Conference moira::parenting_v3

    Gestational Diabetes and regulaer diabetes are similar.  
    
    My mom has the regular kind and takes insulin 4 times a day to control
    it.  This is because she is very sick (kidney disease, arthritis, ect).
    so they had to watch me very closly for gestational diabetes and thank
    god I never got it.  A friend of mine has it and she is due with her
    third baby in September.  She controls her's by diet and is thankful
    that she doesn't have to give herself insulin shots everyday.  The only
    way that you can control it by diet is if it is only a mild case if it
    is to siver then you must take the insulin.
    
    
    Liz

    Gestational diabetes should go away immediatley after birth whether
    or not you must take insulin . I am no doctor, so always ask
    your OB, but the only reason I can imagine it not leaving would
    be if it was not truly gestational. If a person was becoming diabetic
    before pregnancy for example.  I had very mild G.D. with my first
    pregnancy and it was easily controled by diet. In fact my blood
    sugar was low enough at the end, and because I had lost 3 lbs over
    a weekend, they told me to eat whatever I wanted so the baby would
    gain weight. That was great....2 chocolate donuts every morning!!
    
    Always ask your doctor about theses things. 
    
    Good luck.
    
    Dot
                   
    

    My wife was gestationally diabetic with our third child (and was told
    that if we have another, chances are excellent she will get it again),
    and did need insulin. It was initially controlled with diet alone, but
    at about 34-35 weeks, she went on insulin. Not sure of the type, other
    than it was called Humulin, and it was the long-range type...in other
    words it took effect approx. 12 hours after the injection. She took it
    at nite, before bed, so that max. coverage would be in the morning,
    when a gestational diabetics sugar is highest (exact opposite of
    "regular" diabetic, who has highest sugar in the evening). The doctor
    had her use the insulin the night she delivered (baby born at 3 p.m.,
    and used it that night), but that was it. They did keep her on a
    "diabetic diet" while in the hospital (3 days), but her blood sugar was
    just fine, and she ate anything she wanted at home,a nd there was no
    blood sugar problem. It truly does go away right after delivery. 
    According to her, the worst part of the whole thing, was not the diet
    or the insulin injections (they really don't hurt, and you get used to
    it), but the bi-weekly non-stress tests and the weekly ultrasound and
    doctor's visit. She said it felt like her whole life revolved around
    appointments and finding someone to watch the other two kids! 
    When controlled properly and carefully, gestational diabeties is one of
    the least threatening complications of pregnancy...in other words, not
    life-threatening (except in very rare cases) to mother or child. Just
    inconvenient. But it is extremely important that it be managed
    propeerly or it can lead to stillbirth. Her endocrinologist also told
    her there is about a 60% chance she will develop "regular" diabetes as
    she ages, especially since her mom got it at about age 55.
    Wishing you a safe delivery and healthy baby!
    
    --dave--

Just to clear up a possible misconception that one could read into the base
note ...

There is no cure for Diabetes.  Gestational diabetes occurs due to hormonal
changes, and when the hormones return to normal, the diabetes goes away
because the pancreas resumes normal insulin production.

Insulin only replaces the naturally produced insulin made by the pancreas.
Nothing exists to yet "fix a broken pancreas" as it were.  Insulin only
keeps you alive, it is NOT a cure like a lot of people think it is.

Diabetes, even with synthetic insulin, has many complications, such as
reduced blood flow to the peripheral limbs, resulting in gangrene and
hence amputation.  Because of the regular injections, it is easy to develop
infections due to inadequate hygiene.

Sadly, diabetes is still a killer ... and research continues.

Stuart

    	Just to clear things up a little more, the circulation/amputation 
    are LONG term effects of diabetes.  There are many good things being 
    researched these days and god willing there will be a cure for diabetes
    in my son's life time. 

    Okay.  I need to know...
    
    My oldest sister [the 1st child of 5] has had diabetes since age 4.  I
    guess you'd say her diabetis is chronic-- the type you talked about in
    the last two notes.  It's affected her heart, vision, etc., and she
    just lost part of her foot (last month) due to infection.
    
    My mother developed diabetes w/in the last two years or so.  It's also
    in the family elsewhere on my mother's side [2nd or 3rd generation
    cousins?].
    
    Can somebody tell me what they know about the hereditary aspects of
    diabetes?   Would I tend to be more prone to gestational diabetes if it
    is in the family?  
    
    Questions, questions, questions!
    
    Thnx!
    marcia

    re .6
    Marcia,
    
    Check out HYDRA::MEDICAL. I know there are a couple of notes on
    this subject. Also, if you entered a note there are some quite
    knowledgable people who contribute to that conference who would answer
    right away I think.                                  
    
    Dot

    Marcia, 
    	I will get out all the books we have received on diabetes and 
    get some facts for you.  Just off the top of my head, there is a 
    big difference with gestational,Type I and Type II diabetes.  I 
    can't remember exact details but will look them up. 
    
    Malinda

    Thanks for the replies. One thing though , GP's and
    Pediatrician's tend not to paint over optimistic views when
    discussining "will it or not" situations. From our experience
    with our first boy, he was a big baby and had nerve damage on his
    shoulder from the birth ( erbspalsy sp? ). The Pedtr. siad the chances
    are he would never move his arm. Thankfull almost 3 years later he's
    got about 70% movement ( physio & excercise being the only answer
    )          
    
    Is it true that babies from diabetics suffer withdrawl symptoms
    from the high levels of sugar and tend to cry a lot afterwards.???
    
    A couple of weeks to go and counting.
    
    --John 
    
    
    

re: .9
    
    >    Is it true that babies from diabetics suffer withdrawl symptoms
    >    from the high levels of sugar and tend to cry a lot afterwards.???
    
    No.
    
    --bonnie    

    re: .9 and .10
    Well....a blanket "no" is not quite accurate. They can suffer from
    Hypoglycemia, in the few days following birth. What this is, in
    layman's terms, is low blood sugar. You see, the baby has been making
    perfectly adequate insulin in its own pancreas all along, and mom has
    been supplying large quantities of sugar for the baby to metabolize
    with its own insulin. Then, after birth, the extreme quantities of
    sugar the baby has been getting via mom, are abruptly decreased.
    However, the baby's pancreas takes some time to adjust to the new sugar
    levels, and may therefore still make pre-birth quantities of insulin
    for a day or two...this leads to the hypoglycemia, or decreased blood
    sugar, as the over-abundant insulin metabolizes the now-normal
    quantities of sugar. It can cause an irritable baby. The "cure" for the
    baby is, basically, sugar water, either in a bottle or IV, if the
    hypoglycemia is severe. This can then be tapered gradually, giving
    baby's pancreas time to adjust. This reaction does not always happen, 
    but is much more likely to happen in an insulin dependent gestational
    diabetic. It did NOT happen to our son...he was born without any trace
    of blood sugar difficulty, and none developed after birth. But we were
    warned by our doctor that it could happen, and that he may need to stay
    in the hospital an extra day or two, if it did. As it was, they stayed 
    three days, for my wife to recover....our son came out with his arm
    over hsi head and she recieved a very nasty 4th degree tear as a
    result...doctor said it was more like delivering an 11 lb. baby, what
    with the added circumference from the arm! Ouch!
    Hoping that the insulin/sugar problem does not occur in your child, but
    it is a fairly quickly correctable problem if it does occur!
    
    --dave--

    re: .11
    
    When I was being tested for gestational diabetes and my OB was
    explaining the possible consequences, he specifically mentioned
    that research had found the infant hypoglycemia to be independent
    of maternal gestational diabetes -- that about the same percentage
    of infants of normal mothers are sometimes hypoglycemic for the
    first few days as well, as their bodies adjust to being
    independent. 
    
    --bonnie

    Isn't a heel-prick blood test performed on newborns to check for the
    sugar/insulin level or is that for something else, maybe iron level? I 
    know my son had it done (routine test, I was told) and I cannot 
    remember exactly what for now. 
    
    Andrea           

	The heel prick is for PKU.  

Tracey

    re: .14 - What's PKU?
    

    re: .11 and .15
    .11 - Bonnie, I guess our doctors have a difference of opinion
    here...not all that uncommon, I think! I know that 2 doctors can look
    at the same statistics, studies, etc. and reach different conclusions.
    Ous said it was his personal experience that this is more common in
    babies of gestationally diabetic moms...that is not to say it cannot
    happen in babies from moms without the diabetes (as a matter of fact,
    our first son did have a low blood sugar when born...3.5 weeks
    early...but my wife was not diabetic with that one). Actually, the
    endocrinologist who treated my wife also mentioned that it was more
    likely to happen in the diabetic pregnancies, and I believe he even
    gave my wife literature to read on it (i'll check on that).
    Whether it is or is not a diabetic related problem, even if it happens
    , it is not serious.
    .15 - PKU = phenylketonuria. This is a disorder which reslults in the
    body not being able to convert the amino acid, phenylalanine, into
    Thyrosine. It leads to mental retardation if left undetected and
    therefore untreated. The treatment is a diet low in phenylalanine.
    Interestingly, if you read a packet of Nutrasweet, it warns against use
    by phenylketonurics, as Aspartame has phenylalanine as one of its
    components.
    
    --dave--

    re: .17
    
    Hm.  I didn't save any of the stuff I got -- I don't think any of
    it mentioned the hypoglycemia specifically.  I would expect the
    endocrinologist to be more likely to be right than a general OB,
    even a very good one.  
    
    My doctor was telling me this last summer, so maybe there's been
    some new research, or maybe it's as you said, he drew a different
    conclusion from the same studies.  He felt fairly strongly that
    all the potential problems for both baby and mother were before
    the birth (prematurity, stillbirth, increased risk of toxemia),
    and that after the birth both mother and baby were home free. 
    
    I guess compared to those kinds of risks, a little fussiness isn't
    much of a problem . . .
    
    And the real answer is that if you're experiencing gestational
    diabetes, you should talk to your own doctor and find out what his
    interpretation is, and don't be afraid to ask questions.
    
    --bonnie

    I too had gestational diabetes.  It was detected early in my pregnancy. 
    At first it was regulated by diet but at about 30 weeks I became
    insulin dependant.  I was up to 42 units of insulin a day (14 regular
    or short acting and 28 NPH or long acting) by the end of my pregnancy. 
    The biggest problem about having the gestational diabetes was the
    inconvience of it all and the routine I had in the morning.  I had to
    check my sugar level, check my urine for ketones and then give myself
    my insulin.  I had to follow a special diet and eat 6 mini meals a day. 
    I couldn't leave any of the foods out and because I had to check my
    sugar level two hours after eating, I had to make sure I ate at
    certain times and was full enough after the meal so I could go for the
    full two hours with out getting sick.  I also had to have non-stress
    and ultrasounds twice a week to make sure the baby was doing o.k. and
    not growing too rapidly.  At 38 weeks they did an amniocentesis to see
    if the baby's lungs were mature because they wanted to induce labor and
    take him early because they thought he was getting too big.  Well, the
    test came back immature and they decided that they would redue it the
    following Friday, but Shane decided that he was ready to make his
    appearance instead.  He was born on Friday, July 27, 1990 and weighed
    in at only 7 lbs. 5 1/2 oz. (that's small for a gestational diabetic
    mom).  Immediately after the baby was born, they checked my sugar level
    and it was high.  They checked it again about two hours later, still
    high.  I was getting nervous thinking that the diabetes would not go
    away (I was told it would disapear immediately after delivery).  Well,
    about an hour later they checked it again and it was normal and when
    they checked it again later that day, after eating foods loaded with
    sugar (juice, jellow and orange ice) it was also normal.  I was excited
    to know that the diabetes was gone.  They also checked my son and he
    was fine.  They did tell me that I would have to be extremely careful
    later in life because I am overweight and having been gestational
    diabetic, there's a very good chance that I will become diabetic then. 
    Also, they said that I have more than a 50% chance of being gestational
    diabetic in future pregnancies.
    
    Lori B. 

    I had to start insulin a few weeks ago too. I had gestational diabetes
    with my first pregnancy, but controlled it with diet. This time, I take
    2 shots of insulin a day (not quite as many total units as the
    previouse reply). I test my blood 4 times a day and have non-stress
    tests every week. I am 37 weeks along - so should give birth any day. I
    don't mind it much, but I am starting to get bruises in my thighs
    (where I have the shots). They told me to test my blood before eating,
    not 2 hours after. I test it on waking, at 11:00 am, at 4:00 pm and
    8:00 pm...
    

    I know from past entries that there are many women in this notes file
    who will find the following article (copied without permission from
    today's issue of USA TODAY) very interesting.  
    
    It seems impossible that my son RJ, now 27 months old, tall and skinny,
    could possibly turn into a blimp at age 6!!!
    
    CHILD OBESITY AND MOM'S DIABETES
    
    Special for USA TODAY
    
    Children whose mothers are diabetic during pregnancy are more likely
    to be overweight by age 8, a new study shows.
    
    Dr. Bernard Silverman, a pediatrician at Children's Memorial Hospital
    in Chicago, says the study involved 124 children whose mothers were
    either diabetic before pregnancy or became diabetic during it (a mild
    form called gestational diabetes).  Silverman found the children were
    of normal weight at age 1, but many were seriously obese by ages 6
    to 8.
    
    At age 8, the median weight - the point where half a group weighs more
    and half weighs less - was 71 pounds for boys.  The normal is 56
    pounds.  Median for girls studied was 68 pounds; normal is 55 pounds.
    
    More than 1 million people in the USA have diabetes, a disorder of
    blood sugar levels.
    
    One theory for the obesity; excess insulin in the amniotic fluid to
    counteract the mother's high blood sugar levels.  Expectant mothers 
    may reduce risks by monitoring blood sugar levels, Silverman says.
    He reported the findings at a Chicago meeting of the American Diabetes
    Association.
    
    -End of article-
    
    Meg

    I had a routine blood test at 28 weeks which showed that I had a higher
    than average level of sugar in my blood.  I was called back to the
    hospital last Friday (30 weeks) to have a Glucose Tolerance Test (GTT)
    which involved 1 blood test followed by a very sickly sweet drink
    followed by a further 6 injections, one every half hour for three
    hours.  I am awaiting the results at the moment and keeping my fingers
    crossed that I don't have gestational diabetes.  I didn't suffer from
    diabetes before I was pregnant.  If this test shows up with a high
    sugar level as well then they will place me on a sugar free diet for
    the rest of the pregnancy.  Strange things is, nothing has ever shown
    up in my urine samples (no sugar or protein).
    
    Barbara
    

    RE: .1 - I had the *exactly* the same situation occur in my first
    pregnancy.  You might be comforted to know that the subsequent 
    GTT was negative; everything was fine in spite of the high sugar 
    reading on the screening.
    
    The GTT, however, was no fun.      
    
    Next pregnancy I stayed away from sugar the day before the sugar
    screening, and this time came out within the appropriate range on the
    first try.  
    
    Good luck!
    Lois
    

    During her last pregnancy my wife became gestationally diabetic. She
    had to be insulin controlled. It is very common for it to not show up
    in the urine. The levels that they are looking for are far below what
    shows up in the urine. You must have a blood sugar of 189 or above for
    it to show in the urine. In gest. dia., they prefer to keep it below
    120 at all times. I do not know what level they look for in the GTT,
    but my wife's physician told her it was definitely below 180.
     Interesting about the article. All our children are very tall and
    lean, including the one born of the diabetic pregnancy. They seem to
    all follow the same height/weight pattern to a "T". Wonder what will
    happen.
    BTW, my wife is currently pregnant again, and has to have the shorter
    glucose screening at 12 weeks, then again at 24 (if the 12 week one is
    normal). There is a *much* greater chance of her developing it again,
    now that she's had it once. She had it well under control, though, and
    our son weighed 8 lbs. 15 oz. which is excellent for a gest. diab. mom.
    
    --dave--

    I too was gestationally diabetic.  Towards the end of my pregnancy
    I had to be insulin controlled.  There were times when sugar showed
    up in my urine, but only when my sugar levels got too high (which
    was before I started taking the insulin).  My son was born 5 days
    early via emergency c-section (I was not dialating that's why it
    was an emergency) and only weighed 7 lbs. 5 1/2 oz.  They told me
    when I was only 36 or 37 weeks along that his approximate weight
    at that time was 7 lbs. 11 oz. and that he would probably weigh
    at least 9 lbs. at birth (they were off a bit :-] ).  Anyway, he'll
    probably be an overweight child/adult as both his parents are.
    
    Also, we just found out two weeks ago that my boyfriends father is
    dying from severe diabetes.  My boyfriend didn't know that he had
    it (he lives out of state and they haven't spoken to one another
    for over a year), so it's very possible that my son could develop
    diabetes because it runs in the family on both sides and I had it
    while pregnant.
    
    Lori B.

    Looking for nutrition information, and any information, on Gestational
    Diabetes for a friend.  She just failed the second GTT, and will need
    to see a nutritionist, but I'd like to give her some additional
    information.  If you have anything helpful, please send me mail.
    DELNI::SCORMIER
    Thank,
    Sarah
    

    I have a mild case of gestational diabetes.  I wanted to add this note
    because after I read all of the other GD notes, I sort of panicked that
    my doctor wasn't doing enough.  Much of the information in this notes
    file about GD was contributed by mom's who needed insulin.  Diet
    controlled GD is really a different story.  My doctor told me that for
    a mild case of GD which is controlled by diet there is no added risk
    to the pregnancy.  For an insulin dependent pregnancy there is an
    increased risk as described in earlier notes.  For my diet controlled
    GD,   I don't have to check my blood for sugar levels, and the doctor 
    won't retest my blood until week 37. 
    
    My GD was diagnosed by first "failing" the test of drinking the sickening
    sweet drink w/out fasting first.  I then went for the 3 hour test but
    did not need to follow a special diet before, other than to fast 12
    hours before the test.  Only the result at 3 hours was out of line from
    normal.  I have read in this notes file that 2 readings must be out of
    line to be diagnosed as GD.  The lab report shows the normal range of
    blood sugar levels for non-pregnant people.  The levels for a pregnant
    woman are lower than the standard acceptable range.  After my doctor
    received the test results he referred me to a nutritionist to tailor an
    1800 calorie diet for me.  The diet was tailored for my normal eating
    habits and I find it very easy to follow.  The 6 meals a day can be
    inconvenient when you are stuck in a long meeting.  I am now at 35
    weeks and have been on the "diet" for 2 weeks and have lost 6 pounds. 
    My doctor does not expect me to continue losing weight and if I do he
    will have my daily calories increased.  I received an excellent recent
    publication from the nutritionist on GD.  It is published by HHS and
    explains that GD is due to the placenta producing too much of some
    hormones which cause the mother's insulin not to be usable.  It stated
    futher that a GD mom produces more insulin than a non-GD mom.  I never
    showed any sugar in my urine or had any "symptoms".  Since going on my
    diet I can't believe how good I feel.  People can't believe how healthy
    I look.   After putting in a full day at the office, I do housework,
    sewing, shopping or whatever until 11 at night and then get up at 7
    feeling good.  I attribute my feeling good and high energy to my new
    diet.  
    
    My perspective may be different from other's.  At week 16 my baby was
    given optimistic odds of 50% of making it to viability at week 30.  We
    had to stay in bed from week 16 until week 30 and just pray.  After
    making it to the 30 week milestone, my doctor still expected my baby 
    to be quite early.  I am so happy that he has "hung" in so long.  My 
    high energy may also be do to feeling so good that I'm still pregnant 
    at 35 weeks.  
    
    Sandy  

    Further to my note .23 I thought I would let you know I have had the
    result of my GTT test.  Out of the 7 injections, 0 showed up with
    any sugar.  Isn't that just great.  My Doctor says that I must have
    just eaten something too sugary before my first blood test at 28 weeks.
    Got another routine blood test on 20 Dec at 36.5 weeks, so guess who
    won't be eating anything with sugar in it before hand!!!
    
    Barbara
    

    It's great to know that other women have had this.  I didn't realize
    that GD wasn't rare.  I had a mild GD early in 1st pregnancy and
    then during last months, had to adhere to strict diet.  At stress
    test in final month, doctors decided to induce labor.  My daughter
    weighed 9.5lbs 13oz., something like that.  A nurse called these
    big babies, sugar babies.
    
    Anyway, we're just fine.  She's 9 years old now.  Not overweight
    all all, but not thin.  I'm on the thin side.  My 2nd pregnancy
    went fine, except that I was quite low in iron and had to stay on
    at least 6 iron pills a day.  Anyway, he was 8 13oz.
    
    I'm just glad it all ended up O.K.  I never heard that GD led to
    future Diabetes in women?

     
    	I just found out that I have to go back for the 3 hour GTT.
    	
    	Does anyone know what the numbers represent? The one-hour test
    	came back as follows:
    	
    	1st blood test:      103
        After Drink/1 hour:  153
    
    	Should I be alarmed? I'm currently in the 24th week of my 1st
        pregnancy.
    
    	thanks!
    
    	Noreen
    
    	                                         

    Noreen,
    
    The numbers represent the amount of sugar in your blood.  Normal in a
    non-pregnant woman in 80-120 (100 represents 1 tsp of sugar in your
    blood).  A pregnant woman is expected to have lower blood sugars (I
    believe it is about 60-100).  
    
    What you had's not perfect, but not too bad!
    
    Good Luck!
    Patty

I had the one hour test and failed, at about the 25 week mark.  Then I had the
three hour test a week later and passed by quite a bit.

So, it's good to take the test, but taking it doesn't mean you have gestational
diabetes - wait for the results before you worry too much.

    
    .32 and .33 Thanks, I had the 3 hour test and it was 'technically'
    normal, however, they did have me see a nutritionist for a 
    consultation. She put me on on an 1,800 calorie diet. We'll
    see how this goes.
    
    -Noreen