Tuesday, July 31, 2012

Today is a whole other day



So...still no official word yet if I have gestational diabetes or not...but in the meantime, thank you so very much for all of your comments and thoughts. It really, really helps to hear your experiences.

A special thank you from those of you who commented that you had GD but went on to have a normal sized baby. That was heartening and motivating to learn. It was also cool to hear that some of you went to a GD specialist or specialty clinic - I'll have to see if something like that is available here - I think it would help me keep a closer eye on things and stay on track.  Also really helpful to hear that exercise can help bring the glucose levels down if they are initially high. And thanks for the validation that being sick could have affected yesterday's test results (see below for more evidence of that). Also, really interesting to hear that these monitors have an error rate of 20% - that's a wide margin! I'm using the One Touch UltraSmart by the way, not the Freestyle. Not sure why they can't make these devices more accurate than they do...

Just to further confirm that something wonky was maybe going on yesterday, I thought I'd share these numbers from today...they seem so strangely low compared to yesterday's crazy values.

Fasting:                                                                             97 (ok, that's a little high - below 95 is target)


1 hour after breakfast (egg/cheese on 1/2 muffin):     105 (target is below 140)


1 hour after lunch (tuna sandwich on whole wheat):  118


1 hour after snack (banana + almonds):                         99

How can all these levels be so well...normal...when everything looked so wonky yesterday? Perhaps it was the being sick overnight. Or could it be that I just can't consume vast quantities of cake (or yucky glucola) but am otherwise ok?

I tell ya, it's a head scratcher to me. Especially because I don't think my diet today has been particularly healthy.

I also wanted to get your thoughts before tomorrow's appointment on what else I should keep an eye out for as the pregnancy progresses. Once you were diagnosed GD, did your OB do anything differently in terms of doing growth scans or checking for lung maturity? I also read there is an increased risk of stillbirth with GD (shudder). Anything else I should be sure is occurring in terms of blood work, scans, etc., to give everything the best chance of being ok?

I promise I'm not freaking out...I just want to be thorough.

More tomorrow after I meet with the OB. My husband Will will be coming with me... stay tuned.

Mo


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18 comments:

myfertilityjourney said...

Glad to know you are not freaking out. Your levels seem so good today, weird. I'll stay tuned :)

Coreena said...

I was dx with GD at 33 weeks after passing the 3 hour glucose test because I had a couple high readings. My midwife office had me in twice a week for non-stress tests, weekly fluid checks and monthly growth scans. My son was born 10 days early at 6 lbs 14 oz, completely healthy. Your numbers today look great, even if you failed your test yesterday, it looks like you will be able to do a great job of controlling your sugars with diet alone. The risks to baby come when you have constantly high sugars for an extended amount of time. I'm sure you and baby girl will be fine especially with how on top of everything you and Will are!

Jen said...

I had GD with my last baby. My OB offices sends GD patients to a clinic & classes. It was really helpful! I went every week or every 2 weeks and they just looked over my numbers and asked if I had any questions. The diet was REALLY easy to follow. My DD was born happy & healthy :-) Good luck to you!

Laura said...

I had acouple of other scans, but that more because of the hyperemesis. You are higher risk for type 2 diabetes later in life, so you'll have to keep on top of that. While you're pregnant you probably start non stress tests and/or biophysical profiles to make sure that baby is doing well. Good luck!

TheThirtiesGirl said...

When I eat normal food--like you've listed--my numbers look dang similar. What you've eaten is very GD friendly. The glucola, however, raised my numbers. Additionally, there are some things (like Chinese food) that will always raise my numbers. I wouldn't be surprised if you are diagnosed with GD but are able to control it fairly easily with diet alone. My drs office told me that someone without GD should be able to eat sugar all day and not have their numbers get out of control--hence them using the glucola (I'm not sure how much truth there is in this).

Because I am diet controlled, I have had absolutely no additional testing. In some ways, this makes me nervous. Especially when I see most others in the same position having NSTs and BPP. However, I'm also not being forced to induce at 39 weeks--and that also seems to be a fairly common phenom. So, I guess their are trade-offs. Once I hit 40 weeks I will be sent for bi-weekly NSTs and a BPP to make sure everything is ok with baby.

I'd keep doing what you're doing food-wise until you get your results back. It seems to be working for you.

Anonymous said...

I just wanted to throw in - I didn't have GD, but I had a friend who was very thin and fit, but has a family history of diabetes and massively failed her 1 hour and 3 hour tests. She didn't even strictly follow the GD diet and still had a 7# baby. She had a few extra growth scans, but this is definitely a very common occurrence and doctors generally are very conscientious about making sure delivery is safe.

Mina said...

It is very expensive to make the gizmos more accurate, that is why the self reading blood sugar monitors have such a wide tolerance.
And there is something about that glucose syrup that gives different readings than normal food. I never once had a high reading during my entire second pregnancy, yet at 13 weeks tested positive for GD. And I ate pretty much whatever I fancied,and I fancied a lotless healthier food this time.
I had two very normal babies, long but rather skinny (56 and 54 cm and 3750 and 3830 gr), two great vaginal birth experiences, really great, and I also gained about 2-4 pounds, so both times I weighed less post baby than pre-. Which is not bad.
The reason for which I got induced at 40w was low amniotic fluid. And the placenta started calcifying a bit earlier than normal. But nothing to justify other measures than weekly monitoring during 3rd tri (I also have a private insurance and could afford it, which is how it goes in Germany, otherwise it would have been a tad less, but still quite frequent monitoring).
You'll be just fine, both of you. :-)

PJ said...

Oh yea, At 37 weeks my twins were 4lb6oz and 6lb4oz with my GD!

Those levels sound good to me.

Best Of luck.

B. said...

With my first, I had bi-weekly NSTs and weekly BPPs for the last 8 or 10 weeks of the pregnancy. The tech doing the BPPs did a couple of "unofficial (ergo unbilled)" growth estimates along the way just to keep me apprised of how she was doing. I was in one office or another every other day for the last 8 weeks, which was pretty exhausting but kept me from worrying overly much. I don't know if the extra attention was because of GD or AMA. I was 41.
With my second, I was 43 and again diagnosed with GD, but had weekly NSTs for the last 7 weeks and no BPPs at all. I was terribly worried that something could happen to #2 and wished I could have had the same monitoring I'd had the first time around. I had a different midwife, though, who believed that my age wasn't as much of a concern as my first midwife did.

My second midwife, who was less concerned about age, was older than my first. I wonder if that had anything to do with it.

Your numbers sound right on target, and your diet is already GD-friendly. I suspect that a session with a dietician will help set your mind at ease, and if your numbers stay in the healthy range you won't see anything worrisome on the growth scans that I'm sure you'll request from here on out.

Alexicographer said...

As I understand it, what else you have in your stomach (prior to or along with whatever carbs you are eating) has a huge impact on how fast blood sugar rises, which is why the whole glucola thing (on an empty stomach) is such a strenuous "test." I definitely found I had to fine-tune what I ate and how I combined it to achieve optimal results. I also remember I had to get "enough" carbs at dinner or my fasting result the next morning would still be high -- I think I needed a modest post-prandial rise to trigger the insulin that would then cause the fastings to drop? Don't really know, of course.

Not to downplay anything, but my general recollection/sense is that the effects of well-controlled GD (beyond the frustrations involved in achieving that) are generally slim to none. I don't mean to trivialize the risks of being the statistical outlier; I know that if you are the outlier, knowledge that that's what you are doesn't help, and I know you know that, but, all the same.

Also, if things do get wonky and you find yourself discussing such things as an induction or a scheduled c-section, well, you've got the advantage of knowing Magpie's exact gestational age. You're not going to induce at "37 weeks" and then realize she was really only 34 weeks along.

I know I've said this before, but yes, my DS was among the GD babies born resoundingly normal weight (if memory serves he was 25th percentile for both weight and height -- 7# 4 (or was it 5?) oz. That persisted through his first year and then at year 2 he jumped to 75 percent for height, still 25% for weight. Now as he approaches kindergarten he's 90th percentile for height, 40th for weight. The point being, sure, GD is associated with higher propensity to various problems including high birth weight and weight issues as a child, but ... well, that hasn't been an issue for us.

I was in a midwifery practice and got bounced to an OB for one check after the GD dx (plus dietician etc.) but, again, if memory serves, that was it. I went into labor with the midwives (who worked with the local hospital), though I did, as noted earlier, end up needing a c-section after many hours with not much accomplished -- (and sure, maybe that was the result of the GD, but of course I'll never know).

Melissia said...

I did not comment yesterday because everyone left super great comments. My kids are older and when I was pregnant we were not screened for GD. Looking back I suspect that I would have failed. My second child was induced 2 weeks early for pre eclampsia and weighed 8 lbs 11 oz. My next two children both weighed 9 pounds. For several years before I was finally diagnosed with type two diabestes in my l mid thirties I struggled with issues of low blood sugar and found myself over eating in an effort to self treat my constant hypoglycemia. My blood sugars have never actually been elevated however I too routinely fail any type of glucose tolerance test. I treat my diabetes with glucuphage which works very well at regulating my pancreas.

Mon said...

I was with midwife, so i was transferred eventually to the OB due to being high risk. I had the baby on the day of the first scheduled visit. Never heard of increased stillborn risk. But, my daughter was 8.4 almost a month early so I was not a lucky exception to the size. She had bad jaundice for 7 weeks and was orange as an, well, orange. Then it cleared overnight. She is very hyper now, though and i think its due to the gd, although everytime i ask about it no one seems to agree. However, if I had a chance to do it all over again, I would probably work even harder (i left you a comment about getting fit last post) and I would definitely take the nursing even more seriously, so thats something Id recommend to watch for. She is now otherwise fine, tall and skinny, in about 75th percentile for height and 25th for weight, at 3

SarahM said...

Thought I would share my story. I was diagnosed with GD at 12 weeks. They tested early in my first pregnancy (we miscarried at 12 weeks)and I tested positive so rather than chance it they tested me early again with my next pregnancy. I ended up having to test my numbers five times a day, take insulin shots three times a day and watch my diet very closely. Excercise does help alot with the numbers. Anyhow, with all that being said, my son was born three weeks early at 6lbs1oz. So definitely not a biggy by any means. Having a large baby was a major fear with GD. He is now an amazing perfectly healthy advanced for his age 10 month old. He even just started walking :) Way earlier than I expected. So don't stress yourself sweetie. Even if you do have GD it only last for a short wil and goes away literaly as soon as the baby is born. Best wishes and congratulations.

Rebecca said...

A couple of things...I think your numbers were high yesterday in large part because of how much glucose is involved in that test. That's a lot of glucose to ingest really quickly, and most normal people don't eat that much sugar all at once. Also, stress increases your glucose levels, and you were probably a bit nervous about the test. For my test, I had ridiculously high numbers (I think my fasting level was above 200), and yet when I tested at home, my levels pretty easily stayed within the normal range, even without a whole lot of diet modification. And I didn't really do any exercise to speak of at all, other than go up and down the stairs in our house a few times a day.

The only things my peri did differently after the GD diagnosis was she had me go in weekly for ultrasounds instead of every other week, and I started biophysical profiles (hooked up to a monitor to track contractions and fetal heart rate during fetal movement on Tuesdays, ultrasound measuring certain things that I don't remember on Fridays) a week or two earlier than planned. So I started them at 30 or 31 weeks instead of 32 weeks.

Other than that, they just had me monitor my levels four times a day, and since I was doing really well with staying in range, they said there wasn't anything else that needed to be done. Miss A was 2 weeks early, and the day before she was born, the ultrasound tech estimated her weight at a little over 8 lb. She wound up weighing 7 lb. 12 oz. when she was born.

I think that given how on top of it you are, you're doing everything that can be done to help ensure the best possible outcome. I think when GD causes major problems tends to be when it's either undiagnosed or diagnosed but poorly controlled.

Lydia said...

Two things to remember.

1) A lot of the older studies on GD only include women with really severe GD. Glucose testing of all pregnant women is only relatively recent. Before that, it was only women with really severe symptoms who were detected and diagnosed. Thus, a lot of the older studies are not representative of a case like yours.

2) As you alluded to, drinking a hundred grams of glucose on an empty stomach is a fundamentally different metabolic process to the normal processing of food. It might be that yes, you are unable to corectly maintain your blood sugar when downing a large amount of liquid glucose, but you might be fine when eating actual food. As long as you don't begin every day with a three hour glucose test, you're probably fine.

I had more ultrasounds near the end to check the size of the baby. In the end, I requested for him to be induced four days early, we had a vaginal birth with epidural and vacuum, and he weighed 9.7 pounds and was 21.5 inches long, with an APGAR score of 9/10. After birth, his and my blood glucose were both perfectly normal.

He is now a happy and healthy one year old boy, hovering around the 70% percentile for height and weight.

kimalli1 said...

No GD, just good old fashioned type 1 diabetes. I managed to get through 2 pregnancies and birth 2 normal sized babies (7 pounds, 14 ounces and 7 pounds, 15 ounces). Extra monitoring for sure, including growth scans, but both of my girls were no worse for the wear. Best of luck- in the grand scheme of things, GD is a minor nuisance.

Two Shorten the Road said...

Those levels are normal because you're eating an appropriate diet for someone with GD. If you don't have a severe case, diet is a great way to manage it. I didn't need any meds at all - just the right diet. Now, throw a big slice of lemon merengue pie in there if you really want to see how your body is reacting to the GD. ;)

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