Gestational Diabetes Concerns

Updated on October 16, 2008
K.M. asks from Langhorne, PA
23 answers

I am 32 weeks and have just found out that I have gestational diabetes and now I am very concerned and nervous about the health of my baby and my deliver options. If at all possible I would prefer to avoid having a c section. I am just wondering if there is any advice on how to cope with gestational diabetes or any other mothers who have also been through this.

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C.H.

answers from Allentown on

1st of all calm down and relax. It is not uncommon thing at all and yes can have a vaginal delivery.

Watch what you eat and follow doctors orders.

As for if you need a c section that is a possibility whether or not you have GD and what is going on at time of delivery.

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T.A.

answers from Philadelphia on

Hi K. I had gestational diabetes as well. I followed my diet and monitor my sugars closely. My son was 7 12. I did have a c section but that was for other reasons not for his size..It is tough to tell a pregnant woman no ice cream.. LOL I did find things sugar free and things like that, they would help me with any cravings... See if you can see a nutritionist. They set me up with one and that helped too. Good luck... Take care T.

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D.W.

answers from Philadelphia on

first of all why did the doctor not have you do a test for the gestational diabetes before this? I took the test for it when i was around 24 weeks along.I went to the dietician by recommendation of the doctor and did what they told me to do. you need to watch your blood sugars and in turn watch what you eat. i did not have to take any type of insulin or medicine and my son was 7lbs and 5 ounces when he was born and i had him the good old fashion way.You need to watch what you eat. I am sure they will have you do non stress tests,once a week to make the sure the baby is okay. that is what they did with me. i had to take my blood sugars 4 times a day. I had to chart them and show them to the perineonatalogist. was the baby coming up as being really big? i am just suprised it took them this long to find out you had gestational diabetes. watch the carbs you eat and make sure that you exercise. drink lots of water. talk to the doctor with any of these concerns or let me know if you have any additional questions since i have been through this.

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A.F.

answers from Philadelphia on

Hi K.,
I too had GD and was worried about delivery. I had to have a c-section, but that was because my son was "sunny-side up" and just couldn't get past my pelvic bone.

Some advice...call the American Diabetes Association and find out if they have any classes in your area. Your OB may know too. I took a couple of classes on how to balance what I ate (insurance covered it) and I only gained 25 pounds and my baby was 6 pounds, 6 ounces. You have to be diligent in your eating...not too many sweets or carbs AND ALWAYS balance your meal with protein.

If you are diligent and the sugar levels are still out of whack, INSIST on insulin. A friend said that the only way she could manage her GD was with insulin. She had a healthy baby at 7 pounds.

Please email if you need snack ideas or have any questions. I've scanned some of my GD info for friends that I can email you.

Best,
A.

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A.S.

answers from Philadelphia on

I had GD with my first child- I stuck to the diet they gave me to the letter and ended up with a 6lb 13 oz baby and a natural birth! I also lost a ton of weight and came home from the hospital weighing less than I did when I got pregnant- definitely the one plus. I also felt much, much better once I went all the way off sugar and followed the diet. I didn't want to have to do any insulin or anything.
Good luck!
You can do it!

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H.F.

answers from Pittsburgh on

First of all relax. Gestational diabetes does have risks and concerns but most of those occur when your sugar is not controlled during your pregnancy. You know about it now, so now you monitor your sugar levels (with a glucometer). You, also, follow a stricter diet that keeps your sugar fluctuations more controlled. If necessary, your doctor will put you on insulin but that is if you cannot control the sugars through diet.

I won't lie to you, it is a bit extra work. Also, as I mentioned there are a few higher risks. They probably won't let you go past your due date. This may mean that they will induce labor. Inducing labor, does NOT mean a c-section. However, please don't let a c-section frighten you. I've met many women who were induced and successfully delivered vaginally. A c-section will be a last resort if you don't want it. The reasons for a c-section would be either you or the baby are in danger, you are not progressing in labor (after several hours of labor -- usually they will let you try very long with this one), or the baby is in a breech position.

I had gestational diabetes with all three of my children. Like I said, it is a little more work monitoring your blood sugars and meals, but things went very well throughout my pregnancies. They, also, did more sonograms to monitor the growth of each baby better. (One of the risks with uncontrolled diabetes in pregnancy is that they baby can grow very large. At the same time, since the energy is put into growing larger, the internal organs, like the lungs, do not develop as quickly. Keeping your sugars controlled prevents this.) Unfortunately, I have to say that I had a c-section with all three. But please don't take this as the norm. My first child was a failure to progress baby. Her head never engaged. My doctor thinks that the opening in my uterus (those bones down there whatever you want to call it) may be on the small side. With my second child, we tried a vbac but he was an emergency c-section for something having nothing to do with diabetes (he tied the cord in a not and then wrapped it around his neck and then around his body so when my water broke his weight was cutting off the supply of oxygen and nutrients coming from the cord.) After two other c-sections and still not knowing if the head would fit through, we planned a c-section for the third. So while you plan on a natural birth, having had three sections, I urge you not to worry or be concerned about one yourself. Also, do not be afraid to ask your doctor any and every question you have. It is part of his job to answer your questions and ease your anxiety.

Good luck and feel free to email me if you have any questions or need any support as you get yourself into a new schedule of eating and monitoring your blood sugars.

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M.N.

answers from Philadelphia on

I am so sorry you have GD! I had it with my first and followed the diet and he was perfectly fine. He was born vaginally a day after his due date and was just over 8 lbs. Just make sure to work in lots of proteins and veggies and follow the diet they give you. It took a little getting used to, but it actually becae second nature for me and it went away as soon as my baby was born. He was perfectly healthy with no signs of problems. Good luck!

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S.S.

answers from Scranton on

Hi K.. I had GD, also, and I understand how stressed out you are. There is a lot of scary things that "can" happen if you do not take care of yourself. Your doctor should set you up with a dietician, that is the most important thing. You must learn how to eat properly and test yourself regularly. If yoiur insurance does not cover this, go to the American Diabetes website and get yourself a full education. You can also get diabetic testing supplies free. If not through your insurance, then contact the American Diabetes Assoc or the manufacturers of testing kits. Next, your doctor should monitor your baby's activity. This may mean only taking certain times out of your day yourself to "count kicks" or can mean going for regular tests. I went for non-stress tests (to track baby's movement) 3 times per week. This was a total pain, but it reassured me every time that things were going well. (it was also a nice opportunity for some me-time. I was able to relax and read books) You may also need an extra ultrasound to measure the baby's development. You can control the effects your GD has on your baby through proper diet and exercise, and monitoring, but you must educate yourself by asking questions and getting instructions from your doctor. The danger during birth occurs when the baby's body grows disproportionately to the head which could (but not always) cause them to get stuck in the birth canal. That sounds scary, but as I said with proper monitoring, your doctors will know what to do. You will not need a C section if your baby is developing normally, but your doctor will be concerned about delivering on or before your due date to prevent further complications so they may recommend an induction. Upon delivery, they will test your baby for hypoglycemia, which is very common and often cured with the first feeding. Follow the diabetic diet, exercise safely as often as your doctor recommends, and everything will be just fine. Stay calm, be glad you KNOW about it, you're a step ahead of the game because now you can do something about it. Hugs to you!

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D.P.

answers from Pittsburgh on

I didn't have it, but my boss had it with both of her children and she delivered both naturally. I would suggest that you follow your OB's recommendations for diet closely. Meet with your hospital's nutritionist -- often free or covered by your insurance. Good luck!

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F.H.

answers from Sharon on

I followed my diet super strictly and it worked. I also was refered to a nutritionist who taught me how to measure everything correctly and how many grams of carbohydrates to have at each meal and snack. I delivered normally and the baby was fine. (I also lost weight during my preganncy becuase of the diet and was 20lbs lighter than my prepregnancy weight a few weeks after the baby - it pays to stick to it!)

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A.M.

answers from Scranton on

I had GD with both of my pregnancies and now have two very healthy daughters. One was 8lbs. 2oz. at birth, the other was 7lbs. 3 oz. I did control with diet, but with the first, I had to go on insulin for the last 3 weeks of my pregnancy. With the second, I was on a pill to control my sugars once I was out of my first trimester, and stayed on that until I was around 7 months, and then I was switched to insulin. I had to test my blood sugar levels 4 times a day and worked with an excellent endocrinologist who made sure my levels stayed reasonable.

I will say that I did have a c-section both times. The first, I was induced and labored for several hours with no real progress, and baby's heart rate was decelerating enough that they felt they needed to do the c/s (and by then, I wanted her OUT and didn't care how it happened). The second time we scheduled the c/s and I was really ok with that.

The thing with GD-a lot of docs will not let you go past your due date because they want to make sure the baby doesn't get too big (which is a worry with GD). I had my first DD 4 days before her due date...and the second came 6 days before her due date. My BFF had GD and had a c-section on her due date...they were going to induce but her baby was measuring very large despite the insulin she was taking, so they opted for surgery and it ended up being a good thing, he was well over 9 pounds and she is a TINY woman!

It's hard because c/s is very common when you have GD, but it is POSSIBLE to deliver on your own...but you need to prepare for the fact that it might not go your way. The end result you are hoping for is a healthy baby, and how the baby arrives does not really matter at the end of it.

You can email me at [email protected]____.com if you want more info...I can tell you which endocrinologists I have worked with (I saw two different ones and both were wonderful) and some other tips if you want. I also saw a nutritionist the first time around and that helped a LOT.

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S.V.

answers from Philadelphia on

Hi K.,

It seems that you have some good, sound advice on controlling your GD. I only wanted to add that I suggest you not worry about having a c-section. Take that worry off of your plate. Make it known to your OB that you want to avoide a c-section; however, if the time comes and you need to have a c-section, there is not much you can do about it.

If it helps you at all, I had a c-section with my first and a vaginal (VBAC) with my second. I would take the c-section any day over the vaginal delivery.

Take care of yourself, and good luck.

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B.B.

answers from Philadelphia on

Hello. I actually had diabetes before I got pregnant. The doctor told me I need to make sure my sugars are well controlled to make sure the baby doesn't get too big. They have said that I wil be able to deliver vaginally unless she gets too big. You just have to eat healthy and exercise and be sure to take your medication. Don't worry, it will all be fine.

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T.W.

answers from Philadelphia on

Hi K.,

I had gestational diabetes with my son and was able to control my blood sugar by watching my diet closely and testing my blood sugar three times a day as recommended. The testing helped me get a handle on the kinds of foods and amounts that would keep my blood sugar within normal limits. I had good nutritional counseling and instruction on how to test my sugar after the diagnosis and adhered very strictly to the diet they recommended. If you're able to, exercise will help keep your sugar stable as well.

I did ultimately have to have a C-section, but it didn't seem to have anything to do with the diabetes. My son was a good weight, 7lbs-4oz, and his shoulders were not large, etc... His blood sugar was also normal after birth and the gestational diabetes cleared up within a few weeks of the delivery.

That would be my advice, to get some nutritional counseling, get a meter and learn how to test your blood sugar (insurance should pay for the counseling, meter and supplies) and do some gentle exercise if possible. I know it's easy to say, but try not to worry too much and enjoy the last trimester of your pregnancy. All the best for a smooth delivery and healthy baby. I'll keep you in my thoughts and prayers.

Best,
T. W.

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D.M.

answers from Philadelphia on

K., you have gotten a lot of really good advice about diet and exercise so I'm not going to comment on that any further.

The only thing that I want to add is that if you plan on breastfeeding your baby make it perfectly clear in the delivery room that you want to nurse your baby first - no matter what. Once the baby is born the nurses will test his/her blood sugar and may need to administer glucose (sugar) water. If you plan on nursing, demand that you nurse first before the baby is given anything. Your colostrum will most likely have everything the baby needs to stabilize his/her sugar without needing glucose water. Best of luck.

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M.B.

answers from Philadelphia on

Gestational diabetes can be a pain to deal with, but if you follow your doctor's advice, you and your baby should be fine. I had GD with my 3rd (not the others), and she was actually my smallest baby at 7lbs. 7 oz. and was perfectly healthy. I had a c-section, but not because of the GD (I'd had 2 previous sections). Your OB should send you to a nutritionist, and they should be able to set you up with a diet/plan and will also likely give you a glucometer to test your blood sugar. I had to test mine 4 times a day and fax them to the doc weekly. The most important things were eating every few hours, combining your starches with proteins, and trying to eat more complex starches instead of simple sugars. You can still have the occasional bit of ice cream, etc. as long as you keep the portions small and fit them into your plan.

As others have mentioned, you will also likely have a couple more ultrasounds along the way to insure the baby is not getting too big and that the placenta is still healthy. I was actually sent to a high risk OB to follow this, so don't get nervous if this is recommended to you. And while the extra ultrasounds and check ups are a good idea, remember that even with the ultrasounds they can only estimate the baby's weight and are often off a fair amount. They expected my baby to be close to 9 pounds (she was 7-7).

Just try to relax and follow your doc's advice. Good luck!

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L.W.

answers from Philadelphia on

Hi! Sorry to hear about your GD. I had it with my first pregnancy. It was scary when I found out, but they immediately gave me a free glucometer and sent me to diabetic teaching to learn how to eat. I followed my diet quite closely and had to show my doctor all my glucose readings at each appointment. I did have more ultrasounds than the avg. person because they like to keep track of the baby's size. Also, with GD moms, toward the end the placenta can start to die off a little early and in that case they induce you early. I was induced at 39 weeks, did not have to take insulin while pregnant or during delivery. My daughter was very healthy and not big at all. She was 6 pounds 4 ounces. You and your baby will be fine. Just work closely with your doc and follow all health/diet restrictions. God bless. :)

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J.K.

answers from Harrisburg on

I had GD with my last 2 pregnancys :) They were both induced at 38 weeks and had vaginal births. The first of the 2 GD births had a birth weight of 6lbs. 13 oz, but I was on insulin (8 years ago). My 6 month old was 8lbs 9 oz, but I am remarried and he is a much taller and broader man then my ex.

The best advice that I can give you is to understand that this is NOT related to you, or anything that you did wrong. The baby makes a hormone (in GD moms) that blocks our own insulin from being used. We did not cheat, we didn't do something wrong! This is very important to understand. This is why the majority of us will have no further complications after delivery. In some cases (much more rare) the baby can cause your pancrease to stop making insulin and then you will be diabetic for life. Not to make you sweat, but its true but rare.

Follow your diet and check your sugar as recommended. Go to all your check ups. As you are farther along you *may* go for non-stress tests, they don't hrt and just take up some of your time. If your sugars are out of wack, call your doc :)

Another thing: Let everyone you know that you are spending time with know that you have GD. You want then to be aware of any side effects of your GD and can help monitor you if you might be having a low blood sugar.

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J.C.

answers from Lancaster on

Hi K., I had the same thing with my little girl. Everything turned out fine. I was induced a week before my due date and was able to contract fine without any pitocin, no epidural, nothing. Today we are both perfectly healthy. I understand your concern and why you are so scared because I felt it too, so it's ok for you to be concern but dont loose sleep :0)

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K.B.

answers from Philadelphia on

I had GD really bad. I was only considered high risk because I had GD. My midwife was even allowed to keep me as a ptient. I went for weekly non-stress tests and I had about 4 u/s. First they had me do exercise and diet directed by the hospital's nutritionist. That wasn't working my numbers were still high. So they then gave me a free meter and strips and I was put on insulin. 5 days before my due date they decided to induce because my levels were increasing and clearly the insulin wasnt doing anything and plus the hospital I was delivering at doesn't allow women to go to 40 weeks or even past 40 weeks with GD. I delivered natural and during labor and delivery they checked my sugar levels throughout while I labored (only 4 hours). I didnt need an insulin drip thank god!!! and my daughter came out a health size of 7lbs 8.4oz and apgars were 9's. They tested her sugars and before she was released they checked them again. Then at her pediatrician's office I had them run bloodwork for diabetes and she was negative.

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A.P.

answers from Allentown on

I can imagine how stressed out you must be!
First of all, GD is VERY highly mis-diagnosed. The standard tests are notorious for false-positives.

Have you ever looked on www.ChildbirthConnection.org ? It is an ALL-EVIDENCE-BASED site, which has a lot of info from some really wonderful books & studies. Many midwives and even some of the (few) "good" OB's use this site regularly.

The most important thing is for you to take really good care of yourself and for you to educate yourself.

I strongly suggest reading "The Thinking Woman's Guide to a Better Birth" by Henci Goer IMMEDIATELY. It is a wonderful, evidence-based book!

Good luck!!!!!!!!!!!!!!!!!!!

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J.B.

answers from Philadelphia on

K.,

I had that with my son and everything was fine. I'm sure they will send you in for an ultrasound (pictures yeah) to make sure everything is fine. I had a natural birth with no complications. Watch what you eat- I now have diabetes so it's just not about sugars but more carbs.

Jen

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K.B.

answers from Harrisburg on

Your doctors office can give you lots of info on the best way to care for you and your baby, since every situation and pregnancy is different. Let them know that you're very concerned and they give you everything you need to know like diet, exercise, etc. Good luck!

K. B
mom to 5 including triplets

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