3-hour GD screening results. What now?

[Anonymous]

I did a 3-hour glucose screening after flagging barely positive on the 1 hour.

My numbers were:

Fasting:86 (normal, sub 94)
1 hr: 211 (high, over 180)
2hrs: 174 (high, over 155)
3hrs: 87 (normal, sub 140)

What does this mean for management? I spiked but cleared back to a low level relatively quickly. I obviously never drink anything resembling 100g of sugar on an empty stomach like this…Dr hasn’t called me yet. Help!

[Anonymous]

You’re going to be fine!!!

The next steps are to start monitoring your blood sugar levels and control your carbohydrate intake. That might be all you need.

If that isn’t enough, you may need to take insulin. It’s a lot scarier than it sounds. I cried and freaked out about the injections but within a week it was old hat. And worked perfectly. Healthy me, healthy baby. The thing to focus on with GD is that it’s very treatable. So that makes it a lot better to deal with than other pregnancy problems.

If you wait for the doctor to call you it could take a while before you get a prescription for the monitor and an appointment with the diabetes educator (who may be pretty useless if you already know how to read a nutrition label).

If you are a Take Action type person, do these three things:
1) get a blood sugar monitor. It’s a finger prick and strip you feed into a little doodad. Call your OB nurse line for a prescription or just buy one at CVS (<$50). Start checking your blood sugar when you wake up and an hour after meals and keep a log.
2) aim to be around 30g carbs for meals and 15g for snacks. Complex carbs are better than “fast” carbs. Pair everything with protein, fiber, and fat. You can read the Lily Nichols book for ideas without buying into her whole philosophy but you don’t need it if you have a working knowledge of nutrition. Some people swear by a bedtime snack, ymmv.
3) Keep a detailed food log. I used My Fitness Pal, which is clunky but has a lot of foods in the database. There’s probably something better by now. The point of the food log is so you can remember what spikes your blood sugar but mainly it’s to prove to the doctor that you have been controlling your diet. Otherwise they may waste time telling you how to read a food label.

If you do those things, when you do get to the doctor having your blood sugar log and your food diary will help move things along.

Good luck!!

[Anonymous]

PP has good advice, although I suspect she means insulin is NOT as scary as it sounds. With those numbers, I doubt you’d need insulin anyway.

[Anonymous]

First lesson of GD - it’s not sugar, it’s the carbs!

Second lesson of GD, anyone can get it. It’s not a moral failing.

[Anonymous]

OP here. Anyone have any tips on lowering fasting blood glucose levels?

My fasting levels at home are in the mid 90s, but my levels 1 hour after eating are only 100-110. (ie, my numbers all day are good other than the morning.) Is this insulin level Am fasting levels or what to do differently?

[Anonymous]

A protein heavy snack before bed can help with morning fasting numbers.

[Anonymous]

What kind of fasting levels require you to go on insulin? Is it like one number of 95 and you're toast, or is hovering in the mid-90s a problem?

[Anonymous]

This was me in August. I cried a lot. I felt very overwhelmed by having to change my diet. The first few weeks were tough, but eventually I found a handful of snacks/meals that worked and ate the same thing everyday. RxBar, nuts and cheese, applesauce and cheese, turkey sandwich, lower sugar yogurt, turkey pepperoni, etc. I didn’t have the energy working full time and feeding a picky husband and toddler. I also told my husband the first few weeks he either had to eat with my restrictions or make his own meals—I couldn’t manage both.

In retrospect it wasn’t nearly as devastating as I thought it would be. I also had plenty of treats to satisfy me. And towards the end I had really figured out that I could eat way more carbs than suggested and stay under my numbers.

[Anonymous]

OP some people have a lot of success with a bedtime snack for fasting numbers. I’ve heard cheese, yogurt, nuts etc. None of that worked and I ended up needing insulin at night. I didn’t need it for meals, though I was super careful about diet. It worked great. Sometimes it’s just your placenta’s problem and you can’t fix it on your own.

I highly recommend just putting some snacks and meals on repeat. Some of my favorites were Greek yogury and strawberries, nature valley protein bars, and sweetgreen salads. For breakdast I ate a piece of Ezekiel bread (in the freezer) and eggs or peanut butter 85% of the time and it just made things simple. I could always do more than 30g carbs in a sweetgreen salad without a spike, because they’re complex carbs paired with fiber etc.

[Anonymous]

Anonymous wrote:OP some people have a lot of success with a bedtime snack for fasting numbers. I’ve heard cheese, yogurt, nuts etc. None of that worked and I ended up needing insulin at night. I didn’t need it for meals, though I was super careful about diet. It worked great. Sometimes it’s just your placenta’s problem and you can’t fix it on your own.

I highly recommend just putting some snacks and meals on repeat. Some of my favorites were Greek yogury and strawberries, nature valley protein bars, and sweetgreen salads. For breakdast I ate a piece of Ezekiel bread (in the freezer) and eggs or peanut butter 85% of the time and it just made things simple. I could always do more than 30g carbs in a sweetgreen salad without a spike, because they’re complex carbs paired with fiber etc.

I like cheese as a snack or peanutbutter can be good, but start with cheese. With my third kid I had GD and when I ate cheese my blood sugar was too low in the am so I switched to peanubutter. Always something.

[Anonymous]

Anonymous wrote:What kind of fasting levels require you to go on insulin? Is it like one number of 95 and you're toast, or is hovering in the mid-90s a problem?

You should be speaking to someone about this. It should be below 94, ideally low 90s or lower. If you can’t get it under control they’ll do insulin.

[Anonymous]

My GD baby is six now, but I had to take metformin for my fasting levels. The rest was managed by diet but I couldn’t get my fasting number down. Is metformin not a thing anymore?

[Anonymous]

Anonymous wrote:

Anonymous wrote:What kind of fasting levels require you to go on insulin? Is it like one number of 95 and you're toast, or is hovering in the mid-90s a problem?

You should be speaking to someone about this. It should be below 94, ideally low 90s or lower. If you can’t get it under control they’ll do insulin.

My doctor said they want no more than 20% out of range. For me I was testing four times a day so I had like 5 times I could be over before they would suggest insulin.

My first week was great, second week not great so they gave me one more week and then I was fine. At one point I had a few high days (no more than 10 over) but they said it was still so close to the target that insulin would make my numbers too low.

I would say though if you fasting numbers are consistently high then they might do insulin just for then. I was told it’s the hardest number to control. I had no problem but a friend said hers was solved literally with a cheese stick before bed.

[Anonymous]

You have gotten fantastic advice! Just wanted to add that while my post-eating numbers were always fine, my fasting was sky high and a huge dose of insulin did not get it within range.

Nevertheless, my baby was born healthy (and medium sized). Slightly hypoglycemic but that may have been due to a long fasted labor, and they know exactly what to do about it.

It will be okay!

[Anonymous]

Those of you who had diet-controlled GD, what did your OB recommend re: induction? I'd really prefer not to if everything is looking okay.