Who's had Gestational Diabetes and needed insulin?

[7beasley]

Nicole - I have conferred with soem other people that I know that have had GD and they agree that your carb allowances are WAY high. Did you say you are seeing a nutritionist/dietician?

Hi

Yes -- I am seeing a dietician and a diabetes nurse at the Diabetes clinic at the hospital in my city. I don't know if you saw my post a few back but based on all your comments - I emailed the dietatician again to see if I had misunderstood the carb numbers and told her other people were telling me they were too high.

She emailed me back and changed them slightly to:

Breakfast 45grams
Snack 15
Lunch 45
Snack 15
Dinner 60
Snack 30

Sounds like you still think those numbers are too high?

Frankly - my DH and I are totally confused!! It would seem to me that if high blood sugar is the problem -- I should be on a low-carb/no carb kind of Atkins type diet -- i.e -- lots of protein and no carbs --- instead -- they have me eating carbs at every meal and my snacks being all carbs -- I just don't get it.

I have another appt next Wed and I will voice my concerns and try to restructure the diet with them -- I am still waiting to hear from my doctor.

The diabetes nurse was all doom and gloom yesterday and telling me that if my numbers yesterday and today were high I had to call her immediately and go on insulin immediately ---- so I do that - and call her - and now she is telling me to calm down and relax and not to panic and that while I will probably need insulin I should wait to talk to my doctor and she will see me next Wed.

***?

Yesterday she made it out to seem that I would need the insulin ASAP and now they are being all causual about things.

Do you think I should create my own low-carb diet -- heavy protein and low carb or should I do what they say and wait till my appt on Wed?

-Nicole

 

[marshallandcartersmo]

I had gestational diabetes w/DS#2. Didn't need insulin, but my diet was different than yours.

I think I remember it being about 20 carbs per meal, and 15-20 carbs per snack. I too remember a 400 reading!! I had eaten a BBQ beef sandwich (didn't realize how many carbs were in BBQ sauce) and fries. I thought I had killed myself and DS would be 15 pounds!!

Honestly, like another poster said, even if you do need injections it isn't for long.

Talk to your diabetes nurse. If you don't click with her request another one.

 

[Minnesota!]

I had gestational diabetes w/DS#2. Didn't need insulin, but my diet was different than yours.

I think I remember it being about 20 carbs per meal, and 15-20 carbs per snack. I too remember a 400 reading!! I had eaten a BBQ beef sandwich (didn't realize how many carbs were in BBQ sauce) and fries. I thought I had killed myself and DS would be 15 pounds!!

Honestly, like another poster said, even if you do need injections it isn't for long.

Talk to your diabetes nurse. If you don't click with her request another one.

Agreed

You need to be able to have a good relationship with this person as you will be dealing with her/him for a while. I still think the carb allowances you were given are still a little high. I would nix all tomato products, all soda/juice. You don't have to go on insulin right away. My dietician liked to see 2 weeks of readings before deciding which route to take. Play around a little and see what works for you.

Best of luck. I know you will do fine with whatever way you have to go.

 

[lexmas]

I had GD when I was pregnant with my son, but the diet they had me follow seemed simpler, "one serving of carb or meat or protein" and they spelled out how much of each to eat and then I got a big reference pamphlet specifying how much of every food would be a serving. So I had to measure and weigh everything (even in the middle of a freak snowstorm that knocked out power here for a week!). I did end up going on insulin, but they gave me the option and I chose it because I felt I was limiting my portions SOO much just to reach the correct numbers. My water broke at 35 weeks and DS was born 5 lbs. 10 oz., so I don't have any experience with that last month though. (Side note, since I had GD we thought he was going to be HUGE and only had 0-3 month clothes...but when he came home he was too small for preemie clothes! He didn't fit into 0-3 month clothes until he was 5 months old! Now I have a big supply of preemie and newborn clothes lol)

Like everyone else has said, I lost tons of weight on the GD diet, so that was a plus! The endocrinologist told me that because there's no diabetes in my family, she was very surprised that I had it, and it was likely that I wouldn't get diabetes later in life. I am still watching my sugars though. I know it seems like a big deal at the time, but it's only for a few weeks, and then your baby is born! Oh, and as for having a baby umm not by C-secion (the correct terminology seems to be edited by the Dis) they weren't even going to consider a C section unless the baby was huge or if something went wrong and it had to be an emergency...most people I know who had GD, if they had any intervention, were just induced.

Eating fewer carbs always helped my numbers, but you have to be careful not to limit carbs TOO much because your baby still needs them! I would just follow the new diet and see what happens. A few days with levels like yours really won't be too bad, your levels aren't all that high, other than your resting numbers. I know I freaked out if my levels were a few points over, but the endcrinologist didn't seem to worry too much. Controlling my diet worked for awhile, but your levels become more difficult to control as pregnancy continues.

Personally, it was a great comfort to me to be monitored so closely, and to go to all those extra ultrasounds...if I don't have GD next time (hopefully not!) I'll probably end up being more worried because of the lack of doctors visits!

Anyway, sorry to ramble! I just wanted to say don't worry too much, it will all be okay! Congrats on your baby!

 

[cybrkitn]

Hi

Yes -- I am seeing a dietician and a diabetes nurse at the Diabetes clinic at the hospital in my city. I don't know if you saw my post a few back but based on all your comments - I emailed the dietatician again to see if I had misunderstood the carb numbers and told her other people were telling me they were too high.

She emailed me back and changed them slightly to:

Breakfast 45grams
Snack 15
Lunch 45
Snack 15
Dinner 60
Snack 30

Sounds like you still think those numbers are too high?

Frankly - my DH and I are totally confused!! It would seem to me that if high blood sugar is the problem -- I should be on a low-carb/no carb kind of Atkins type diet -- i.e -- lots of protein and no carbs --- instead -- they have me eating carbs at every meal and my snacks being all carbs -- I just don't get it.

I have another appt next Wed and I will voice my concerns and try to restructure the diet with them -- I am still waiting to hear from my doctor.

The diabetes nurse was all doom and gloom yesterday and telling me that if my numbers yesterday and today were high I had to call her immediately and go on insulin immediately ---- so I do that - and call her - and now she is telling me to calm down and relax and not to panic and that while I will probably need insulin I should wait to talk to my doctor and she will see me next Wed.

***?

Yesterday she made it out to seem that I would need the insulin ASAP and now they are being all causual about things.

Do you think I should create my own low-carb diet -- heavy protein and low carb or should I do what they say and wait till my appt on Wed?

-Nicole

The diabetic diet is usually a balanced diet. It's x amount of carbs, protein, vegetables, fruit and dairy per meal per day. However, there are some people who cannot process the carbs as quickly as someone else. I was one of them.

I love potatoes, but when I had them while pregnant, it would raise my sugar levels up. I had problems getting them to come down b/c the carbs were very slow at being processed. Same thing happened with pasta, and I think, rice. I wound up having legumes (beans) and starchy vegetables (peas, corn) in addition to what ever vegetable I was eating. My body processed these carbs better than potatoes, rice and pasta and my sugar levels would adjust when I had to test at the 2 hour mark.

My dietician/nutritionist also had to adjust my milk intake as well. I usually have 2% milk and can't stand the tast of 1% or fat free (too watery with a horrible taste to me), so I went for a different brand whose name escapes me at the moment. Even with that, I had to adjust it from 8 ounces with 2 meals, to 4 ounces with every meal so that my sugars would still be under control.

Trust me, I know how difficult all this can be. I was getting very frustrated and at my wits end, b/c my sugars were high and I couldn't seem to get them under control. I couldn't wait until it was over. But I still loved being pregnant.

ETA: You know, I'm wondering if maybe your carb snack intake maybe too high :? I pretty much cut out the snacks b/c I was either not hungry for them, or it would raise my sugars up. My dietician/nutritionist was ok with that.

 

[mickeyboat]

I was one of them.

I can't remember if on the other thread if you said you had been tested for PCOS / insulin resistance. If not, this makes a really good case for you to be tested, and maybe something that developed after your pregnancy.

Denae

 

[cybrkitn]

I can't remember if on the other thread if you said you had been tested for PCOS / insulin resistance. If not, this makes a really good case for you to be tested, and maybe something that developed after your pregnancy.

Denae

I don't think I did mention it. What exactly is PCOS?

I'm real bad on this, but I was supposed to get checked out every year to see if I do become diabetic. But I haven't done so b/c I'm scared to find out, especially since it's on both my father's side and my mother's. With DH being diabetic, I have tested myself on his meter every now and then, and my sugar levels are within the correct range for someone who isn't diabetic. I'm just worried about having gestational diabetes again whenever I get pregnant with #2 (we'll be trying again soon!).

 

[Savanah'sMom]

Hi

I followed the EXACT diet they told me to follow.

I had my appt at 1130am yesterday and ate breakfast late right before that appt. Breakfast was: 1 scrambled egg w/ ketchup, 1 piece of whole wheat toast with margarine and 4 oz of milk --- sugar = 118

Lunch was: 1 small cup of corn chowder, 1 package of oyster crackers and 20 oz of water --- sugar = 145

Snack before dinner was: 1 serving of Sunchips

Dinner was: 4 oz of sirloin steak, 3/4 cup of rice, some yellow squash, and a salad with italian dressing and diet rootbeer --- sugar = 165.

Snack before bed was: 5 small graham crackers with peanut butter and 8 oz of milk (which is what they told me to eat!!) ---- sugar when I woke up this morning= 130.

I did everything they told me to do.

For breakfast this morning they told me to eat cereal (rice chex) with 8 oz milk and 1/2 a banana -- I did just that -- I need to test in about half an hour.

I have a call into both my doctor and the nurse.

I am particularly nervous about all that I have read - namely that the baby will have to be delivered early (36-38 weeks) -- I am against that!! I have not had an ultrasound since June 22nd so whenever the doctor calls back I am going to ask for that so we can see how big the baby is. I really wanted to deliver ******lly -- I DO NOT want a c-section!!! And I want the baby to stay in there as long as possible -- although everything I read indicates that if you are on insulin - they don't let you go to 40 weeks!

Ugh.

What stress.

Especially after how hard it was to get pregnant -- it is killing me to think that the baby could be in any danger or won't be healthy.

-Nicole

Hi Nicole, so far I haven't read past your quote, but just wanted to give you a little bit of what I've gone/going through. I was already a Type 2 diabetic when I got pregnant with DD & already on insulin. The first shot I had to give myself was the hardest thing I've ever had to do but then it was ok, not great, but ok. It actualy hurts less in the belly than in the thigh. My DD was perfectly fine throughout pregnacy, delivery, & after. If you keep you sugars under control, (even if it's through insulin) the babies weight should be fine, DD was 7lb 9oz. She went to full term, I had her 1.5 weeks early when my water broke.

As far as what you are eating, just b/c they said you can eat it doesn't mean you body can handle it. I can not drink milk, even just enough milk to wet my cereal while send my sugars to around 200, milk is not my friend. Also, watch your carbs, I have to keep an eye on how much I eat.

Like a pp said, being high-risks just means they watch you more. Good luck!!

 

[ajsmommy1129]

PCOS is poly cystic ovarian syndrome. Most women who have PCOS are insulin resistant diabetics, whichs means your body produces enough insulin, but doesn't know how to use it properly. This is me! Glocophage, or metfornin, can help this. I had IVF with my DS, who is now 5. I took glucophage the entire pregnancy, which was ok'd by my ob/gyn and the IVF doctor. I ended up with GD at about 5 months into the pregnancy, and had to take minimal insulin since I was on the glucophage. I gained a total of 14 pounds, my son was 7 lbs 3 oz and was born at 39 weeks. He is completely healthy, and just started kindergarten. So, I know the shots stink, but hey, after IVF, you should be used to them!!! By the way, congratulations on the new little one...when is he/she set to make an appearance?

 

[ADisneyQueen]

I didn't have time to read all the posts so I hope I'm not repeating what was said. I had G.D w/ both pregnancies. I agree with the others about the sugar intake- the ketchup, dressing, peanut butter and especially the graham crackers were things I would not have had. THey all have sugar and my diet had very little in it. I was able to control it with diet and not insulin. It's very hard to do this but it is only for a few months. I hope you have a good dietician. My first one did not explain things well to me and I was eating way too many carbs. Also, you may want to eat more snacks thru the day to maintain your blood sugar. I would have eaten much more than what you had down and I am a small person.
Best Wishes!

 

[ADisneyQueen]

I also wanted to add that I think you are not getting enough protein. You need a protein and a carb at every meal or snack to maintain your blood sugar.I can' t believe they wanted you to eat cereal and a banana for breakfast. I'm hypoglycemic and I would be fainting by lunchtime if that's all I had.

 

[TaraPA]

I had insulin dependent GD with one pregnancy but not the other. They told me never to give myself shots in the tummy - but that was 10 years ago, so times have changed! I did 4 shots a day, arm, arm, thigh, thigh. I had to mix 2 kinds of insulin, what a pain. Not all babies born to diabetic moms are big - my DS was born at 37 weeks & weighed 5 lbs. 8oz. He also had IUGR & I had low amniotic fluid. They induced at 37 weeks because of those things, and my placenta was dating at 41 weeks. I also followed the diet to a T but could not regulate my sugars. My fastings were great - 65-75, but after meals they were always 140-180. I was never so happy to be off that insulin - and able to eat what I wanted without reading labels & weighing it! I really did learn a lot about foods & how most of them are high in sugar or turn into sugar. I had been a huge fan of Rita's Italian Ice before finding out I had GD, so as soon as I delivered (literally within the hour) 3 people brough me Rita's!

 

[ahutton]

The carb numbers you listed on page 1 were what my GD nutritionist told me was my max for the day - 60 grams of carbs.

I had the best luck controlling my numbers by adding nuts. I ate a spoon of peanut butter for my morning and evening snacks, I drank water, decaf coffee or tea with Splenda or the low carb juices. I don't like diet soda but could have had some of that too. If I ate my nuts my sugar was right where it was supposed to be, and at times even got too low and I ate fruit to bring it back up (74 was too low - sweats, shakes, yuck!).

 

[My2Cinderellas]

I was diagnosed with Glucose Intolerance (also called pre-diabetic) several years before I got pregnant, and already had an endocrinologist.

When I got pregnant with DD, she had me start watching blood sugars, and felt they were too high. While my numbers were fine for a non-pregnant person, she wanted them lower while I was pregnant. I basically starved myself for a week, trying to get my blood sugars down, and it didn't work. So I started insulin shots when I was 6 weeks pregnant. I had very low doses, it didn't take much to keep things under control. I was supposed to gain no more than 15 pounds, but because of the strict diet control, I only gained 4. woohoo! put it all back on plus because of "I can eat this now" and "breastfeeding munchies". Anyway, I was induced 10 days before my due date, and delivered an 8 lb. 8 oz baby. no problems or complications for her due the gestational diabetes.

I had a routine visit with my endocrinologist and mentioned that we wanted to have another baby. She wanted me to get my numbers down to acceptable pregnancy numbers BEFORE I got pregnant this time. so I started on the insulin again for the duration of the pregnancy. Turns out I was pregnant at that visit, I just didn't know it yet. This time it took higher doses of insulin to keep the numbers in check, and because I was with a toddler all day it was harder to stick to the diet, but managed. This time, I was induced 9 days before my due date. I could have gone a week earlier if I had agreed to an amnio to check lung function. Lung function can be delayed in moms with diabetes, so it's a fine line between mature lungs and the baby getting too big. The day before I delivered, the sonogram estimated DD at 9 lb. and 5 oz. The doctor asked me to consider a c-section and I said I wanted to try ******l first. He agreed but refused to do any interventions like lots of pitocin or vacuum/forceps. She ended up being a 10 lb. 5 oz baby and she had complications from the gestational diabetes. she had a blood sugar of 0 and needed to go to the NICU and be on a dextrose IV and an NG feeding tube until she learned how to regulate her own sugar levels. They said it would take 4 or 5 days, and she went home after 5 nights.


quick lesson: sugar crosses the placenta, insulin does not. baby produces its own insulin for the sugar coming in. When you cut the cord, you stop the sugar delivery, but my DD was still cranking out the insulin, so her blood sugar plummeted.

my endocrinologist asked if I would be having more kids. I told her she was crazy after what happened to DD2, but she said that shouldn't stop me from having more kids if I wanted. I stopped anyway.

6 months after delivering DD#2 I started feeling funny and checked my blood sugars and they were out of whack. I go back to the endocrinologist and get the dreaded Type II diagnosis. I went back on insulin while breast feeding and then switched to oral meds, and now oral plus Byetta (injected).

I usually injected insulin around my navel, even 9 months pregnant I had a little extra room there . I only use my leg if I need to inject in public and it's inconvenient to get to a rest room. It hurts more in the leg, I think.

good luck to you, shots aren't the end of the world, they actually hurt less than the finger pricks. I takes a while to work up the courage for the first injection, but gets easier after that.

 

[7beasley]

Thanks again for all your replies and great advice!

I am very nervous that I do NOT have a good dietatician.

I confirmed with her the carb numbers yesterday and she says she has calculated me at 210 grams of carbs a day.

She also said all I need to look at is the carb number -- it does not matter if it is 20 grams 10 of which is sugar or 20 grams 20 of which is sugar -- it still counts as 20 grams.

I did not think that sounded right and I confirmed it with her and she said that was how she wanted me to count carbs....but based on what all of you are saying I agree that it sounds wrong!!

Maybe I should see another nurse and dietatician...

Also - she told me that peanut butter should be my staple protein -- I am supposed to have it with both my snack after breakfast (peanut butter crackers - like ritz with peanut butter) and my after lunch snack (apple with peanut butter)

I am not so much stressing out over the diagnosis anymore or even the needles -- now I am stressing out because it seems the care and advice I am getting from the diabetes center is not good and it clearly does not match what any of you were told! That worries me!!

I am STILL waiting to hear from my doctor -- he is supposed to call today.

I am hoping to schedule an ultrasound ASAP and I think he is going to have me meet with an endocrinologist re the insulin issue -- I am on the fence as to whether I should go to Boston (I live about 1 hr away) for a second opinion -- I could go to the world famous Josyln Diabetes Center.

Thanks again!

I will keep you all posted.

-Nicole

 

[Stimpy]

It's never a bad idea to get a second opinion for anything medical, especially relating to your baby.

BTW, I was allowed to have peanut butter, again as a protein like you mentioned...I just hate peanut butter Some people react differently to different foods.

Good luck

 

[My2Cinderellas]

210 carbs per day sounds like a lot. That's 14 carb servings a day, counting 15 carbs as 1 carb serving. Has the dietician broken them down into something like 4 cups of milk, 3 servings of fruit, and 7 servings of bread/rice/potato/pasta? I don't know why she wants you having that many, there may be other things going on we don't know about. If weight gain isn't an issue for you, then this # may be ok.

I do agree that for your situation, carbs are carbs are carbs. don't do the low-carb counting trick of subracting fiber and sugar alcohols from the carb total. You will feel better and have better sugar control eating whole grain carbs and milk and whole fruit (no juices) than all high sugary snacks, but for the insulin purposes 15 carbs in a glass of milk needs to be treated like 15 carbs in a slice of bread or 15 carbs of candy.

It can matter what carbs you eat during certain times of the day. I couldn't have fruit before noon or my numbers jumped way up. I couldn't have dessert right after a meal, but I was ok with saving it for a bedtime snack. Eating 3 meals and 3 snacks a day is crucial, the bedtime snack is especially important so that your liver doesn't panic and spill sugar, creating high morning numbers.

I would be concerned with making peanut butter your main protein, unless you are having difficulty with keeping anything else down or are vegetarian. I would consider switching to a no-sugar version, if you have a whole foods or similar grocery store, look into the grind your own PB or almond butter, they are delicious. There is no reason you couldn't have a few slices of cooked chicken or other lean meat, or slices of cheese for your protein instead of PB. Your diet will have limitations already, there is no need to impose more.