Gestational Diabetes

[buggie]

Hi Guys,

Just wondering if anyone's been through this during their pregnancies?? I was diagnosed last week and currently controlling diet/checking my blood sugar 4 times a day.

Am bit worried as seem to run high post breakfast, and in clinic yesterday was said that I may need to start morning insulin - any advice or experience in dealing with this more than welcome, especially with breakfast and lunch ideas (dinner seems to be the easiest meal to sort out!)

Much as I know what to do with sick children, this is a completely new field for me and finding it a bit daunting - especially over breakfast!

Cheers in advance x

[duchessofdulwich]

I was boarderline gestational diabetes. went for the fasting blood glucose test and luckily got the all clear. i spoke to a midwife about my diet and she said try and quit the quick fixes (eg chocolate biccies) and go for the slow release carbs. basically i had been eating rubbish during the first part of the pregnancy. i used to get the Low GI bread from the bakery and have a piece of that for morning. sorry if this dosent help and they have already told you this??

[duchessofdulwich]

just thought bananas for the morning might be another idea?

[buggie]

Thanks but all junk is well and truly out! Am doing

low gi but still getting morning spike- one slice granary bread, scrambled eggs and couple of cherry tomatoes sent my blood sugar from 3.8 to 9.3 (norm is 3-7) this morning.

Bananas are out on 2 counts - their actually v high in sugar and are high gi, plus, I can't stand them!!

[Peckhamgatecrasher]

Perhaps try porridge for brekky.

[Helen GV]

I had GD during my first pregnancy, and I managed to control it with just diet but only just!

I found that I couldn't eat bread at all (or rice or pasta or oats/cereal, no matter how wholegrain is was!), used to have unsweetened yoghurt or soy milk with nuts at breakfast, or a couple of boiled eggs, salad with chicken/fish/chickpeas/beans/omelette/meatballs made without breadcrumbs for lunch, and similar things for dinner. I found that I could have grilled fish with mushy peas and about 5 chips and still be well under 7mmols. Also used to get chicken breasts, grill them or fry them and eat with salad and seeds. Also there's no reason (apart from time and expense, of course) that you couldn't have steak for breakfast with some veg, or leftovers from the night before. hummus and vege sticks should be ok too...

Fruit is tricky but I think berries are a very good option, and full of good things for you. you could have (unsweetened)greek yoghurt and blueberries for dessert or a snack perhaps, or even try it sprinkled with assorted seeds (food doctor for eg) for breakfast. looking back it was quite atkins-like! Have to be careful not to go the other way and have too little carbs as then you can get ketones, which are not good for bubs, but might be worth experimenting with tiny amounts of things like baby potatoes. I found I got used to things fairly quickly and didn't miss sweets as much as i thought i would.

As well as looking at the GI values of food it might be useful to look at the GL (glycemic load) values too. These values are basically GI values but take into account the actual amount of a certain food you would realistically eat as a portion. GI testing is done on a standard amount, regardless of the food being tested, can't for the life of me remember what it is but I remember reading that to get the high GI reaction from carrots, for example, which have a high GI, you'd have to eat a kilo or so at once. The load on your body when you eat one carrot is actually very low and therefore so is the effect on your blood sugar. Hope that made sense... There are loads of books available on the subject and probably plenty of information online too.

Also, do as much exercise as you can. A walk after breakfast if possible might help.

I remember crying in the nutritionists office just after being diagnosed, i was so so upset. but in the end it meant that I lost a bit of weight in the last few weeks of pregnancy (was worried about this but the specialists at Kings were fab and assured me it was fine and normal and not affecting the baby) also felt much better while eating so well, and during labour i was looked after by the ruskin midwives who were fantastic.

If I think of anything else that worked for me I'll let you know!

Best of luck in the meantime x

[Helen GV]

Also just wanted to add that one reason I was so determined not to need insulin was that I thought that if I didn't need it during pregnancy then I would not have to have the glucose/insulin drip during labour. It turned out that I needed it anyway!

I know that it's more complicated if you need to have insulin, as they need to get your dosage right, but if you do need it it won't be the end of the world, and it should all go away as soon as the baby and placenta are out so it's not forever.

[buggie]

Thank you so much for your posts Helen - was crying my eyes out in diabetic clinic on Fri so glad I've not been the only one to react like that :-$ !!

I've had no probs with pasta/rice at lunch/dinner - does just seem to be breakfast I'm having difficulty with. Chicken is a mainstay of my dinners anyhoo so not too much of a stress to con't with that.

Hubbie is offering to wake early at the w/e to knock up bacon and mushrooms for me before I go to work (whether come Sat morning he's as keen waits to be seen!).

The dietician was singing the praises of berries yesterday so have got some in today and just had a lil snack of a few with some unsweetened/zero fat greek yogurt - yum!

Have been so lucky not to have probs with my own health before, this just really scares me as I worry about the effects on bubs, everything I've read talks about risk of stillbirth/breathing and heart probs but not the percentage/any context on when these happen.... rational part of my brain says that surely one slightly out of range post breakfast reading a day won't cause too serious a problem, but it doesn't stop me worrying :'(

Is there anyone else coping with this at the mo?? Would be cool to have wt room buddies at Kings on a Tues morning!

[blainiac]

I had this with both my pregnancies. Do not worry or stress about having to take the insulin if you have to - it's whatever's best for the baby. Fingers crossed you can control it with diet!

I found the following of use diet wise in the mornings - in the am next to no carbs or a slice of Rye Bread with protein of some kind (ham, cheese, egg, bacon), spinach, mushrooms. Milk has sugar so if porridge make with water (not to my taste but it fills you up). No fruit or juice as sends your levels through the roof. Tea or coffee with no milk.

The rest of the time you are kind of following a Hay diet of sorts - the food combining works. When you have carbs you have to cut the portions; everything should be as unrefined as possible. Eat loads of leafy greens, sweet potatoes I found were a good sub for ordinary spuds which are best avoided as they have the highest sugar content of any vegetable.

Cut out all biscuits, sweets, chocolate (although a couple of squares of 90% dark was OK). Puddings were extremely limited, things like panacottas I could handle as the fat of the milk counteracted the sugar of the fruit. Low sugar yogs.

You need to eat fruit but space it through the day and eat with a handful of nuts. Don't have your fruit as a pud.

All in all it is difficult I won't lie to you, but you will not put on tons of baby weight and you will be really healthy following the diabetic diet. Most importantly exercise - even flinging your arms about and running on the spot will get your levels down. If you have a supportive partner who can join you in your new healthy diet all the better!

You will have the best care though at Kings and a fab team of midwives. I had to have CSections with both mine, so do familiarise yourself with all that this entails early on to avoid any heartache. They are not keen in letting you go over term for all the reasons that you outline above - stillbirth etc. If you want a natural labour really go all guns to make this happen, visualisation, hypno whatever it takes, when it comes up to your due date.

Try and enjoy your pregnancy - it is hard with the diabetes, but think of the good you'll be doing you and the baby by being a little bit strict with your diet. On a positive note, both my sons had no problem with their blood sugar after birth, and I returned to normal with no sign of the diabetes (so far!).

Good luck with it all and enjoy your baby!

[sb]

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[Fuschia]

How about making frittata with eggs, feta (can you have green peppers?) and coriander leaves.... leave in frisge overnight for a quick breakfast?

[buggie]

Oo Fuschia- you could be onto a good idea there!

Thank you ever so much blaininc and sb esp for giving me hope I might be

able to have some choice in labour!

[Fuschia]

Frittata can be heated for a few moments in the microwave if you don't like it cold. but cold and wrapped in foil it makes a good meal on the run...

Here's a recipe:

http://lowcarbdiets.about.com/od/cooking/ht/howtofrittata.htm

Basically a thick omelette with stuff in, and after part cooking, it's put under the grill for the top to cook. It can be frozen. If you make several large ones, will keep you going for a while.

We like with feta, red onions (but caramelised, so possibly not low GI?) green peppers and sometimes tomatoes. But you can vary the veg to suit yourself and create variety by using different cheeses and meat as well...

[Fuschia]

And buggie, you can always get choice in labour, it's a question of getting as informed as you can, and discussing in advance so you know how much "risk" you're happy to take. Have you got an obsterician already? leonie Penna is very good (flexible and listens to what you want)

[sb]

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[buggie]

Thanks so much sb.

Have been v impressed with the service so far, am still seeing my oakwood mw's but saw the ruskin mw's in the GD clinic and they are happy to see me next in 4wks - as far as I know I might only need the diabetic nurse this wk (although did get confusing as waited hr for obs to see me and then found out that wasn't needed!) I'd had a 28wk scan anyway a wk before my appt so had very recent details on bubs to show them.

Wasn't thinking of home birth anyway so not too worried about being in hospital, but has made me realise what I really want to aim for with the birth (albeit subject to change!).

Am making sure I walk lots on days off (would love swimming if it wasn't for the whole drying afterwards!) don't think I'm up to 5 miles a day but might be tempted as time goes on! At work is bit more difficult, but do have steady level of activity rather than just sitting down so not so worried.

[sb]

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[buggie]

as a nurse had a fairly high TMI limit (can't blush at some of the things I have to ask patients!) so with pregnancy added in I've practically no limit!

Omlette with ham/cheese/few olives was filling and kept me well under this am so v happy! Think I may try the prunes though as too many eggs...! :)

Am seriously considering having a choc brownie in my eyeline during labour as motivation!! (the one I had from homemade a few wks back was so good!)

[Moos]

buggie, have you thought about buying a pedometer? I'm sure you have a very busy and active work life, and it would might be useful to see how many miles you cover in the course of a working day, that you could then use to inform your off-work exercise plans.

Lots of love and thoughts with you as you progress - lovely brownie and lovely and equally edible baby in your sights as reward for your efforts... just make sure you only nibble gently at the latter ...

[buggie]

Hey Moos,

Am not finding it too hard to incorporate walking into regular day - always need few bits on LL or can head for walk round Dulwich Park and have fair idea from when I ran of local distances. Work is bit problematic as although up and down, being senior I often have to ensure I'm nearby - am taking the long way round to do anything and everything though!!

... edited to add - am fairly hopeful I'll nibble the brownie harder than the baby... it's avoiding squidging the brownie as much as I plan so squidge the baby that might be difficult (esp if it's got juicy thighs!!)

[Moos]

Pretty sure you can count on baby squidginess, buggie - hurray.

[prm]

Hi, I have also been diagnosed with GD so will be joining you ladies on Tuesday mornings as well! I also feel a bit overwhelmed..I have been very healthy all my life and I had taken it for granted that my pregnancy would go without any issues.At least it is reassuring to know that we are not the only ones going through this & are being well looked after at Kings.

Buggie I am also with Oakwood...does having GD mean we won?t be looked after them but the specialist midwives instead?

[buggie]

Aw prm - going to PM you - have you let Oakwood know yet??

I've asked to stay with them (had been needing to see them for fortnightly bp checks so had had more contact with them than typical), but if I need to go onto insulin have been told I'd need to have Ruskin take over - no sign of needing insulin yet so fingers crossed!

Don't know if it's me relaxing or whether the wt I've lossed has helped but control seems to be getting easier (was expecting it to get harder!), still with 7wks to go might be speaking too soon!!