Gestational Diabetes (long)

[dshepperd]

Hi Everyone,
I don't post that often but I wanted to know if any of you have had any experience with gestational diabetes. I failed my 3-hour glucose tolerance test (after failing my 1-hour test earlier in the week) so I've been referred to an endocrinologist. My OB's nurse told my they would probably just put me on a special diet and that the only real danger is that the baby might be big (10+ pounds) if I don't control my blood sugar. Of course I'll find out more from the endocrinologist but I don't have my appt. until the 17th.

My main question for anyone who knows anything about this is
am I doomed for massive weight gain, and if so, does the weight tend to come off easily after the baby is born and the diabetes goes away? I've continued a moderate exercise program and plan on keeping that up, but I have already gained a little more weight than I probably should have. Maybe the diet will help but I really haven't been eating a lot of sweets or junk food anyway. Thankfully, that is not really one of my weaknesses.

I have always maintained a healthy weight on my small frame (until now that is). Of course my primary concern is my baby's health but I have to admit I'm really worried about excess weight gain too. Any insights any of you have would be greatly appreciated.

Thanks,
Dana

 

[Sheila]

Hi Dana,

Congratulations on your pregnancy. I can definitely understand your concern about the gestational diabetes. I know that you are anxious and that you aren't going to see the endocrinologist until the 17th. I am going to "repost" below an answer to a question regarding gestational diabetes that we got on the forum back in 1999. (Wow, we've been doing this awhile now!) In the last 13+ years my company, Healthy Moms(R), has trained over 1800 pregnant and new moms. In those 14 years, I have always allowed the pregnant moms who had been diagnosed with GM to enter class right away, even when we had a waiting list. I can honestly tell you that the ones with GM who exercised and followed their diet pretty faithfully did not gain an excessive amount of weight and after they gave birth did not seem to have any more of a problem than usual losing the weight than their non - GM counterparts. Exercise plays a very important role in the management of this disorder.

As promised here is that post.....


Diabetes is a condition in which blood sugar or glucose levels are not regulated properly. It is related to the hormone insulin, which is responsible for controlling blood sugar levels. In Type I Diabetes (juvenile-onset or diabetes that develops before adulthood) the body does not produce enough insulin. In another form of diabetes, the insulin produced by the body is not used effectively. This is the case in both adult-onset diabetes and gestational diabetes.

Gestational diabetes, by definition, is diabetes that develops during pregnancy in a woman who did not have diabetes before she became pregnant. It is thought to result from metabolic changes brought on by the hormones of pregnancy and is only found in 1-5% of women who are tested for gestational diabetes during their pregnancies.

Although gestational diabetes is usually not a threat to the mother’s health, it should be taken as a warning sign that she is at a greater risk for developing adult-onset diabetes later in life. Also, gestational diabetes poses some real risks for the baby. However, when the problem is properly diagnosed and managed, the baby is put at no greater risk that it would have been had the mother not had the disorder.

The major risk for babies whose mothers have gestational diabetes is macrosomia or excessive birth weight. Macrosomia is defined as a birthweight of greater than 4500 grams or 9 pounds 14 ounces. Babies as big as this may have difficulty being born. Also the likelihood of a C-section is increased with these babies. Keeping blood sugar levels within the normal range is imperative in order to decrease the above risk.

Other problems that may develop as a result of gestational diabetes include hypoglycemia or low blood sugar shortly after birth. This may occur because the baby is used to getting high amounts of glucose across the placenta and once the umbilical cord is cut at birth, the source of this glucose is abruptly stopped. These babies are usually monitored after birth to prevent their blood sugar levels from becoming too low.

The key to managing gestational diabetes is to control mom’s blood sugar level. In most cases this can be done with careful diet planning, exercise and regular blood sugar testing. Home blood sugar testing may be recommended. Urine testing is not accurate as there is little correlation between urine sugar and blood sugar levels.

In almost all women who have the condition, diet, exercise and blood sugar monitoring can bring it under control. If diet and exercise do not seem to be controlling the condition, mom may require daily insulin injections.

Gestational diabetes almost always goes away after delivery. However, if mom has had gestational diabetes in one pregnancy, the likelihood that she will experience it in subsequent pregnancies is increased. Also as mentioned above, the likelihood that she will develop adult-onset diabetes in the future is increased. Therefore diet and exercise are especially important in the long term for moms who have had this condition during pregnancy.

The American Diabetes Association says that “All women with gestational diabetes mellitus should receive nutritional counseling, by a registered dietitian when possible, consistent with the recommendations for calorie distribution proposed by the American Diabetes Association. Individualization of the diet depending on maternal weight and height is recommended. Diet therapy should include the provision of adequate calories and nutrients to meet the needs of pregnancy, and should be consistent with the maternal blood glucose goals that have been established. Intake of sucrose (sugar) and other caloric sweeteners should be limited.”


Please let us hear what the doctor says on the 17th.

Take care and keep exercising!!

Sheila Watkins, MLSci.
Founder and National Program Director
Healthy Moms(R) Fitness Programs
www.healthymomsfitness.com

 

[Joanna]

Hi Dana,

I'm glad Shelia has given you such a throrough and professional answer. My own experience is that I was tested but ended up not having gestational diabetes. I struggled with weight gain, though, and like you had never eaten many sweets. I was an 11 lb. baby and now they think my mother probably suffered with it during her pregnancy with me. Anyway, my weight came off with varying levels of difficulty, and was greatly influenced by my attitude during and after. The most important thing right now is to eat balanced and healthy, and especially to follow guidelines offered by your doctors and/or nutritionist.

You will survive.

Joanna
Mom of five...

 

[dshepperd]

Sheila,
Thanks so much for your response. It is very reassuring to know that adhering to the diet and exercise recommendations can help keep things under control. This is what I had read, but anecdotal evidence is always reassuring too. Reading what "should" work and what real people actually experience can often be very different.

Thanks again for the info!

Dana

 

[dshepperd]

Joanna,
Thanks for sharing your experience. It's amazing how different our pregnancies are from our mothers', and the advances in medicine that allow for screening of risks women used to not even be aware of.

Take care,
Dana

 

[Cathe Friedrich]

Thanks Sheila! I very much enjoyed the refresher on this topic. Having failed my first one hour test when I was pregnant(but passing my three hour) I read this post with great interest. Very thorough information, thank you!

 

[LizN]

Oh Dana,
You poor dear! My OB-GYN didn't test me for gestational diabetes and I wish that he had - I had a 10lb 4oz baby girl first time around. I don't know if I had GD or not, or whether it was the Dr Clapp prediction of stopping exercise mid way through pregnancy. All I can say is thank goodness I had a C-Section.

I don't know if I mentioned I gained nearly 60pounds last preg and yes, it took me ages to lose it (18 months). However the fact that you've found out about it now should mean that you have even more reason to keep exercising and eating right - I think it would be doubtful that you'll gain too much weight.

Anyway, I'm soon due for my test (I'm 25 weeks), but I feel really positive about it, having gained 16 pounds so far in this pregnancy. I'm sure the exercise has a lot to do with it..I feel so much more positive about life in general this time.

Good luck
Liz N

 

[dshepperd]

Hi Liz,
Good luck with your glucose test! My mom has a friend whose daughter had GD with her 1st and 3rd baby, but not 2nd, so it's possible you did have GD last time but don't have it this time. At any rate, it sounds like this pregnancy is much easier for you! That's great.

Personally, having had a few days to adjust to this and reading about Sheila's experience with GD moms, I'm feeling a lot more optimistic and like I have some control over this. Just one more reason to keep up that exercise program!

Take care,
Dana

 

[dshepperd]

Update

Just wanted to post an update for anyone else who has to deal with this or does a search later hoping to find some info.

I've now seen the endocrinologist twice and all my lab work has been normal. I will have to monitor my blood sugar levels 4 times a day, but can't do that until after I've seen the diabetes educator and couldn't get an appointment with her until July 3. However, my blood sugar levels have been completely normal when they've been checked in the doctor's office and the endocrinologist is not worried in the least. He said he is 99% sure I will not need insulin.

In addition, I've been watching my diet pretty closely and have lost a few pounds, putting me right about where I should be in terms of weight gain. So...I'm no longer in a panic about that.

Most importantly, I had another sonogram last week (at 28 weeks) and the baby is doing great. Because I have a history of miscarriage, my OB is now having me come in once a week for a non stress test just to be extra cautious. Although all these doctor's appointments get to be a logistics challenge on some days, I feel really good knowing the baby is getting such close monitoring.

Sorry this was so long but wanted to post on a more upbeat note for anyone else who is worried when they get this diagnosis.

Take care,
Dana