I have another gd question

[Debra_Maine]

Okay ladies, I need help. I cannot figure out how to keep my fasting level within the normal range. On a given day, I will have a bedtime snack of 3 whole grain crackers with peanut butter and wake up with a level of 90. The next day, same bedtime snack and I wake up with 108. What gives? I am at a loss as to what to do. Any advice? Thanks.

[shubunkin]

It is strange how our bodies work. I do not understand it either.I have found the more I eat at night for a snack ( I make sure I eat my FULL allowance of carbs) plus the protein with it the lower it seems to be. Do you like boiled eggs? I think you said you do not like cold cheese. I live off of cheese sticks. I eat one after each snack. But I do the eggs from time to time. Have you tries eating fruit as your carb at night? Sometimes that settles better with me. It is just a guessing game. You will figure it out. I know a few women who have had problems with their fastings and they take insulin only at bedtime to keep them down. But I think you have to have  quite a few of those to be considered for it. Depends on the doc I guess. Good luck! Danielle

[cinnamonheart]

Some things react differently  If i ate peanut butter it through me over even a smidge!
In Canada our numbers are different after fasting we need to be under 5.3 in the morning

I had as a pm snack ice cream (now i was measuring ketones) so she told me to take it to keep them down
It was ice cream that had guar gum in it they said it was okay!
My numbers were fine in morning.

maybe try a fruit- something natural seems to absorb the sugars easier I found
Yes its a game of trial and error

[Debra_Maine]

Okay,maybe I'll try fruit tonight. The woman at the diabetes center told me I may need to take insulin pills only at night. We'll see. I just had no idea how confusing this would be. I thought if I do what they tell me, I'll be fine. Nope. Fluctuations. Very frustrating! Thanks you guys.

[Debra_Maine]

Okay, the diabetes center had me in tears. The nurse practicioner there said that from looking at my fasting numbers, I am clearly creeping my way up above normal which tells her that my hormones are causing the problem. She suggested I go on insulin injections at night only. They told me to call my doc and talk to him. I did and he was very upset with them. He said that the OB standard for gd is under 100 fasting and under 120 all other meals and that looking at my numbers, although there were a couple over 100, they looked good to him. He also said the monitor has a fudge factor that the lab testing doesn't and that's why he only goes by the lab. I'm having lab work done on Friday and those are the numbers he will go by. Given my fluctuating numbers, they could very well be low or high that day. He had me give him the number of the center because he wanted to talk to the NP to let her know that she shouldn't be telling me these things, she should be telling me to call him. I begged him not to get me in trouble there, I have to go back in 3 weeks. He promised he'd be nice, but wanted them to know where he is coming from. So, I guess I should go by what my doc says. What do you guys think?

[cinnamonheart]

First off dont cry!
Its not as bad as it seems its frustrating yes,
Exercise will help bring them down too, Is it just the morning one?When do you test it?
Well I know from one post we all didnt seem to think the doctor was too concerned, I think I would stick with the diabetic clinic, It wont do you any harm watching what you eat anyways until your pregnancy is through And of course you dont want anything to happen to your babe. I always figure error on the side of caution.
It took me about 2 weeks to get things straightened around to know what to eat, how much,
My SIL had to do the injections  maybe you will to but it is all for a good cause!! And a good thing is you know its not forever Once you have your baby Make sure your hubby drives you right to Mc Donalds on the way home--I did!

[shubunkin]

I know it is upseting but try not to get too worked up. My doc has my fasting #'s set at 95 or below. I would listen to my doc but I agree with cinnamon that I would lean more towards the diabetic clinic. Just from what you have told us he does not seem to be too educated in the diabetic feild and I am sure he is trying but I would be cautious. My doctor had said if my fastings were over 95 more than a few times she would consider insulin. That is also what I have read in the books. It seems to me your doctor should not be getting so upset about this. You would think he would want you on top of it for you and the babies sake. I certainly think he should not call the clinic upset with them after all, that is their profession. Please do not think I am downing your doc because by all means I am not but sometimes it is best to go with gut instinct. Danielle

[Christie2004]

Deb
I'm sorry you are going through this.

I believe you should take a happy medium away from this, and combine what both are telling you.

I would still probably test, but as long as you are near the ballpark, you should't worry about it so much.  The difference between 100 and 108 is negligible--really.  You could probably test twice within 10 minutes and get 2 different numbers anyway.  Don't let this make you crazy--perhaps this is exactly why your doctor didn't want you to test.  Pregnancy should be a happy, joyous time, and worrying about whether to have fruit or peanut butter crackers or both at night when you are just a hair above normal is not conducive to being happy--its conducive to making you obsessive!

If your numbers were consistently creeping upwards- one morning 110, the next 118, the next 124,--coupled with consistently out of range 2 hr numbers--then yes, at some point they would consider insulin.  But a couple of fastings slightly above 100?  Not worrisome at all.  

The reason for encouraging glucose control is probably more for women who are  more overtly gestationally diabetic.  To make you comply with a rigid diet when you were only slightly over the arbitrary "cut off" and test and worry about numbers only a few points above normal will not likely contribute to any better outcome than if you simply decreased your simple sugar and empty starch intake.  

So try to do both--test, but simply write down the numbers and bring them with you to the office to show your doctor.  If they get to where they are consistently rising bring it to his attention.  The key word is consistently.  Don't get involved in fine tuning something that really doesn't have to be fine tuned so closely.  Stick with the diet 80% of the time and you will likely be fine.  

I'm sorry you are having to go through so much turmoil right now.  Be happy!  Pregnancy should be a wonderful time, not full of worry about every bite you eat.  You are to be commended for diving in to this so deeply, but don't let it make you crazy.

[Debra_Maine]

Once again, your words are so helpful. I think that is exactly what I needed to hear. Not to disregard the opinions of the others, they are extremely helpful to me too. You are right, this is why he didn't want me to test, I'm sure, because I am worrying about it and he didn't want that. It helps me that you put the numbers in prospective as an educated third party. I will continue to do what I am doing diet wise as I feel I am doing what I should. I will check for my own knowledge, but trust the doc with what he finds with the blood tests and follow his advice. I so do not want to have to take insulin if I don't need it. And I do want to enjoy these last 9 weeks. I feel so fortunate to not have all the aches and pains and problems sleeping that most of the other women on this forum seem to be having. I guess I just thought that no one gets off scott free and this was my thing to have to deal with. I'll try to be a little more open about the situation and not lock into one fear. Thanks again, you are an angel to us on this forum.
Debra :o)

[Christie2004]

And I agree w/your doctor that the diabetes center really shouldn't be telling you things like that.  Remember--they usually deal with the more problematic diabetics where tight control is more ideal.

Consistency is the key.  If your numbers are CONSISTENTLY out of range there could be a case made for insulin.  A few slightly out of range numbers don't mean very much.  

I don't mean to come off harpy and preachy.  If you could see what other ladies do on "gestational diabetic diets" you would faint.  You are a paragon of compliance in my book!

[shubunkin]

I do agree with Christie. A few higher than normal fasting to me is of not much concern. Like she said if they were consistantly going up each day that would be one thing. And with the #'s you had been telling me they sound great to me. Not anything that would warrant her telling you that yours cannot be controlled by diet. Like I said, go with your gut instinct. You sound like you trust your doc so go with it. If I come across as sounding like I was telling you not to I am sorry, I did not mean too. I know what you mean about the not wanting to take the insulin thing. Me either. As a matter of fact I had already told myself that if I go a few points over 95 a few times I was not going to tell her. Because to me that does not warrant insulin and that is just my gut feeling so I am going with it. Just like last night I ate a meal that I had not tried since being diagnosed and at 1 hour my sugar was 145. Suppose to be under 140. O well. I am not going to fret over those 5 points and the machines do have a certian percent of error. I so worried about everything in the beginning but now I just go with the flow(or try to)! My readings vary from day to day. From the amount of activity I do to whether I am stressed out. And yes, I have read stress affects your blood sugar. So just try to relax, it gets easier with time and you do not worry as much. Hugs :) Danielle

[cinnamonheart]

Maybe the only thing throwing them up is your emotional upset. You can ask the NP if this could do it.
Maybe your diet is great!! I can remember waiting for the monitor to see the results and getting upset if you stuck to the diet and it didnt work.
Its not worth worrying over
Is this your first pregnancy? if not did you have it with the others?
Due to my age, weight,  with this last baby- i did  not have it  with the first two. But since it is in my family I am more prone to get it  later on in life.

[Debra_Maine]

I can't tell you how much I appreciate all of your words. I feel so much better now. With this being my first baby, I just want to do everything right and I'm an anal retentive control freak, I admit it, so when things don't go as they should, I get upset. I need to work on that :o) I don't know what I'd do without you guys! Hugs and Hugs!!!
Debra

[cinnamonheart]

Whether its a first second or third pregnancy, We all worry I think mostly because its out of our hands. Then when the little buggers come we still worry. Your little boy will be just fine
Relax Mommy!!

[Debra_Maine]

Thanks. I know, can you imagine me AFTER he's here!!!

[Debra_Maine]

I hear you both. I am torn. You would think that a doc who has been doing this for 25 years (and never having his patients checking their sugars) knows what he is doing. He clearly isn't putting his patients and their babies in jeopardy or he wouldn't be in business. On the flip side, he has shown in his words that he doesn't understand the concept of carbs and is doing things differently than all of your docs. But the bottom line is, he would be the one to prescribe the insulin and he will only do that based on the blood tests from the lab. So, if he deems the numbers good and the diabetic clinic deems them bad, my choice is to stay in his care or find a new doc. After 21 years with him and at 31 weeks pg, I don't want a new doc now. I'm going to continue to monitor myself, but the clinic made it sound like it's not even food manageable anymore. Do you guys still have elevated fasting numbers occasionally, or did your diet straighten those numbers out permanently?

[cinnamonheart]

I was able to control mine by diet alone
but if you cant - that's okay
You have to do whats best for you and baby
Stressing can also cause numbers to fluctate(so I was told) I had a crying night and mine were up
Keep on trying  things will work out
I found raw green beans great to snack on and i think they dont count for anything~~

[Debra_Maine]

Thanks. I was told in the beginning that my numbers were so borderline that it was totally diet manageable. With today's events, I don't know what to think.