29 weeks appointment

[Kazh]

Went for another scan today, baby growing nicely already weighing in =
around 4lb (2.1kg). All well with her.

Urine tests said -=20
Glucose +++
Ketones ++

Got the results of the GTT.
First test - 6.1 (normal 0-6)
Second test - 10.6 (normal up to 7.8)

So yes they think I have GD now..........sent me home with a blood =
testing kit which I have to do 7 tests a day for a week with diet =
control and see how we go.

So glad I opted for the tests now.

Will keep you all informed of the results next week.

--=20
Karen
DS 10th Aug 1986 - VB - 9lb 13oz
DD 13th Aug 1988 - VB - 10lb 9oz
EDD 9th May 2005 - It's a girl !!
Sophie's Prediction for us - Girl
--
Our Latest Scan Photo
http://www.freewebs.com/kazh/
--
Unlock codes =A35 only
http://www.freewebs.com/kazh/unlockcodes.htm

[[email protected]]

Hi Karen,

I am due 2 days after you. I have type II diabetes, so I test the
entire pg, and take lots of insulin. I've had type II diabetes for all
of my 3 pgs, and all have been healthy so far. If you keep good
control, all will be well as you probably already know.

KC

[Kazh]

If you could give me some tips on maintaining good health and eating =
habits it would be great.

thanks

> wrote in message =
ups.com...
Hi Karen,

I am due 2 days after you. I have type II diabetes, so I test the
entire pg, and take lots of insulin. I've had type II diabetes for all
of my 3 pgs, and all have been healthy so far. If you keep good
control, all will be well as you probably already know.

KC

[Jo]

Kazh wrote:
> Went for another scan today, baby growing nicely already weighing in around 4lb (2.1kg). All well with her.
>
> Urine tests said -
> Glucose +++
> Ketones ++
>
> Got the results of the GTT.
> First test - 6.1 (normal 0-6)
> Second test - 10.6 (normal up to 7.8)
>
> So yes they think I have GD now..........sent me home with a blood testing kit which I have to do 7 tests a day for a week with diet control and see how we go.
>
> So glad I opted for the tests now.
>
> Will keep you all informed of the results next week.
>


Woah, 2.1kg? Are you sure?? I looked up on a foetal growth chart
yesterday how big my baby would be, and for 28 weeks it said 1kg.
Triplets were born at 33 weeks the other day and they were all the sizes
of singletons - 1.6, 1.7 and 1.8kg. Did you mean 1.2kg?

Jo (RM)

[Kazh]

Yep, def 2.1 kg. 4.9lb in weight already.

If you look on the chart my baby is following the top curve on the =
graph, if she carries on she will be 9lb+ art birth.


"Jo" > wrote in message =
...


Woah, 2.1kg? Are you sure?? I looked up on a foetal growth chart=20
yesterday how big my baby would be, and for 28 weeks it said 1kg.=20
Triplets were born at 33 weeks the other day and they were all the sizes =

of singletons - 1.6, 1.7 and 1.8kg. Did you mean 1.2kg?

Jo (RM)

[Anne Rogers]

>Yep, def 2.1 kg. 4.9lb in weight already.

>If you look on the chart my baby is following the top curve on the graph,
>if she carries >on she will be 9lb+ art birth.

they can be way off though, I had an ultrasound at 31+? last time, which
came out with a similar current weight to what you say, a little bit more I
think, not quite as high on the centiles, due to the later date, but 75th
ish, baby popped out at a mere 2.6kg, 5lb 13oz 6 weeks later.

Anne

[Kazh]

9lb to me would still be small <LOL> but thanks for the advice

"Anne Rogers" > wrote in message =
...

>Yep, def 2.1 kg. 4.9lb in weight already.

>If you look on the chart my baby is following the top curve on the =
graph,=20
>if she carries >on she will be 9lb+ art birth.

they can be way off though, I had an ultrasound at 31+? last time, =
which=20
came out with a similar current weight to what you say, a little bit =
more I=20
think, not quite as high on the centiles, due to the later date, but =
75th=20
ish, baby popped out at a mere 2.6kg, 5lb 13oz 6 weeks later.

Anne=20

[[email protected]]

> If you could give me some tips on maintaining good health and eating
habits it would be great.

With my first pg I kept my levels under really strict tight control,
and my baby was actually a little small at first and had some troubles
with her blood sugar and temperature at first, so with the next pg we
purposely upped what blood sugar levels I was shooting for (95 for
fasting and 130 after meals instead of 90 for fasting and 120 after
meals in the first pg) and the baby was a better weight and more
robust.

In my first pg I also tried to keep my level of carbs I ate lower, but
in the second pg I ate more carbs. It's easier for me in a way because
I always get to shoot insulin to cover carbs I eat, while if you are
trying to do it by diet alone you have to be more restrictive of what
you eat. If they put you on a diet, and you are still hungry, you can
eat as much additional protein and fat as you want without raising your
blood sugar values, and alot of veggies have very few carbs too, like
salad mix with ranch or blue cheese dressing will not raise your blood
sugar unless there is lots of carrots in the salad mix. You just have
to watch the carbs. I have also found that some food with alot of fat
in them like nuts, don't seem to raise my blood sugar even though there
are carbs in them. In general, eating some protein with your carbs
helps them to get digested slower, and thus keeps them from raising
your blood sugar as much.

Also, walking right after meals for 15 minutes will really suck down
the blood sugar levels. Walking could be a real godsend for you in
trying to control blood sugars without insulin.

Good luck,

KC

[Ericka Kammerer]

wrote:

>>If you could give me some tips on maintaining good health and eating
>
> habits it would be great.
>
> With my first pg I kept my levels under really strict tight control,
> and my baby was actually a little small at first and had some troubles
> with her blood sugar and temperature at first, so with the next pg we
> purposely upped what blood sugar levels I was shooting for (95 for
> fasting and 130 after meals instead of 90 for fasting and 120 after
> meals in the first pg) and the baby was a better weight and more
> robust.
>
> In my first pg I also tried to keep my level of carbs I ate lower, but
> in the second pg I ate more carbs. It's easier for me in a way because
> I always get to shoot insulin to cover carbs I eat, while if you are
> trying to do it by diet alone you have to be more restrictive of what
> you eat. If they put you on a diet, and you are still hungry, you can
> eat as much additional protein and fat as you want without raising your
> blood sugar values, and alot of veggies have very few carbs too, like
> salad mix with ranch or blue cheese dressing will not raise your blood
> sugar unless there is lots of carrots in the salad mix. You just have
> to watch the carbs. I have also found that some food with alot of fat
> in them like nuts, don't seem to raise my blood sugar even though there
> are carbs in them. In general, eating some protein with your carbs
> helps them to get digested slower, and thus keeps them from raising
> your blood sugar as much.
>
> Also, walking right after meals for 15 minutes will really suck down
> the blood sugar levels. Walking could be a real godsend for you in
> trying to control blood sugars without insulin.

Keep in mind, though, that gestational diabetes is NOT
the same as true diabetes. There is precious little evidence
that insulin is warranted in gestational diabetes, while it
is clearly indicated in some true diabetic situations. In fact,
the evidence is so weak that in Enkins et al.'s _Guide to
Effective Care in Pregnancy and Childbirth_ (based on reviews
by the Cochrane Collaboration, one of the most respected evidence-
based medicine organizations in the world), they say that the
use of inuslin for gestational diabetes with so little supporting
evidence would be considered *unethical* in any other area of
medicine. Another finding by the Cochrane Collaboration is
that there is little evidence to support the value of very
tight dietary control over less rigid control in improving
outcomes with gestational diabetes. (When you get right down
to it, there is precious little evidence that any treatment
improves the major outcome variables significantly, which
is yet another difference between gestational diabetes
and true diabetes.)
I'm not saying one shouldn't follow reasonable
dietary guidelines, but you make a very good point that
if the diet is resulting in too much calorie deprivation,
that is not a good thing for the baby. Exercise is also
a great thing by anyone's standards, and will certainly
improve blood sugar levels. But someone with gestational
diabetes should think long and hard before agreeing to
insulin use, and some doctors are very quick to suggest
it.

Best wishes,
Ericka

[Kazh]

"Ericka Kammerer" > wrote in message =
...
wrote:
<snip with respect>

But someone with gestational
diabetes should think long and hard before agreeing to
insulin use, and some doctors are very quick to suggest
it.

Best wishes,
Ericka
-------------
They told me if after a week using diet control if it is still high they =
WILL put me on insulin. Where can I find more information on benefits / =
impartial info on whether it is good or not during PG ?

[Kazh]

> wrote in message =
ups.com...
>

Thanks for this Kathy, it really helps.

[Ericka Kammerer]

Kazh wrote:

> "Ericka Kammerer" > wrote in message ...
> wrote:
> <snip with respect>
>
> But someone with gestational
> diabetes should think long and hard before agreeing to
> insulin use, and some doctors are very quick to suggest
> it.
>
> Best wishes,
> Ericka
> -------------
> They told me if after a week using diet control if it is
> still high they WILL put me on insulin. Where can I find more
> information on benefits / impartial info on whether it is good
> or not during PG ?

There is some information in Enkins et al.'s _Guide
to Effective Care in Pregnancy and Childbirth_. I believe
Henci Goer covers some of it in _Obstetric Myths versus
Research Realities_. Here are some of her online articles,
which have cites so that you can double check the studies
yourself, if you like:

http://parenting.ivillage.com/pregnancy/pcomplications/0,,9cgc,00.html
http://parenting.ivillage.com/pregnancy/pcomplications/0,,9z3m,00.html
http://www.gentlebirth.org/archives/gdhgoer.html
http://www.ahcpr.gov/clinic/3rduspstf/gdm/gdmsum.htm
http://www.cochrane.org/cochrane/revabstr/AB003395.htm

I have to say, this is one area where reading the PubMed abstracts
is very challenging. You'll find a zillion studies that purport
to show that GD treatment in general or insulin in particular
"improve outcomes." BUT, you will also find that those studies
have major methodological flaws, and/or they'll show something
like insulin reducing the incidence of macrosomia, but *not*
the incidence of c-section, brachial plexus injury, dystocia,
etc. (all the things one *really* cares about). They also rarely
look at the potential risks of treatment, so you have little
to compare it with. Personally, I find Henci Goer extremely
persuasive and accurate--and because she gives her cites, you
can always double check her interpretation of the literature.

I have to say, giving you a mere *week* to get things
under control with diet (any mention of exercise?) seems
outrageously aggressive to me. By the way, you only gave
two results for your test. Which test did you have? The
standard oral glucose tolerance test would have had your
blood drawn five times (initial draw, then 30 minutes, 1
hour, 2 hours, and 3 hours after the drink). If you just
had the one hour test, that just isn't particularly reliable.

Best wishes,
Ericka

[Kazh]

"Ericka Kammerer" > wrote in message =
...
Kazh wrote:
<snip>
I have to say, giving you a mere *week* to get things
under control with diet (any mention of exercise?) seems
outrageously aggressive to me. By the way, you only gave
two results for your test. Which test did you have? The
standard oral glucose tolerance test would have had your
blood drawn five times (initial draw, then 30 minutes, 1
hour, 2 hours, and 3 hours after the drink). If you just
had the one hour test, that just isn't particularly reliable.

Best wishes,
Ericka

------------
Thanks Ericka, will look in to these.

I had a ''fasting'' GTT. 12 hours fasting overnight, 1 blood taken (6.1) =
then drink 395ml of lucazade and back to be tested in 2 hours (10.2) no =
food in between.

Then I went to the hospital for scan and results 1 week later and bingo, =
I'm testing 7 times a day now - before breakfast, 1.5 hours after =
breakfast, before lunch, 1.5 hours after lunch, before dinner, 1.5 hours =
after dinner and before bed. Levels are ALL over the place right now =
ranging from 5.2 to 14.2 !!=20

She did mention exercise but I have a hernia (mentioned in previous =
posts) which the baby seems to be pushing against and walking more than =
100 yards leaves me in agony. So I am trying to do exercises at home but =
it'd difficult to find effect things to do. Any suggestions would be =
great (sit-ups out of the question as they make the hernia worse)


--=20
Karen
DS 10th Aug 1986 - VB - 9lb 13oz
DD 13th Aug 1988 - VB - 10lb 9oz
EDD 9th May 2005 - It's a girl !!
Sophie's Prediction for us - Girl
--
Our Latest Scan Photo
http://www.freewebs.com/kazh/
--
Unlock codes =A35 only
http://www.freewebs.com/kazh/unlockcodes.htm

[Ericka Kammerer]

Kazh wrote:


> I had a ''fasting'' GTT. 12 hours fasting overnight, 1 blood taken (6.1)

Okay...so your fasting level was not at diabetic levels, and you
don't even hit the target for impaired fasting glucose.

> then drink 395ml of lucazade and back to be tested in 2 hours (10.2)
> no food in between.

So your 2 hour result is just barely over the true diabetic
cutoff, and without the other values from blood draws at other times,
it's even harder to know if it's a spurious result. I wouldn't argue
that you don't have any glucose metabolism issues, but is it really
serious enough for insulin? I'd ask a lot of hard questions.

> She did mention exercise but I have a hernia (mentioned in previous posts)
> which the baby seems to be pushing against and walking more than 100 yards
> leaves me in agony. So I am trying to do exercises at home but it'd difficult
> to find effect things to do. Any suggestions would be great (sit-ups out of
> the question as they make the hernia worse)

What about swimming or a pregnancy water exercise program
or something like that?

Best wishes,
Ericka

[[email protected]]

Leg lifts, holding cans while moving the arms about in different
directions, riding a stationary bike.

KC

[Chookie]

In article >, "Kazh" >
wrote:

> I had a ''fasting'' GTT. 12 hours fasting overnight, 1 blood taken (6.1) then
> drink 395ml of lucazade and back to be tested in 2 hours (10.2) no food in
> between.

Ericka, I am wondering if the Cochrane results you mention say much about how
these tests are done?

The one-hour glucose test is used here as a screening tool in mid-pregnancy.
I've passed both times, so I don't know what the protocol is for the
subsequent test, but my test protocol was:

No fast, drink the icky sweet stuff, wait for an hour with no exercise except
toilet breaks, then have a blood test. I am pretty sure that the cutoff
result is 8 mmol/l, not 6 as Kazh's appears to be.

This is plainly rather different from Kazh's test, but of course I had not had
glucose appear in my urine.

The only person I know well who had GD found that dietary control made her
miserable with fatigue and had no effect on her blood sugar, so she went on to
insulin. Perhaps our definition of GD is rather strict here, but she was
informed that people with GD have (IIRC) a 50% chance of developing Type II
diabetes within 5 years... and that is in fact what has just happened to her.
She could tell it was coming on, too.

I agree that a week is aremarkably short time to try dietary control before
hitting the insulin, especially as they don't appear to have given much
information about what Kazh ought to do!

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"In Melbourne there is plenty of vigour and eagerness, but there is
nothing worth being eager or vigorous about."
Francis Adams, The Australians, 1893.

[Ericka Kammerer]

Chookie wrote:

> In article >, "Kazh" >
> wrote:
>
>
>>I had a ''fasting'' GTT. 12 hours fasting overnight, 1 blood taken (6.1) then
>>drink 395ml of lucazade and back to be tested in 2 hours (10.2) no food in
>>between.
>
>
> Ericka, I am wondering if the Cochrane results you mention say much about how
> these tests are done?
>
> The one-hour glucose test is used here as a screening tool in mid-pregnancy.
> I've passed both times, so I don't know what the protocol is for the
> subsequent test, but my test protocol was:
>
> No fast, drink the icky sweet stuff, wait for an hour with no exercise except
> toilet breaks, then have a blood test. I am pretty sure that the cutoff
> result is 8 mmol/l, not 6 as Kazh's appears to be.
>
> This is plainly rather different from Kazh's test, but of course I had not had
> glucose appear in my urine.

One of the problems with this whole mess is that there *isn't*
consistency or consensus on what tests, when, how to administer them,
and what the cutoffs should be. Glucose in the urine is a very
unreliable indicator. Lots of people have it with perfectly normal
glucose metabolism, and others spill no sugar and have very wonky
glucose metabolism. Yours is a somewhat more orthodox way of doing
the 50g oral glucose challenge test, and your cutoff is more the
cutoff for true diabetes. In other parts, there are many who keep
pushing the cutoffs lower and lower.

> The only person I know well who had GD found that dietary control made her
> miserable with fatigue and had no effect on her blood sugar, so she went on to
> insulin. Perhaps our definition of GD is rather strict here, but she was
> informed that people with GD have (IIRC) a 50% chance of developing Type II
> diabetes within 5 years... and that is in fact what has just happened to her.
> She could tell it was coming on, too.

Yes, about the only clear result of all the research is that
a diagnosis of GD makes it more likely that you'll get type II diabetes
in the future. It *is* likely that pregnancy is a sort of stress test
that gives you a peek into your future. If you do get diagnosed with
GD, it's a heads up that you ought to do what you can WRT lifestyle
factors (e.g., diet and exercise, mainly) to tip the odds in your
favor. Still, overweight and obesity is pretty tightly linked to
a diagnosis of GD, and also to type II diabetes ;-) A lot of these
confounds are not very well accounted for in the research.
Of course, that still doesn't say much about what the risks might
be for mother or baby related to the pregnancy.

Best wishes,
Ericka

[Kazh]

Thanks everyone for the advice, I am still undecided on whether to allow =
them to give me insulin or not and I'd like one final piece of advice on =
the results of my Blood sugars tests I've done over the past week.

This is going on the test they say it *should be* lower than the =
following -=20

Before Breakfast =3D 5.5
1.5 hours after breakfast =3D 8
Before lunch =3D 5.5
1.5 hours after lunch =3D 8
Before Dinner =3D 5.5
1.5 hours after dinner =3D 8
Before Bedtime =3D 6-7

Day 1 -=20
Before Lunch =3D 6.8
1.5 hours after lunch =3D 7.5
Before Dinner =3D 6.5
1.5 hours after dinner =3D 7.9
Before Bedtime =3D 8.2

Day 2 -
Before Breakfast =3D 6.1
1.5 hours after breakfast =3D 11.2
Before lunch =3D 6.4
1.5 hours after lunch =3D 6.3
Before Dinner =3D 6.8
1.5 hours after dinner =3D 14.1
Before Bedtime =3D 8.2

Day 3 -=20
Before Breakfast =3D 5.2
1.5 hours after breakfast =3D 9.5
Before lunch =3D 7.6
1.5 hours after lunch =3D 7.9
Before Dinner =3D 5.8
1.5 hours after dinner =3D 11.6
Before Bedtime =3D 6.9

Day 4 -=20
Before Breakfast =3D 5.9
1.5 hours after breakfast =3D 7.9
Before lunch =3D 3.8
1.5 hours after lunch =3D 12.4
Before Dinner =3D 13.6
1.5 hours after dinner =3D 10.2
Before Bedtime =3D 7.2

Day 5 -=20
Before Breakfast =3D 6.3
1.5 hours after breakfast =3D 9.7
Before lunch =3D 4.1
1.5 hours after lunch =3D 10.6
Before Dinner =3D 8.6
1.5 hours after dinner =3D 9.7
Before Bedtime =3D ........

Day 6 -=20
Before Breakfast =3D 5.2
1.5 hours after breakfast =3D 7.8
Before lunch =3D 5.1
1.5 hours after lunch =3D 7.5
Before Dinner =3D 6.1
1.5 hours after dinner =3D 8.7
Before Bedtime =3D 7.4

Day 7 - TODAY
Before Breakfast =3D 6.2
1.5 hours after breakfast =3D=20
Before lunch =3D=20
1.5 hours after lunch =3D=20
Before Dinner =3D=20
1.5 hours after dinner =3D=20
Before Bedtime =3D=20

If anyone knows what they would indicate to a doctor / dietician please =
advise.

Karen


--=20
Karen
DS 10th Aug 1986 - VB - 9lb 13oz
DD 13th Aug 1988 - VB - 10lb 9oz
EDD 9th May 2005 - It's a girl !!
Sophie's Prediction for us - Girl
--
Our Latest Scan Photo
http://www.freewebs.com/kazh/
--
Unlock codes =A35 only
http://www.freewebs.com/kazh/unlockcodes.htm

[Ericka Kammerer]

Kazh wrote:

> Thanks everyone for the advice, I am still undecided on whether
> to allow them to give me insulin or not and I'd like one final
> piece of advice on the results of my Blood sugars tests I've
> done over the past week.

By the way...what dietary advice did they give you, and
what have you been eating?

Also, did you ever mention whether you have been tested
when not pregnant?

Best wishes,
Ericka

[Ericka Kammerer]

Kazh wrote:

> Thanks everyone for the advice, I am still undecided on whether to
> allow them to give me insulin or not and I'd like one final piece of
> advice on the results of my Blood sugars tests I've done over the past week.

Also, did they do an HbA1c test?

Best wishes,
Ericka

[Kazh]

"Ericka Kammerer" > wrote in message =
news:9s-dncN09_FBjrrfRVn-
By the way...what dietary advice did they give you, and
what have you been eating?

Also, did you ever mention whether you have been tested
when not pregnant?

Best wishes,
Ericka
-----------
Just ''eat sensible'' talk about diet, no strict diets rules and I was =
tested when not PG but it was a while ago, maybe 5 years.

[Kazh]

"Ericka Kammerer" > wrote in message =
...
Kazh wrote:

Also, did they do an HbA1c test?

Best wishes,
Ericka
-------------
Not as far as I know..........but they do that many tests who can tell ?

[Ericka Kammerer]

Kazh wrote:

> "Ericka Kammerer" > wrote in message news:9s-dncN09_FBjrrfRVn-
> By the way...what dietary advice did they give you, and
> what have you been eating?
>
> Also, did you ever mention whether you have been tested
> when not pregnant?

> Just ''eat sensible'' talk about diet, no strict diets rules and I was
> tested when not PG but it was a while ago, maybe 5 years.

ARE YOU KIDDING ME?!!! Okay, sorry for yelling, but
this is flat out incompetent. *IF* you have problems with
glucose metabolism and you want to treat it with diet, it makes
a *huge* difference precisely what you eat, and in what
combinations. There are lots of high glycemic index foods
that one would normally consider quite healthy that could
send your blood sugars way high. If they haven't given you
any better diet advice than that and they expected you to
fix everything in a week, they're flat out crazy. I'm sorry,
but this is absolutely incompetent and I wouldn't trust them
farther than I could throw them. Frankly, it would cause me
to be hunting for new caregivers.

Best wishes,
Ericka

[Ericka Kammerer]

Kazh wrote:

> "Ericka Kammerer" > wrote in message ...

>> Also, did they do an HbA1c test?

> Not as far as I know..........but they do that many tests who can tell ?

That test will give you an idea how your blood sugars have
been, on average, over the last few months. I wouldn't go anywhere
near insulin without having those results either.

Best wishes,
Ericka

[Chookie]

In article >,
Ericka Kammerer > wrote:

> If they haven't given you
> any better diet advice than that and they expected you to
> fix everything in a week, they're flat out crazy. I'm sorry,
> but this is absolutely incompetent and I wouldn't trust them
> farther than I could throw them. Frankly, it would cause me
> to be hunting for new caregivers.

I'll me-too that!

What the heck are they thinking? Don't they think diabetes is serious enough
to treat properly? I would go to your regular doctor (unless this is him) for
another opinion on your numbers and more dietary advice.

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"In Melbourne there is plenty of vigour and eagerness, but there is
nothing worth being eager or vigorous about."
Francis Adams, The Australians, 1893.

[Kazh]

"Ericka Kammerer" > wrote in message =
...
Kazh wrote:

ARE YOU KIDDING ME?!!! Okay, sorry for yelling, but
this is flat out incompetent. *IF* you have problems with
glucose metabolism and you want to treat it with diet, it makes
a *huge* difference precisely what you eat, and in what
combinations. There are lots of high glycemic index foods
that one would normally consider quite healthy that could
send your blood sugars way high. If they haven't given you
any better diet advice than that and they expected you to
fix everything in a week, they're flat out crazy. I'm sorry,
but this is absolutely incompetent and I wouldn't trust them
farther than I could throw them. Frankly, it would cause me
to be hunting for new caregivers.

Best wishes,
Ericka
------------
I saw the diabetes dietician and she said ''eat sensibily''=20
Breakfast =3D some carbohydrates like toast or cereal
Dinner =3D 1/2 my dinner plate to be veg, 1/4 to be protein and 1/4 to =
be carbohydrates.
Tea =3D some carbohydrates

Basically that was it, apart from the no sweets, fizzy pop or cakes bit.

I asked if they expected me ''sort this out in a week'' and told them it =
was an unreasonable amount of time but they said ''as you only have 10 =
weeks of your pregnancy left, and are testing your levels 7 times a day, =
we think a week is a good indicator of whether or not you have GD'' and =
left it at that.

[Kazh]

"Ericka Kammerer" > wrote in message =
...

That test will give you an idea how your blood sugars have
been, on average, over the last few months. I wouldn't go anywhere
near insulin without having those results either.

Best wishes,
Ericka
---------------
When I went on Thursday for the checkup and they reviewed the 49 blood =
tests I'd done over the past week they ''adviced strongly'' to go on =
insulin (4 units) apprantly a low dose, and see how we =
go..............I'm on my second day and my levels are no better than =
they were without it !! In fact some are higher !!

Thursday -=20
Before Breakfast =3D 6.2
1.5 hours after breakfast =3D 10.5
(insulin shot)
Before lunch =3D 4.7
1.5 hours after lunch =3D 8.1
(insulin shot)
Before Dinner =3D 4.5
1.5 hours after dinner =3D 5.9
Before Bedtime =3D ......

Friday -=20
(insulin shot)
Before Breakfast =3D 6.8
1.5 hours after breakfast =3D 9.3
(insulin shot)
Before lunch =3D 4.5
1.5 hours after lunch =3D 9.1
(insulin shot)
Before Dinner =3D 4.8
1.5 hours after dinner =3D 10

Saturday -=20
(insulin shot)
Before Breakfast =3D 6.9
1.5 hours after breakfast =3D 9.2

[Kazh]

"Chookie" > wrote in message =
...
In article >,

I'll me-too that!

What the heck are they thinking? Don't they think diabetes is serious =
enough=20
to treat properly? I would go to your regular doctor (unless this is =
him) for=20
another opinion on your numbers and more dietary advice.

--------------
I saw their dietician, an obstetrician, a diabetes specialist and they =
all want me on insulin !!

[Ericka Kammerer]

Kazh wrote:

> I saw the diabetes dietician and she said ''eat sensibily''
> Breakfast = some carbohydrates like toast or cereal
> Dinner = 1/2 my dinner plate to be veg, 1/4 to be protein and 1/4 to be carbohydrates.
> Tea = some carbohydrates

I'm sorry, but that's crap. With diet advice like that, it's
no wonder you're not achieving the very tight targets they're setting.
It's a wonder if they've got anyone who would. There's no one-size-
fits-all way to eat if you're diabetic, but in general, you shouldn't
be eating *ANY* meals that are all carbs. Carbs shouldn't be more than
about 50 percent of your entire diet, and the carbs you eat should be
carbs that are high in fiber. You should be avoiding foods that are
high on the glycemic index, as they will also cause your blood sugar
to spike. You could follow the advice they gave you and still have
horribly high numbers all over the place. I'm shocked that you could
actually go see a dietician and get such awful advice. ANY meal where
you eat almost all carbs (with no thought even towards making them
high fiber/low glycemic index) is likely to result in high numbers.
You should also shoot for more frequent, smaller meals each day.
Many people find that they can't keep their numbers within their
goals without snacking (where snacks need to be balanced as well--
no grabbing just an apple for a snack, unless you want to see
your numbers shoot over the moon!).

> I asked if they expected me ''sort this out in a week'' and told them it
> was an unreasonable amount of time but they said ''as you only have 10
> weeks of your pregnancy left, and are testing your levels 7 times a day,
> we think a week is a good indicator of whether or not you have GD'' and
> left it at that.

Just because you may have GD is *NOT* necessarily a reason
to have insulin. You can test until you're blue in the face, but
you're not going to get better numbers following their dietary
advice, except by blind luck.

Best wishes,
Ericka

[Maggie]

Kazh spake thusly
>I saw the diabetes dietician and she said ''eat sensibily''
>Breakfast = some carbohydrates like toast or cereal
>Dinner = 1/2 my dinner plate to be veg, 1/4 to be protein and 1/4 to be
>carbohydrates.
>Tea = some carbohydrates
>
>Basically that was it, apart from the no sweets, fizzy pop or cakes bit.

I was diagnosed with GD at 33 weeks, and told I would need to go on
insulin and that I would be induced at 37 weeks. Since I had no
intention of doing either, I followed a very strict diet and kept up
with my exercise. It worked, and I ended up being discharged back into
the care of my midwife at 37 weeks.

Main things I did were cut out all white bread, potatoes, rice, and of
course biscuits and cakes, anything with sugar or refined carbs. I'd
have sweetcorn (on the cob) instead of potatoes, wild rice instead of
white. I would have fruit sparingly and always with protein (eg. apple
and cheese), except in the mornings when I'd have oats and grapefruit.
I looked at the GI value of food, but we found that GL (glycemic load)
more useful.

White potatoes are the worst! Avoid at all costs!

I found this website invaluable:
http://www.plus-size-pregnancy.org/gd/gd_index.html

>
>I asked if they expected me ''sort this out in a week'' and told them
>it was an unreasonable amount of time but they said ''as you only have
>10 weeks of your pregnancy left, and are testing your levels 7 times a
>day, we think a week is a good indicator of whether or not you have
>GD'' and left it at that.
>

Well, if they've tested you and decided you have GD, what's a week worth
of testing supposed to do?

All the best - 10 weeks is not long, though I found 7 weeks a long time
without my spuds. :)
--
Maggie

[Kazh]

I'm even more confused about GD now than ever..........

Can anyone point me in the direction of a site to show me the types of =
foods to eat at meals and the types to avoid. Like a example menu

I know I need to find the ''triggers'' for myself but surely therre are =
some which affect everyone like grapes or apples.

I really don't want ot take the insulin as it looks like it's not =
controlling anything anyway, but need an alternative to decrease my BG.

AAAARRRRRRGGGGGGGGGHHHHHH

Just 9 weeks 1 day to go ............

[Kazh]

"Maggie" > wrote in message =
...
I was diagnosed with GD at 33 weeks, and told I would need to go on=20
insulin and that I would be induced at 37 weeks. Since I had no=20
intention of doing either, I followed a very strict diet and kept up=20
with my exercise. It worked, and I ended up being discharged back into=20
the care of my midwife at 37 weeks.

Main things I did were cut out all white bread, potatoes, rice, and of=20
course biscuits and cakes, anything with sugar or refined carbs. I'd=20
have sweetcorn (on the cob) instead of potatoes, wild rice instead of=20
white. I would have fruit sparingly and always with protein (eg. apple=20
and cheese), except in the mornings when I'd have oats and grapefruit.=20
I looked at the GI value of food, but we found that GL (glycemic load)=20
more useful.

White potatoes are the worst! Avoid at all costs!

I found this website invaluable:
http://www.plus-size-pregnancy.org/gd/gd_index.html

--=20
Maggie
-----------------------
This is of great help Maggie, can you help point me in the direction of =
examples of good and bad diet in relate to GD, like example meals or =
what is good to lower BG and what raises it ?

[Ericka Kammerer]

Kazh wrote:

> I'm even more confused about GD now than ever..........
>
> Can anyone point me in the direction of a site to show me the types
> of foods to eat at meals and the types to avoid. Like a example menu

Google "glycemic index" and you should turn up a site that
lists the glycemic index of foods. You want to choose food that
are low on the glycemic index (55 or less) and have a low glucose
load (10 or less). Glycemic load takes into account the amount
you eat, so it's not always an issue of just totally avoiding all
high GI foods--you can include small quantities of high GI foods
as long as you keep the glycemic load low. There are foods out there
that have a higher glycemic index than sugar, many of which have
probably been on your plate--including white bread and white potatoes.
Shoot for several small meals a day. Don't go more than
three hours without eating.
Never eat carbs alone. Balancing then with protein, fiber,
and fat will help with your body's response. When
you mix things up in a meal, their glycemic index can be affected
by the combination, so the weighted average of the GIs of the
various foods won't necessarily be accurate, but you sure as
heck will know a lot more than you did just following your
dietician's advice.
Eat foods that are processed as little as possible.
Things like cooking pasta longer (or really, cooking just about
anything) raises its glycemic index.
Glycemic index or glycemic load isn't the be all and end
all. You can manage things just by limiting carbs and eating
"good" carbs when you do eat carbs, but the glycemic index helps
you figure out which carbs are better carbs and you *do* need
carbs. If you are too ruthless in eliminating carbs, you can
have hypoglycemic episodes which aren't fun either.

> I know I need to find the ''triggers'' for myself but surely therre
> are some which affect everyone like grapes or apples.

Absolutely, which is why your dietician's advice was wholly
inadequate. There are lots of books out there. You might look for
a book on diabetic diets that is new enough to discuss glycemic index
and glycemic load.

> I really don't want ot take the insulin as it looks like it's not
> controlling anything anyway, but need an alternative to decrease my BG.

Be careful. They're likely to have you keep ratcheting up
the insulin until they get the numbers they want--and if they do
that giving you as little information as they have about the diet,
that could lead to some unpleasant situations.

Best wishes,
Ericka

[Maggie]

>
>I found this website invaluable:
>http://www.plus-size-pregnancy.org/gd/gd_index.html
>
>This is of great help Maggie, can you help point me in the direction of examples of good and bad diet in relate to GD, like example meals or what is
>good to lower BG and what raises it ?

You're going to have to do a little reading. Glycemic load index
information is here:
http://www.mendosa.com/gilists.htm

I found it extremely useful, and DH and I used it extensively when
trying to work out what to cook for dinner, etc.

I'm a sample size of one. You may find your blood sugars react
differently to certain foods than mine, but the GL index is a good
guideline.

If you're not exercising, start walking. Now. Even if it's only
fifteen minutes a day. You want to keep your blood sugars even over the
day, so that means snacking, having say 6 mini-meals rather than three
large ones.

Sample diet for one day for me (from what I can remember):

Breakfast - bowl of oats (not 'instant oats') with fresh grapefruit
Mid morning snack - one apple and some full-fat cheese
Lunch - green salad with balsamic vinegar, chicken noodle cup-a-soup,
cheese sandwich with low GI bread
Afternoon snack : handful of unroasted unsalted nuts (almonds, pecan,
walnut, not peanuts)
Pre dinner snack - 6 low GI crackers and salsa
Dinner - meat and vege, low GI carb such as wild rice or corn on the cob
Supper - two slices of low GI fruit toast and butter with glass of milk
(this helped me having leg cramps in the middle of the night! :))

All the best
--
Maggie

[Chookie]

In article >,
Ericka Kammerer > wrote:

> > I really don't want ot take the insulin as it looks like it's not
> > controlling anything anyway, but need an alternative to decrease my BG.
>
> Be careful. They're likely to have you keep ratcheting up
> the insulin until they get the numbers they want--and if they do
> that giving you as little information as they have about the diet,
> that could lead to some unpleasant situations.

Such as...?

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"In Melbourne there is plenty of vigour and eagerness, but there is
nothing worth being eager or vigorous about."
Francis Adams, The Australians, 1893.

[Chookie]

In article >, "Kazh" >
wrote:

> I'm even more confused about GD now than ever..........
>
> Can anyone point me in the direction of a site to show me the types of foods
> to eat at meals and the types to avoid. Like a example menu
>
> I know I need to find the ''triggers'' for myself but surely there are some
> which affect everyone like grapes or apples.

I think most of them affect everyone. Diabetes Australia
(http://www.diabetesaustralia.com.au/home/index.htm) have a fact sheet on GD and
on food choices. In both cases, the emphasis is on dietary management and
exercise, not insulin (though insulin might well be required).

The Australasian Diabetes in Pregnancy Society has its guidelines for
appropriate glucose levels here:
http://www.adips.org/guidelines.htm
They also have some useful consumer info:
http://www.adips.org/consumer.htm

it includes:

Will the diabetes go away at the end of the pregnancy?
It is very likely that the diabetes is only associated with pregnancy, and in
almost every case, will go away as soon as the baby (and placenta) are born.
As you have been identified with the gene for diabetes you are at risk of
developing diabetes some time in the future. ADIPS recommend that you be
tested 6 - 12 weeks following birth of your baby, and again each 2-3 years.

What are the risks of Gestational Diabetes?
The immediate risk for baby if blood glucose remain uncontrolled is becoming
overweight which makes birth difficult. Large infants can mean an episiotomy
(cut in the perineum to allow baby to be born), a forceps delivery or
caesarean section. Learning to control blood glucose levels within normal
range can reduce these risks significantly. Babies born to mothers with
undiagnosed Diabetes or who have been unsuccessful in controlling blood
glucose levels are more likely to be overweight as children. This may increase
the child¹s risk of health problems (eg high blood pressure, heart disease and
diabetes) in the future.

Will I be able to breastfeed my baby?
Yes. You have the right to choose how you feed your baby. The baby will not
develop diabetes or gestational diabetes from breast milk.Your baby will be
tested for low blood glucose levels (blood test from heel prick) on the first
day and early breastfeeding (within half an hour of birth) will assist baby to
maintain normal levels of blood glucose. Talk to your midwife about strategies
to reduce separation time of you and your baby and steps to take for
successful breastfeeding.

Why have I got gestational diabetes?
There was no problem in my last pregnancy / no one in my family has diabetes /
my diet is healthy / I do lots of physical activity. There are certain risk
factors associated with the development of gestational diabetes. Age, weight,
family history of diabetes or previous complicated pregnancy are the main risk
factors. Gestational diabetes may occur in women with no identifiable risk
factors. This is why ADIPS recommend that every woman be screened at 24-28
weeks.

My result of glucose level is only a little above normal. Do I really have to
bother?
The level of blood glucose is only a predictor of potential problems.
Generally, the higher the level the higher the risk. Blood glucose levels rise
as the pregnancy progress, you and your baby are still at risk if no education
and management of blood glucose occurs.

Will I need insulin injections?
Between 10% - 25% of all women with gestational diabetes need to use insulin
injections as part of their treatment. The best method of determining this
need is by checking your blood glucose levels daily as recommended by your
Doctor or Diabetes Educator.
No proof yet exists that tablets are a safe way of controlling blood glucose
levels during pregnancy. Trials are in process and some women may continue to
use their diabetes tablets under supervision during pregnancy.

And here is the Glycemic Index site, with database:
http://www.glycemicindex.com/

HTH,

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"In Melbourne there is plenty of vigour and eagerness, but there is
nothing worth being eager or vigorous about."
Francis Adams, The Australians, 1893.

[Ericka Kammerer]

Chookie wrote:

> In article >,
> Ericka Kammerer > wrote:
>
>
>>>I really don't want ot take the insulin as it looks like it's not
>>>controlling anything anyway, but need an alternative to decrease my BG.
>>
>> Be careful. They're likely to have you keep ratcheting up
>>the insulin until they get the numbers they want--and if they do
>>that giving you as little information as they have about the diet,
>>that could lead to some unpleasant situations.
>
>
> Such as...?

Depriving the baby of enough glucose to thrive.

Best wishes,
Ericka

[Ericka Kammerer]

Chookie wrote:


> The Australasian Diabetes in Pregnancy Society has its guidelines for
> appropriate glucose levels here:
> http://www.adips.org/guidelines.htm
> They also have some useful consumer info:
> http://www.adips.org/consumer.htm
>
> it includes:
<snip>
> What are the risks of Gestational Diabetes?
> The immediate risk for baby if blood glucose remain uncontrolled is becoming
> overweight which makes birth difficult. Large infants can mean an episiotomy
> (cut in the perineum to allow baby to be born), a forceps delivery or
> caesarean section. Learning to control blood glucose levels within normal
> range can reduce these risks significantly.

Studies show that treatment (usually only aggressive treatment)
can sometimes reduce the size of the babies, but they rarely show
any improvement in these other factors (episiotomy, instrumental
delivery, c-section, dystocia).

> Will I need insulin injections?
> Between 10% - 25% of all women with gestational diabetes need to use insulin
> injections as part of their treatment.

There is no high quality medical evidence to support this
statement.

Best wishes,
Ericka

[Kazh]

"Ericka Kammerer" > wrote in message =
...
Kazh wrote:

thanks Ericka, BG results still rising and they want to increase the =
insulin but I'm going to try the GI diet first before agreeing to =
anything more.

[Kazh]

"Maggie" > wrote in message =
...

thanks Maggie will take a look

[Chookie]

In article >,
Ericka Kammerer > wrote:

> Studies show that treatment (usually only aggressive treatment)
> can sometimes reduce the size of the babies, but they rarely show
> any improvement in these other factors (episiotomy, instrumental
> delivery, c-section, dystocia).

That's why I wonder at the hoo-ha in the US about GD, as noted in this thread.
After all, you've got such a high rate of interventions anyway...

> > Will I need insulin injections?
> > Between 10% - 25% of all women with gestational diabetes need to use
> > insulin
> > injections as part of their treatment.
>
> There is no high quality medical evidence to support this statement.

It may be that this is the %age of women prescribed insulin -- as you say,
there is quite a bit of dispute about when it's necessary.

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"In Melbourne there is plenty of vigour and eagerness, but there is
nothing worth being eager or vigorous about."
Francis Adams, The Australians, 1893.

[Ericka Kammerer]

Chookie wrote:

> In article >,
> Ericka Kammerer > wrote:
>
>
>> Studies show that treatment (usually only aggressive treatment)
>>can sometimes reduce the size of the babies, but they rarely show
>>any improvement in these other factors (episiotomy, instrumental
>>delivery, c-section, dystocia).
>
>
> That's why I wonder at the hoo-ha in the US about GD, as noted in this thread.
> After all, you've got such a high rate of interventions anyway...

I think it's mostly CYA medicine. No one wants to be
the caregiver who didn't diagnose GD when the baby turned out
big and *maybe* something happened as a result. Also, there
remains the problem of women who are undiagnosed true diabetics.
Of course, screening at 28 weeks is too little, too late for
those women.

Best wishes,
Ericka