph one at 18 weeks, can't wait to see bub. Ut I always find these things nerve wracking.

#3 Chelara

Posted 27 April 2012 - 12:51 PM

Oh and Dettol if you're still around I just wanted to suggest something to you which you may not have considered.

I don't know your hospital's policy but a diagnosis of gd, no matter how well managed at my hospital means immediate scn for the baby, no matter my or their levels. It also means bub having their heal pricked at birth and other times throughout their first few days, it may also mean constant monitoring, checking bsl during labour, no early discharge, more likely to have an induction or a Caesar, and they'll want you to do a retest when the baby is 6 weeks old.

Just further consideration, you may be better off suggesting a retest now and not have you or your baby go through that. Some of it may not apply to you at all. Make sure you ask and get a clear answer about policy though, my Ob was very blasé and my diabetes educator who works from a totally different hospital was the only one to inform me of my hospitals policy regarding scn for the baby.

#4 Dettol

Posted 27 April 2012 - 10:29 PM

Thanks for the heads up Chelara.

I have appointment Monday with the OB will ask him, when I asked him last week about my readings being perfectly normal.  He said to speak to the educators.  Asked the educators and all they did was say well done on keeping your levels so low.  

Feel like I have been butting my head against a brick wall with the whole thing.




#5 Chelara

Posted 28 April 2012 - 09:07 AM

I know how you feel my Ob doesn't even want to see my levels, I don't meet with my educators s they work from a bigger hospital elsewhere. If no one told m anything and they took my baby from me after birth for special care I would feel distraught. I am glad at least I know it is most likely coming.

If your Ob wont answer you find someone in your hospital who can go thought It with you, you've a right to know what interventions are likely to take place.

#6 PreachersWife

Posted 29 April 2012 - 02:52 PM

I agree with Chelara, find out the hospital policy. I have a private OB and give birth Ina small private hospital so the situation is a bit different, but I would rather not have to do the GD thing if possible! Also, I think 33/34 weeks is the GD hot spot, so if they do another GTT then and your clear, then you can be cleared before?

With pregnancy #2 I was considering a VBAC but the GD meant that was ruled out as my OB won't induce after a previous caesar and he wouldnt let me go past 39weeks, so elective Caesar was booked. This time I just went with the Caesar straight away, so getting GD didn't really complicate my birth plan at all, except I will probably have it closer to 38weeks. All depends on how big they predict baby will be and how my levels/amount of insulin are.

At least everyone keeps saying how well I look, I know I haven't put on much weight (maybe 7-8kg) and I am 5kg lighter than when I was diagnosed with DS. I think it has helped my levels too. I had a small amount of pasta during the week, porridge a couple of times and still had good readings. I think I'm more active this time as well, I was at work with DS part time and sitting down all day, now with two kids, I never get the chance!

Good luck with the scan on Tuesday Chelara, its always so nice to see your baby and feel reassured. And I hope everyone else has a good week too!

#7 Dettol

Posted 30 April 2012 - 10:34 AM

I am going public even though I have private health insurance.  You give birth at the public hospital where I live regardless of if you are private of public and then you are transferred to the private after birth.  ( you need to make your own way there).  So I did not see the point.

I am not over weight.  Have put on the grand total of 6kgs at 35 weeks.  When I went to the OB last fortnight, he made the comment that by looking at me he would not have thought that GD would have been a problem.  And that I would not require insulin to manage it, diet would be enough ?

There is  a strong family history of diabetes on my fathers side ie.  Every female has it before they hit teenage years.

Will ask questions today on special care.  I am not keen on being induced at 38 weeks unless I am ready to go ( which is what he told me would need to happen at my last appointment).  Have a list of questions to ask him today so will have answers to all my questions, including the induction he mentioned last appointment.  I have half given up on testing 4 times a day and have dropped it down to twice if I am lucky, the results are always fine, constantly having to prick my fingers when they are starting to get sore is giving me the irrits when there is no difference in my readings.

Funnily enough the educators told me that chocoloate does not make most peoples levels go up?  The fact content is more of an issue.

#8 Chelara

Posted 01 May 2012 - 04:07 PM

Feeling a little down. Don't like my chances of achieving a vbac but still some hope. Ob finally told me this morning I will only be allowed to go to term, not 41 weeks that I was under he impression of.

Had my scan after seeing the Ob, bub is already estimated at 3.6 kg so looking like over 4kg at term. Tummy was a little large (still normal) everything else was fine.

I haven't had a high reading in 2 weeks, still diet controlled. I thought I had a good chance of avoiding gd related complications and would be allowed to go over. Seeing the stats and hearing my Ob actually say induce at term, it is on my card too so no mistaking it. I can't have gel so if I am not dilating it is automatic Caesar. sad.gif



#9 a letter to Elise.

Posted 01 May 2012 - 04:38 PM

Sorry to hear it's not looking good for VBAC Chelara. It wasn't looking promising for a VBAC for me either, and now with the GD diagnosis, the OB has recommended I just opt for an elective c section at 39 weeks. She won't allow me to go past 39 weeks, and she won't induce.

Saw the Endo today, and all is going well with diet management now. I'm really relieved. My levels have been really stable for the last week, so she's happy for me to only test twice a day now. I did find out my Cholesterol is 9.5 ohmy.gif. Apparently this increases my chances of a really big baby, even if the GD is under control. We'll see though, they thought DS would be massive, and he was 3.3kg at nearly 38weeks, so pretty average.

I've hit 32 weeks today, and I'm starting to feel so uncomfortable and tired. Really missing the chocolate pick me up in the afternoon right now!

#10 boofloo

Posted 02 May 2012 - 04:35 PM

I was also originally hoping for a VBAC, but have now (under advice from the doctors) decided on a c-section.  They said they would not let me go overdue (2 of my previous 3 were 10 days overdue and induced), they dont really want to do anything other than break my waters to try and induce me (which didnt work with previous 2!), the pacenta is near (but not on) my previous c-section scar, bubs is looking biggish, my blood levels refuse to come under control for more than a day or two at a time and now my blood pressure is starting to go up more and more each week....all little things that I could handle one at a time, but when added together are not so good  sad.gif

But I figure, as long as I get a healthy, happy baby at the end it will be worth it - doesn't matter exactly HOW they are born really.

The good news is that they upped my insulin dose lots at the last visit - which has actually meant I can eat without putting my levels right over  biggrin.gif   Will be good while it lasts anyway!

#11 PreachersWife

Posted 02 May 2012 - 09:40 PM

QUOTE (Chelara @ 01/05/2012, 04:07 PM) <{POST_SNAPBACK}>
Had my scan after seeing the Ob, bub is already estimated at 3.6 kg so looking like over 4kg at term. Tummy was a little large (still normal) everything else was fine.



QUOTE (Matthias' mum @ 01/05/2012, 04:38 PM) <{POST_SNAPBACK}>
I've hit 32 weeks today, and I'm starting to feel so uncomfortable and tired. Really missing the chocolate pick me up in the afternoon right now!


Glad to hear your scan went well Chelara, even if a VBAC isn't looking like an option. At least you can prepare a bit mentally for whatever might be the final decision. Well done on keeping up with the diet, I think the last few weeks are the hardest, you can see the end of the tunnel! With my DS I missed fresh fruit the most and my sister sent the best fruit basket to the hospital instead of flowers, it was awesome.

I'm 32 weeks as well Matthias mum and I know how you feel. I fell like my body has packed it in. Sore hips and lower back, waking up every couple of hours a night, skin feeling stretched and tight and lots of big baby moves, like backflips! We are on holiday at Airlie Beach for a week and while its been so lovely (swimming, first time in months I haven't felt heavily pregnant) I miss things from home, like the changetable! Changing a 14kg two year old is hard with the belly in the way! It's been pretty easy to keep going with the diet here though, plenty of seafood and salads, just have to stay away from the hot chips and dessert.



#12 Chelara

Posted 03 May 2012 - 09:08 AM

They're definitely not ruling out vbac, just ruling out going over term. I could be fine I just need to get my body ready. The will let me have induction I just have to have started dilating. Considering I went a week over with dd, labored all day at home, water broke came in and was examined at 0 cms I am just not getting my hopes up.

Sorry you ladies are feeling it physically. It is hard when you're uncomfy. I generally feel great just itchy. I swear I will be huge in another 3 weeks lol.

Glad everything has been fine for you food wise preacherswife. I love Airlie beach, what a fantastic place for a holiday! I found 33-34 weeks the hardest with regards to getting good readings. I know what you mean about those last few weeks, sometimes I just want to say stuff it and have an apple/piece of fresh crusty bread with butter. Oh and pineapple, I can't buy one as id have to ration it over days and days and it would go off.

Mattias mum that's good your adjusted insulin is giving you the chance to be a bit freer with your diet. Makes life easier.

Has anyone been told they need to do another gtt at 6 weeks post partem? I think I will decline the testing. I want to breastfeed, one thing I hope I can achieve, and don't want to fast and then spend the 2 plus hours of the test without being allowed to feed. I am hoping it's ok to wait until 4-6 months or so.

Hope everyone has a good rest of week and weekend.

#13 boofloo

Posted 03 May 2012 - 09:31 AM

QUOTE
Has anyone been told they need to do another gtt at 6 weeks post partem? I think I will decline the testing. I want to breastfeed, one thing I hope I can achieve, and don't want to fast and then spend the 2 plus hours of the test without being allowed to feed. I am hoping it's ok to wait until 4-6 months or so.
  I have been told that I will need to get another test done at 6 weeks post birth - but they said to skip the 2 hour long 'fizzy drink' test, and they will just get me to do the longer one where you follow the diet for 3 days, then come in for the blood tests.  This way you are still eating lots while breastfeeding, you can breastfeed your child throughout the test and they will also get more accurate results.  They also did it this way when I had DD2, so it might be worth checking with them which test they want you to do.

#14 MickeyBoo

Posted 03 May 2012 - 10:49 AM

Hi ladies,

We've just been away on a short holiday so things were crazy here last week getting ready to go and now that we're home I've been sick and the kids have been under the weather too, so it's taken a few days to get back into the swing of things.

I have my last scan next Wednesday and then my OB/Endo appointment on Thursday where they will officially book me in for my induction for the following week. I can't believe that in exactly two weeks today I will be going in to start things off, it just seems so surreal right now and I think I should start getting my head in the game instead of living with the fairies! I really hope that bub has slowed down with her growth though because she was powering ahead at the last scan again.

My BSL levels have actually dropped significantly, I hit 34 weeks two weeks ago and pretty much overnight they went from verging on out of control, upping insulin every three days, high 6's after basic meals to being low 4's after meals and I've also had several hypos when I have left it half an hour past meal or snack time. I've got to wait until next Thursday to see if they want to drop them a little bit. But it's nice in the meantime to have a bit of variety back in my diet, I can eat peanut butter for breakfast again!

Chelara It's really important to do the GTT after birth, and to also have a follow up test at 6 months and 12 months post baby as well. Having GD can really increase the risk of developing Type II, after my second bub with undiagnosed GD things went pear shaped for me very quickly and by the time she was 8 months I had full blown Type II and PCOS also kicked in so have needed to be on medication since 2004 and will be on it for the rest of my life regardless of my weight. It's better to catch this stuff as early as possible.

I really hope that you get a chance to go into labour before your due date and have an opportunity to try for a VBAC. What date is your cut off date?

Special Care Just wanted to note that it's not automatic that bub goes to special care, I've never had any of my bubs (except the undiagnosed GD bub) taken to special care, but they do like to pay a bit of extra attention to them, and will come around and make sure that they are feeding, and do the BSL checks on them, but if their temps are fine and their levels are responding well then there's no reason for them to be taken away. You can always ask for a small formula top up feed after the colostrum if bub is too sleepy at the breast to feed well and get a good BSL result too.

AFM Well I'm 36 weeks tomorrow and I am really feeling over it now, the SPD is the worst its ever been and I am looking forward to just being able to sleep pain free, I don't care if it's just 2 hours at a time but just without pain and being able to roll over would be my idea of heaven right now! I have put on about 2kg in the last 3 weeks and I know that bub and fluid accounts for at least 1kg of that according to scans, but the rest is fluid piling up on my ankles, feet, hands and face and I'm just feeling yuck, I don't normally swell in pregnancy so this is new for me, my BP is up a bit too, but no protein in my urine so I'm hoping it just stabilises and I can ride it out till my induction.

Anyway, I'll leave it there, sorry for the lack of personals got to keep my boys entertained!

Mic

#15 Eeyolet

Posted 03 May 2012 - 11:16 AM

Hi ladies,
Just thought I would introduce myself as I am pretty sure I will get GD in this pregnancy. My DD is 20months now and I had insulin controlled GD in my pregnancy with her, I am also 7kg heavier this time around.

With DD I was induced at 38w6d purely because of the GD, my choice, I was sick of the injections and my stomach was huge she was born 3.86kg so on the large side, she never went into the special care unit, they just did a heel prick at birth to check her BSL and she was fine.

I am getting a GTT done this week at 6w as it has been a while since my last, I keep putting it off as it is a horrible test at anytime but add morning sickness into the mix and I don't think it is going to end well. If clear I will get another done around 16w then again at 26-28w.

Does anyone here have GD the second time around? I didn't get it with my first though.

6 week GTT I really think you should get this done, you need to know if you have type II so you can look after your self. My hospital does them at 7.30am, I took DD with me and breastfed her like normal and just had a late breakfast at around 9.30, no drama at all really.

#16 a letter to Elise.

Posted 03 May 2012 - 11:39 AM

Hi Eeyolet, hope the GTT goes well for you. My first pregnancy I was just under on the GTT at 28 weeks. My Endo thinks had I been tested a few weeks later I probably would have had a positive result. DS was fine though, thank goodness. This time I was just over on the GTT, so managing with just diet at this stage.

Re: Post baby testing GTT, my Endo wants me to redo the test 3 months after I have the baby, and then 1 year after that. Due to my current results, she is expecting that the Diabetes will disappear as soon as I have the baby, and has given me lower odds of it returning (about 20-30% in the next 10 years), if I manage my weight and diet well.

I didn't even think of the breast feeding aspect. That will be tricky. I used to get so hungry when I was feeding DS! I am going to try and get this baby to take a bottle of EBM a little earlier this time. With DS, I didn't bother, and then I could never get him to take a bottle at all.

As far as SCN goes, my cousin works as a SCN nurse, and she told me that most GD babies don't go there - it's generally only if the diabetes was undiagnosed or not well managed, with the occasional exception. She did say if I can't BF within the first hour, that bub will probably need formula. As I'm having a c section, I've resigned myself to this, as I know it will be pushing it when I have to get stitched up and go to recovery before I can BF.

#17 Chelara

Posted 03 May 2012 - 12:06 PM

Thanks everyone, good info. I was told by my educator (different hospital than where I'm booked in) that I couldn't breastfeed during the 2 hour wait after having the drink as the sugars will upset he baby. I will get all of the details from pathology and see what they recommend. I was planning on still self checking until I had the all clear.

With regards to special care I was told that was my hospitals policy, 4 hours of special care.  I know other hospitals don't do that but apparently penrith's private hospital is 24 hours automatic special care and nepean there's no such policy. That's according to my educator who does those districts and works from nepean.

Good luck with your gtt eeyolet, I didn't have gd first time around either, this is my second bub so first time with gd.

Matthias mum, can you express a first feed of colostrum? That way you might avoid the formula. Might be hard going but you'd only need a very small amount and could freeze it until needed.

Mickeyboo, welcome back, great news about your levels. 2 weeks is so soon, all the best. My due date is May 26th, which is a Saturday. Perhaps I can convince them to let me have the weekend to get things going.

#18 Dettol

Posted 03 May 2012 - 07:48 PM

I asked my OB about special care, he said that things would not be done any differently becuase it was what they call 'diet controlled' told him what was going on, and he made a note that it was diet controlled and everything was progressing as per normal in my VMR, he said they will use that as their guide.  They are now not going to induce me at 38 weeks at this stage.

Baby is smack on the 50th percentile for size and everything looked excellent on scan.

#19 *Lena*

Posted 04 May 2012 - 10:25 PM

I am confused. Tonight and the night before the first reading I did was 7, I tested again right away on another finger and it went down. Tonight to 5.3. How can it be so different in such a short time? Which am I meant to believe, of course I want to believe the 5.3? It only happens of a night.

#20 PreachersWife

Posted 05 May 2012 - 09:20 AM

Lena, I can often get funny readings. If I think it's off (as in I know that what I have eaten shouldn't have given me a high reading) I will retest, usually twice to get a kind of average.

Also, I will give my hands a quick wash with water and dry well as sometimes I think if I have something on my skin it mucks up the reading. I also find if I'm too slow or too fast with the blood sample then it's off too.

I also agree with PP's about the 6 week GTT. There should be no reason you can't breastfeed during the test and it's important to know that the diabetes has stopped. Due to a high family history and being overweight I try and have one every year and definitely had one at around 7 weeks postpartum with my last pregnancy.

#21 Chelara

Posted 06 May 2012 - 09:44 AM

Lena I was getting odd readings at first too, usually at night.  Think nerves made mine go up as adrenaline definitely makes you release sugars into your bloodstream. A few seconds later it will be fine. I would wash my hands again, a few deep breaths, retest. I at first thought these monitors must be very inaccurate but your body chemistry does change all he time and rapidly. Once I got used to doing the test, not nervous etc I have very few odd readings. The ones I do have are where I am too slow to get the sample and it is a low reading as result.

If in doubt of the reading I would retest, especially if it is a meal you eat often and has given a totally different result.

#22 PleaseBeAdvised

Posted 08 May 2012 - 09:16 AM

Hello ladies!

Just popping in to let you know about the safe arrival of my little yet-to-be-named boy. I am breastfeeding as I type: so very gorgeous  blush.gif

I went to hospital 01/05 and was given a dose of prostin, at which time I was fully effaced and 1cm dilated. In the evening it was decided - after a very rough internal by the OB - I wouldn't have another dose and ARM would be attempted the next day. At 10pm 01/05 my waters broke and my little one was born at 5.18am (38+4) after a fast and furious natural labour. 3.6kg, 53cm.

My boy was kept with us from birth and he latched on to the breast straight away. As I had been expressing since 34 weeks I had stored colostrum which was also provided at birth and after feeds until my milk came in day 2. His BSLs were tested for the first few days and all was perfect.

My BSLs for the first few days were also perfect, and I hope my 6week GTT will show no issues. I've had my obligatory chocolate fix but am managing to stay on the diet that I had during pregnancy: GDM was not a great experience and im dong all I can to avoid diabetes from now on.

So just a quick note to remind everyone things will be okay at the end, and that positive birth outcomes can happen despite inductions and nasty OB examinations.

Much love,

Chiara

Edited by PleaseBeAdvised, 08 May 2012 - 09:17 AM.


#23 *Lena*

Posted 08 May 2012 - 09:27 AM

Thanks for your replys girls.

Pleasebeadvise- Congrats on your little boy! Pop in and let us know his name when he has one.

Just some question about expressing beforehand. Do you keep the expressed colostrum and take to the hospital with you? or is it just to get the milk flowing before you have baby? You won't get much will you? If you do take it to the hospital, how much do you take? I have 3 hours to drive to get to my hospital for my c-section will it last that long? What do you store such a little amount in?


#24 PleaseBeAdvised

Posted 08 May 2012 - 01:21 PM

Hi Lena!

I was advised by my diabetes educator to express and store colostrum to give to bub post birth and in the event there was a delay with my milk coming in (apparently this is a risk with gdm).  

I was given little syringes with lids by the hospital and would express in to a spoon, which was then sucked in to the syringe. I would do that for 2 days before freezing for storage (first express in to fridge for 24 hours) and would get 2-3ml in to each syringe.

I think colostrum works like regular bm in that it is fine thawed for abut 8 hrs. As soon as we got to hospital they popped it in the freezer.

I highly recommend doing this. It's 15 mins out of your day and was a great assistance to bub for those first few feeds. I also had my milk come in day 2 and credit the month of daily hand expression to this. Have a chat to your diab educator. You can also try searching the forums here for "expressing colostrum" for info.

#25 PreachersWife

Posted 08 May 2012 - 09:47 PM

Congratulations on the safe arrival of you baby boy Chiara! Glad to hear everything is going smoothly and I'm sure you are loving those squishy baby smiles. Good luck for your 6week GTT, I know how you feel about avoiding future diabetes - its a good kick start.

Lena - sounds like you have a lot going on now. I have never expressed before the birth, or been advised to. I was able to exclusively feed both my two, with only my DD having 10mls of formula on day 3, about 12 hours before my milk came in (and I didn't have GD with her). With both I was in recovery for about 45mins to an hour and then fed straight away in my room. No BGL issues with either.

AFM, I booked in my Caesar date with my OB today, so just 36 days to go! Levels have been good, no insulin yet which is great! About the hit the 33/34 week mark so seeing the light at the end. Have had two friend have little ones on the weekend and my best friend told me tonight she's pregnant with her first which is so exciting.






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