Friday, April 5, 2013

My experience with gestational diabetes (#dblog)

NOTE: This is my own experience. None of this information should be considered medical advice, even when I discuss treatment plans from my doctor. Each person is different.  Please consult your own physician.

My oldest will be 20 years old in June.  *gulp*  It's been 20 years since I was first diagnosed with gestational diabetes.  I don't know the exact date, but it was about this time of year. I don't talk much about my experiences with gestational diabetes, but yesterday someone from Diabetes Advocates asked me to share my experiences.

36 wks with #5
When I was diagnosed the first time, I was scared.  I was 23 years old (yes, I just told you my current age), and unsure of what this diagnosis really meant.  I had no prior experience with diabetes except knowing that my grandfather lost both of his legs from Type 2 diabetes.  But this was only gestational diabetes.  It couldn't be that bad, could it?

The OB I had for my first pregnancy didn't have the best bedside manner.  After being diagnosed and having glucose readings in the mid-120s two hours after meals (guidelines I was given was under 120), he admitted me in the hospital overnight.  His reason: To make sure I wasn't mis-measuring my food to cause the higher numbers.  So here I was, laying around in a hospital room, watching television, limited area to walk around, and he makes his decision whether or not to put my on insulin based on those 24 hrs.  (It took me a few years to figure out the irony of that situation.)

Needless to say, I wound up on insulin with my first pregnancy after hearing, "If you don't watch your blood sugar, you're going to have a 10 pound baby that will die from under-developed lungs."  Not a possible complication.  No talk about increasing activity or cutting carbs.  Just a scare tactic.  I was afraid that I was going to harm my baby, and my husband was mad.  That baby was born eight days before the due date at 6 lbs 7.75 oz.

My second child was born in a different part of the state with a different doctor.  Once again I failed the one hour and three hour glucose tolerance test (GTT).  This doctor didn't put me on insulin but did say he would not let me go over my due date.  He would do an amnio to check for lung development and induce me if I made it that far.  Thankfully this one was born at exactly 39 weeks, weighing 8 lbs even.

Babies three, four, and five were born at the same hospital as my first (I loved those OB nurses!), but this time I went with our family physician.  By this time I was more educated about gestational diabetes.  The internet was more available and information was easier to come by.  This doctor in a round-about way let me know that he would not prescribe insulin if I was only a little over the guidelines.  He only had my do the one hour test with each child, taking into account my previous history.  I tried to get him to skip the testing altogether, but he needed documentation for insurance.

My doctor understood when I told him I had a bad day and over-ate on pizza for dinner, opting to skip a glucose test that evening.  He was also understanding when I ate pretzels while driving my kids two hours to an appointment, resulting in a reading of 178.  As long as I didn't make it a habit and my overall numbers were good, he wasn't going to chastise me.  Those children were born at the weights of 9 lbs 2 oz, 8 lbs 7 oz, and 9 lbs 6 oz with no side effects from my diabetes except temporary low blood sugar shortly after birth.  Nothing a feeding or two couldn't fix.

My youngest
I've been trying to think about the emotions I went through during my pregnancies and dealing with gestational diabetes.  My youngest is 8.5 years old, so it's hard to remember exact details.  I do remember being more confident with each pregnancy, though still scared.  I searched a parenting message board I used to frequent and found some posts I made during my fifth pregnancy.  It was also my fifth time with gestational diabetes, due and born on October 13, 2004.  (Added comments written in italics.)

When I called the nurse she said she had my glucose tolerance test (GTT) results. "Ok, how bad did I fail?" She started laughing. 223 A new record for me! Last time was in the 180s. So she's sending an order over to the dietitian who will call me for an appt. I was told previously by my ins. to call them when I was diagnosed (I called them a couple mos. ago to get info about "preferred" monitors) and they gave me the number for two companies offering free glucometers. I'm getting a Life Scan One Touch Ultra Smart shipped FedEx 2 day – free! Looks like fun! I called the dr's office and left a msg. for the dr. to have the nurse call in an Rx for lancets and test strips so I'll be all set when I get back into town.

I'm not happy that I am gestational diabetic once again but it's a fact of my life. Why dwell on it and get depressed? If I keep a positive attitude, including my jokes, I can better deal with this. An upside is due to my history and how high my result was, I don't have to go through the 3 hr test.

I started testing my blood sugar a week ago even though I didn't meet with the dietitian until this past Friday. I wanted to start seeing what sets me off. My fasting levels are supposed to be below 95 and two hours after meals should be below 120. Every single one of my fasting levels have been high. Over the last seven days, my average is 111. Only one of my after breakfast levels have been on target and that's because I took the kids for a walk up to the farmer's market. Most of my lunch and dinner levels have been great, averaging 110 and 119. And that's with a dinner that was 162! (Two days before we went to the dietitian we made one last trip to the Chinese buffet. hehe)

My main concern, obviously, is my morning levels. I know that this is an indicator of what is to come. A possible Type 2 diagnosis. I thought maybe I was having my nighttime snack too late. Since I can't have my snack until I test my sugar two hours after a meal, we made sure we ate a little earlier so I could have my snack at 8pm. I was up for another 3.5 hrs, but my fasting was still high this morning! (111)

Tonight I'm going to try cutting out my evening snack and either go for a walk or go on the exercise bike before bed. I also need to make sure I do the same after breakfast, though that's my email/msg board time. Guess I'll have to delay it a little bit until after I get my exercise in. Any other suggestions from anyone with experience with high blood sugar welcome! I want to avoid insulin and going straight from GD to Type 2 if I can. (Edited to add: I was diagnosed March 24, 2008.)

8/10/2004 (someone posted links about cinnamon helping glucose levels)
Wow! Who would have thought cinnamon would help reduce sugar levels. Maybe I'll put some on my toast tomorrow (without the sugar) and see how that goes! (Edited to add: It's amazing what we'll latch onto when we're down.)

My fasting and after breakfast levels are still high. I expressed concern at my appt this afternoon and the dr ordered an A1C test to see how my long term glucose levels have been. He also ordered a CBC since I was complaining about being tired and we wanted to check my iron levels again. Hope to get those results in the morning.

After crying on and off yesterday and a little today at the dr's office, I've decided I'm going to follow my diet and try to get some exercise but if my levels are still high it's not my fault. It's just the way my body is working and resisting the insulin that I'm producing. If I need meds than so be it; I will deal.

My second one (8 yrs) offered to get tonight's dessert and went around asking everyone, including hubby, if they wanted ice cream. But she didn't ask me. Instead she said "I love you, Mommy!" It was so cute! She knew I couldn't have any of their ice cream but didn't want to ignore me. She just came by and asked if I wanted some of my special ice cream (low carb, sweetened with splenda). I have to wait until after I test, but her gesture was so sweet!

My Dr. called Wed. night with my blood test results (I wanted to know if the tiredness I was experiencing was due to high sugar or low iron). Of course he called while I was out of the house. Because of the new privacy laws, all he could say to my hubby was that the results were normal and offered to mail the report, which was fine with me because I wanted a copy anyway.

My A1C (long term glucose test) = 6.2 (normal for my condition - GD) My HGB (iron level) = 11.3 (little low), but considering my previous HGB was 10.9 so my anemia has improved. I'm still working on my daily glucose levels though, especially fasting and after breakfast. Just thought I'd update you. Now I need to update my dietitian since I had talked to her this morning before I got my results.

8/14/2004 (replying to offers of emotional support)
Thanks! It is kind of a pain to have to think before I eat. Not just what but also when. For example, I can't have a mid-morning snack until after I've done my breakfast test two hours after I eat. Overall it's not too bad though. I've seen women with a lot worse. Poking my finger four times a day and taking two iron pills per day is nothing compared to one some mamas go through. Some women aren't even able to have children and this is my 5th. I consider myself blessed!

Well I'm actually about 32 wks 5 days, but we’ll just say 33 wks. I'm making my rounds with the other doctors in the practice. I saw another doctor today. In the last two weeks, I've lost 4 lbs (Edited to add: I started my pregnancy a little overweight. My doctor was ok with me losing weight as long as baby and I were healthy.) and now I'm measuring 35 cm (only 2 cm ahead, was 5 cm ahead for last few appts). Dr. wants to watch my glucose levels but said no call for insulin at this level (fasting average 108, two hrs. after meals in the low to mid 120s). WHEW! He is going to consult with my primary doctor to make sure he feels the same. I'll be going every week now. Start weekly non-stress tests in three weeks (36 wks).

Looking back brings up memories of a mom who was more confident though still scared.  I'm still developing that confidence.  Am I still scared?  You bet!  However, unlike that first time mom-to-be of 20 years ago,  I know that education and support of others is so important.  I don't have to do this on my own, and for that I am thankful.

1 comment:

  1. Really you gone through the amazing experience and the way you handle it shows the real character of you.

    Gestational diabetes