Gestational diabetes

[SunnyB1066]

I am a long time lurker on Disboards, but I know that everything that I will ever need to know I can find on the Disboards. Sooooo. I'm going to ask if anyone know where I can find good info about a meal plan for my daughter. She has Type 2 diabetes and has kept it under control with medication. Diet was good in the beginning, but she has gotten back to her old diet habits.

She found out that she's pregnant last week but can't get into the OB until the first week of August. Her blood sugars have been a little out of control today. 235, 195 & 165. She takes metformin.

Just want to try and help her get her BS under control sooner rather than later.

Thank you for reading and for any info you can point me to.

Sunny

 

[minnie mum]

Sounds like she needs a visit to the endocrinologist or internist who monitors the status of her diabetes. Does your area have a Diabetes educator? They may be able to assist her with the extra demands her pregnancy places on her diabetes.

 

[LuvEeyore]

I know you want to help your daughter by finding a diet online. This is not best for her. She needs to see her ob and endocrinoligist (or be referred to one that works with preganacy. She will also have her meds looked at and maybe even changed for pregancy. Insulin needs and resisitance changes during pregnancy. She will be educated about her diet which for pregnancy is very diffierent than what you find online. In the meantime, fresh fruits and veggies and avoid fast foods until seeing her ob.

 

[SunnyB1066]

Thanks! She does have an appt on the 8th. I just want to try to get her eating better now.

 

[jmartinez1895]

That seems like a long time to wait. Has she called and told them that she has a problem? In my doctors office, routine pregnancy check ups book far out, but if you are sick or have a problem one of the doctors will see you right away. It may be worth calling back and checking or maybe she could talk to the nurse and the nurse could adjust her meds and maybe call in a referral to the hospitals nutritionist ( if available).

 

[RF536]

Does she have an endocrinologist, if so that is who she should see to adjust her meds and diet during pregnancy. I developed Gestational Diabetes with my 1st son, and my OB immediately sent me to an edocrinologist to control the diabetes. The edocrinologist will be the one to work with her to get her blood sugars under control.

Encourage her to follow the doctors diet plan, the more controlled her numbers are the better for her baby and her.

 

[PatsMom]

I don't really thing that her diet should be much different than what was recommended pre-pregnancy. Sounds like she doesn't have gestational diabetes, she is a type two diabetic who happens to be pregnant. Watch the carbs and fat, eat lots of veggies, take calcium supplements since they don't want you having too much dairy due to fat.

I had gestational diabetes that never went away and am classified as a type II diabetic. Don't recall my pregnancy diet being much different than my current recommended except I got more calories when I was pregnant.

Also, she should continue to exercise. Walking is great exercise - I started when I was pregnant and continue to walk for my daily exercise.

You can take insulin when pregnant. I took it because they didn't want to start me on any of the oral drugs. My doctor felt the insulin was safer. But since your daughter is already on metformin, they may just continue with that.

I do agree that she should be contacting her ob/gyn and asking to get the appointment moved up because of the out of control diabetes. And seeing her endo woudn't hurt either!

 

[akcire]

I am a long time lurker on Disboards, but I know that everything that I will ever need to know I can find on the Disboards. Sooooo. I'm going to ask if anyone know where I can find good info about a meal plan for my daughter. She has Type 2 diabetes and has kept it under control with medication. Diet was good in the beginning, but she has gotten back to her old diet habits.

She found out that she's pregnant last week but can't get into the OB until the first week of August. Her blood sugars have been a little out of control today. 235, 195 & 165. She takes metformin.

Just want to try and help her get her BS under control sooner rather than later.

Thank you for reading and for any info you can point me to.

Sunny

I too am a type 2 diabetic, and was taking Metformin when I found out I was pregnant. My endocrinologist would not allow me to take it past the first trimester.

I can not stress enough how important it is to have super tight blood sugar control during pregnancy, and especially during the early developmental phases. She needs to get to the doctor now!

Through my entire pregnancy I was not allowed to have a two hour post dinner blood glucose reading of greater than 120. Morning blood sugars are supposed to be under 100. Those are the highest levels your daughter should be seeing.

While pregnant there were times I wanted to just eat "whatever" I am so happy I was able to avoid all that bad food. My daughter was healthy at birth and showed no ill effects of my crappy health. She is now 3 months old, and luckily fit as a fiddle.

As for a diet--no bananas, no bread, no rice, no sweets, no potatoes, nothing that is obviously all sugar--such as fruit juice. Mostly she should be eating fresh fruits and vegetables, dairy, nuts for protein, and lean meats. I spent more money on groceries while pregnant than I ever have in my life---I also felt wonderful. In addition to getting in contact with an endocrinologist she should probably see a nutritionist. I know here the OB's are very concerned, and will make your appointments immediately.

Diabetics can have uncomplicated pregnancies with wonderful outcomes if their sugar is under control, however at the same time without good control the results can be suboptimal.

Feel free to PM me if you want more information.

 

[My2Cinderellas]

I had a diagnosis of Impaired Glucose Tolerance - a pre-cursor to Type 2 diabetes - and was classified as having Gestational Diabetes as soon as I became pregnant.

Your DD needs to call and beg/plead/camp out in the waiting room/whatever it takes to get in to see her endocrinologist NOW. Yesterday if possible. My doctor wanted me to have lower numbers while pregnant then when not pregnant - and started me on insulin immediately.

I met monthly with the endocrinologist, dietitian, and diabetes educator during both pregnancies. This was on top of my OB appointments. I also saw an ophthamologist once each trimester and just after giving birth. Diabetic eye problems can come on suddenly when pregnant.

When I was thinking about getting pregnant a 2nd time, the endocrinologist was not happy with my numbers (remember they need to be lower during pregnancy) and asked that I start insulin to get blood sugar under control before getting pregnant. Turns out I was already pregnant but did start on insulin again within days of conceiving.

Women with Diabetes are considered High-Risk pregnancies. I used my regular ob/gyn but was referred to a perinatal specialist for a Level 2 ultrasound around 18-20 weeks. If there had been any other complications I would have transferred to that practice. I also had several BPP's (bio-physical profile) towards the end of both pregnancies. This involves an ultrasound to measure and monitor the baby, and a non-stress test. I was not allowed to see the PA or ARNP for routine OB checkups - had to be the doctors.

Also - if you DD is planning on breastfeeding - she will have to stay on the insulin after delivering. Once she is done BFing she can go back to the oral medications. I'm a huge BFing advocate - and so is my endocrinologist. At that point I was used to the shots and it was no big deal to continue.

Complications - as a PP noted, there are early developmental risks to the fetus if blood sugar is not controlled. There can also be complications for the baby at the end of the pregnancy and just after birth.

One of the concerns with diabetic mothers is having large babies. This is the reason they are measured with the BPPs. I was induced both times about 10 days before my due date. They need to wait until the baby's lungs are developed - which takes longer if mom is diabetic - but not have the baby get too big. It's a fine line. I had the option to deliver a week earlier, but the doctor required an amnio to verify lung function. I said no to that.

Another complication can be that the baby has low or no blood sugar at birth. Sugar/energy crosses the placenta from mom to baby. Insulin does not. Mom makes or takes insulin to regulate her own blood sugar, the baby makes insulin to process the energy it receives. If the baby is making large amounts of insulin (can happen even if mom maintains good bg control) once the cord is cut, the supply of energy from mom stops and the baby is still making the insulin. One of my kids had a 0 reading and spent 5 days in teh NICU. They start an IV with dextrose and then gradually turn it down so the baby learns to adjust insulin production. Once the baby is stable for 24 hours without the IV they go home, assuming there are no other issues.

good luck to your DD - and get her to the endo NOW!!!!!!!!!