[jasminscent]

Hi, this is my first time posting. Just wanted to introduce myself first.
I was diagnosed with gestational diabetes early since diabetes is in my family. I am now 30 weeks along, and want to ask those of you with more experience with diabetes.
The last time I visited my endo, he seemed to be somewhat concerned that about 1 out of every 5 fasting blood sugar level is over 90 but under 95 with an average of about 85. My 2 hour postprandials are pretty much all below 120 with an average of barely 100. I am not on any meds/insulin, but he asked me how I felt about taking a shot of NPH before bedtime. I said no because I thought he was being way too strict with the guidelines. He then suggested eating a little snack before bedtime... What are your experiences out there? Is this really too high?

 

[Shanny]

Hello & welcome, jasminscent! Your numbers look good to me, but what do I know? It's only been 43 years since I had a baby! And I don't use insulin yet either, so I'm pretty useless. Stay tuned - there are others here who may know better than I!

Thank you for joining us!

 

[breezeonby]

Hi, this is my first time posting. Just wanted to introduce myself first.
I was diagnosed with gestational diabetes early since diabetes is in my family. I am now 30 weeks along, and want to ask those of you with more experience with diabetes.
The last time I visited my endo, he seemed to be somewhat concerned that about 1 out of every 5 fasting blood sugar level is over 90 but under 95 with an average of about 85. My 2 hour postprandials are pretty much all below 120 with an average of barely 100. I am not on any meds/insulin, but he asked me how I felt about taking a shot of NPH before bedtime. I said no because I thought he was being way too strict with the guidelines. He then suggested eating a little snack before bedtime... What are your experiences out there? Is this really too high?

Hello and welcome to the forum! I have never been pregnant, so my knowledge of gestational diabetes is 0. In my opinion, your numbers look good. Maybe you need a second opinion. Adding NPH at bedtime will help your fasting numbers, but you will also be at risk for going low while you sleep. I would think that Lantus would be a better choice. It has no peak and would probably help your other numbers of the day. I hope that you have time to visit often. Take care of you and the baby! Good luck!

 

[wdmama]

Hi and welcome! I'm 31 weeks pg...

Your numbers look great!

I am on glyburide and I still get a number in the 90s maybe once every 7-10 days, but my OB is not concerned b/c the majority of them are well under. So, I would agree that if your numbers are already under 95, then I would not do medication or insulin either. This is my third diabetic pregnancy and they have gotten stricter over the years...with my first under 95 was fine and under 140 for 2 hour number, now they want under 90 for fasting, and under 120 at 2 hours... I know some women who have been told to keep it under 120 at 1 hour!

If it's only one in five of your numbers being over 90, I do not think this is too high at all.

You can try a bedtime snack. I've had the best luck with 2 carbs / 1 protein combo, and eating it 8-9 hours before I wake and test. If I eat earlier or sleep in my number is higher. Choose whole grains and higher fiber carbs.

You are going to get a higher number occasionally, and it's OK. One high number here and there is not going to hurt the baby. As long as the majority of your numbers are under control, try not to stress about the occasional higher number.

 

[foxl]

Yes your numbers look great to me, too, but in pregnancy, concern for the baby and macrosomia are utmost. I would do as your doc suggests -- Gestational Diabetes is a whole different cat.

 

[jasminscent]

Thanks for all the answers! Here's the other thing I was thinking. What would be the benefit of taking insulin in my case? My baby has been measuring between 50-53 percentile for GA, and I'm actually worried about gaining too little weight. I've gained only 10 lbs. and I started out with a BMI of 22. By being on insulin just to try to get that 1/5 fasting number under 90, I may be at risk for hypoglycemia as someone else mentioned. I really don't see the benefit in my case. I will get an opinion from my ob and see what he says. Also, has anyone else noticed that these meters are not that precise? This am I got a FBS of 91, and I retested right away and I got 85...

 

[Shanny]

10-4 on the meters . . . . even using the same drop of blood doesn't get us identical readings. FDA sez that's okay though . . .

 

[foxl]

Whoa -- okay, given those parameters ... sit tight.

BTW, since you are petite, you might want to get GAD-65 antibodies. While you may indeed have insulin resistance, it would not hurt to rule out autoimmune diabetes. And yes, for some reason pregnancy can be a time when it is uncovered!

 

[Aslosman]

Ok,
I’m male, and type II so I don’t have any personal experience to draw on.

If you were the mother of my child I would be concerned and suggest two courses of action:
1 Talk with your OB about the affect your blood sugar levels might be having on the baby.
2 If you are not sure about the advice you are receiving, get a second opinion from another endo, it never hurts to have more information. Be sure you understand the full reasoning behind both opinions weather they agree or not.

The more information you have the stronger the foundation your decision will be based on. It’s your body, it’s your pregnancy, ultimately it is your decision make it based on the best information you can get.

 

[jasminscent]

Just wanted to give an update. I let my ob look at my numbers without saying anything, and he was very happy with them. No problems at all. Then I mentioned about my endo's suggestion. He says he's not concerned at all, and that some endo's tend to be very strict. He says some docs even use 95 as the cutoff for fasting and an occasional higher number doesn't warrant insulin use. Only when numbers consistently become higher than 90/95 does it warrant insulin.

The frustrating thing is that the meters aren't even precise so how do they make a decision to use insulin for sugars that are occasionally 90's but if retested it could be under 90?? For instance, I've retested my FBS two days in a row, and for some reason, my second reading is always lower.

one day, I had 91, then second read was 85
today, I got 87, then second read was 80

 

[wdmama]

That's one of the most frustrating things about it... every doctor has a different opinion. I know some pg women who were put on insulin after having just two fasting numbers over 90... others who are okay with the occasional higher number... Just recently a woman posted (on another board) that her doctor wants her 1 hour numbers under 110! I cannot imagine having to conform to that...I'd have to nix all the carbs or increase the glyburide and by two hours after I ate, I'd probably be crashing.

And the glucometers... don't get me started! LOL I have the same problem, I'll get a high number, retest and it's within range - so which is the right one? I could test three times each time and take the best two out of three, but I can't afford that many strips.

Anyway, I think your numbers look good, and I totally get the frustration!

 

[foxl]

Yes, we sure know about the meters ... I am hoping the inaccuracy keeps the COST down!

Keep testing though, and posting ... and good luck to you and the baby!

 

[jasminscent]

There are so many things that just don't make sense to me. Before I was diagnosed with GD, my A1c was 5.5, and I was drinking apple juice and eating ice cream EVERY day. Now that I've been diagnosed with it, I cut out apple juice and ice cream and also became more careful about what I eat. I admit I don't carb count but I was expecting my A1c to be lower but it's not. It was 5.6 this last time?

 

[jasminscent]

It's crazy but ever since my endo has mentioned about insulin, I've been getting stressed about taking my FBS, which I'm sure isn't helping with my numbers. Now in the past 3 days I've had 90, 91, and 98! Now after the oscars I went to sleep, only to find myself waking up at 1:30am feeling stressed... I feel crazy.

 

[lizzistardust]

Hi, this is my first time posting. Just wanted to introduce myself first.
I was diagnosed with gestational diabetes early since diabetes is in my family. I am now 30 weeks along, and want to ask those of you with more experience with diabetes.
The last time I visited my endo, he seemed to be somewhat concerned that about 1 out of every 5 fasting blood sugar level is over 90 but under 95 with an average of about 85. My 2 hour postprandials are pretty much all below 120 with an average of barely 100. I am not on any meds/insulin, but he asked me how I felt about taking a shot of NPH before bedtime. I said no because I thought he was being way too strict with the guidelines. He then suggested eating a little snack before bedtime... What are your experiences out there? Is this really too high?

I'm pregnant and have type 1 diabetes (so, automatically insulin dependent), and I'd LOVE to have your numbers!!!

The guidelines I have are under 100 fasting or before meals (preferably 80 to 95 when I wake up), and under 120 two hours after meals. I don't always hit the under-120 mark, but it doesn't seem to greatly concern my endo and my OB said she's comfortable with numbers up to 130, and wouldn't worry about the occasional 145, as long as it really is occasional.

With your numbers, adding insulin before bedtime would worry me! I'm not a medical professional, but I think you made a smart call in saying no. If your fasting number creeps above 100, OK, it's probably not a bad idea to start trying a small dose.

That snack before bed isn't going to do you tons of good in the face of NPH, either. NPH is intermediate-acting, so it will peak from about the 4 hour mark to the 12 hour mark. In other words, if you have your snack at the same time as your shot, your body's own insulin will take care of the food for you before the NPH starts to really lower your blood sugar.

When/if you start taking a shot before bedtime, you might want to wake up once or twice in the first night or two to test your blood sugar and make sure you're not starting to go low. Trust me when I say that waking up to very low blood sugar is no fun at all.

 

[lizzistardust]

It's crazy but ever since my endo has mentioned about insulin, I've been getting stressed about taking my FBS, which I'm sure isn't helping with my numbers. Now in the past 3 days I've had 90, 91, and 98! Now after the oscars I went to sleep, only to find myself waking up at 1:30am feeling stressed... I feel crazy.

I really understand. Diabetes is stressful, then add on top of that the extra concern of staying healthy for your baby. Jeez! Talk about pressure. You're not crazy!

 

[jasminscent]

I decided to cancel my upcoming endo appointment because I didn't want to go in with the recent 90-91-98 in one week, and wanted some time to destress. Guess what miraculously, my FBS have been all under 85 for the past 5 days! I am however, exercising a bit more now that the weather is getting warmer so that may have something to do with it as well. I still don't sleep through the night but it's nice not to worry about FBS when waking up. Thanks for all your input!

 

[Eve]

I think your numbers are real good!

I had Gestational Diabetes and my ob-gyn sent me to the Joslin Diabetes Clinic in combination with her care, I faxed over my readings every week. I remember they were never as low as yours, especially fasting. I was able to control it by diet and kept my readings under 140 after eating and under 120 after fasting. My daughter was born weighing 7.1 pounds, healthy and happy. That was 9 years ago though and I am sure the BG guidelines are different.

I'm sorry to see that you are stressing out with the numbers. Maybe discuss your readings and concerns about the Endo with your Ob-gyn. I think its good you are questioning it, I would too.