Conference moira::parenting

    Hi,
    
    I was diagnosed with a mild case of gestational diabetes when I was
    pregnant from Nov 1990 until Aug 1991.  I, too, was very upset and 
    nervous about this, because I did not know too much about the subject
    at the time.  I did a lot of reading about it, the previous versions
    of Parenting have some subjects on this.
    
    My experience was that I saw a dietician several times and a specialist
    as well.  The diet consisted of a low fat low sugar diet.  I did the 
    finger prick monitoring 3 times a day and except for a couple of
    readings, each reading was within the normal range.  This self
    monitoring gave me a lot of comfort, it meant I did not have to worry
    in between Drs. appointments what my sugar level was.  
    
    I'm still not convinced that I actually had a problem or if the initial
    testing was inacurate, but for me I now consider it a blessing, since I
    have a tendancy to overeat, the diet kept me on track and I only gained
    17 pounds throughout the pregnancy.  Karen was 9 1/2 lbs when she was
    born and very healthy.  I did end up having a cesarian, but doesn't 
    neccessarily mean you will too.  My doctor was worried about my age 
    as well as the size of the baby.  (BTW, the cesarian was a very
    positive experience for me).
    
    The dietician did say that I need to watch my weight because I could 
    have a higher tendancy to develop diabetes as I get older.
    
    Now, I only wish I could follow the diet as well as I did when I was
    pregnant!
    
    If you have any other questions or concerns, feel free to contact me.
    
    Best Wishes,
    Janet

    
    Von,
    
    I had GD too.  At first I was so scared because I did not
    understand it.  The good part is once the baby is born
    you do not have it.  You will also most likely have it again,
    if you decide to have another child - as you will have it
    for every pregnancy.
    
    I did not have to prick my finger 3 times per day.  I only
    had to check it once per day 2 hours after I ate.  I do not
    like needles, so I went to the nurses office here.  They
    also have the monitor, so I did not need to have my own.
    
    Once per week I met with the Diabetic Educator - she gave
    me a book to keep track of my readings.  Also, I had to
    buy keosticks and every morning check my urine for Ketones.
    
    The diet was actually pretty easy once I figured out what I
    could have.  In the early morning you cannot have any fruit.  My
    breakfast could be a bowl of cereal, and a cup of decaff tea
    and water, or a boiled egg and a piece of toast.  Then I could
    have a mid morning snack - which could be a piece of cheese
    with a peach, or apple.  Lunch was a sandwich with meat and
    cheese, also was allowed a bag of potato chips.  Or I could
    have 1 slice of pizza.  Afternoon snack - low fat - sugarfree
    yogurt.  Dinner - all the vegies I wanted (except potato -
    only 1 potato), meat or fish.  Then I had to have a late night
    snack before bed so that I would not have any empty stomach
    and produce ketones.  That could be a bowl of cereal, or
    yogurt. 
    
    When you meet with the dietician - they will help you with
    a diet that will work with you.  They don't want you to 
    be miserable.  
    
    My baby was 8 pounds even.  I only gained about 19 pounds 
    during my pregnancy.   
    
    Jeanne
    

For information about testing for gestational diabetes, 
please see note 94.

L
co-mod

    First of all... don't panic! (easier said than done, right?)
    
    We are in the beginning of our third experience with GD, and our fifth
    pregnancy. My wife is 9 weeks along and on insulin already. *But* on
    the first diabetic pregnancy, she was diet controlled until about week
    34, and then on low doses of insulin till she gave birth. Dan weighed 8
    lbs. 15 oz.  Next pregnancy, she began insulin at week 11, and took it
    4X daily by birth... Jacob weighed 7 lb 6 oz. Dan was born naturally,
    Jake was C-section, but only cause he was breech and tangled int he
    cord. Her OB is willing to try Vbac, assuming baby doesn't get too
    huge. 
    Diet is a very healthy diet, which is low-fat and not processed/refined
    sugars. Having a protein for breakfast (and egg, a slice of cheese,
    etc.) is recommended if the sugars 2 hours after breakfast are high,
    and fruit is *usually* not allowed for breakfast, but you can have it
    mid-morning. Whole fruit is generally preferred to juice. You generally
    eat more often and in smaller portions so that you don't dump loads of
    food into your system at long intervals, but smaller quantities at
    shorter intervals, which helps keep the blood sugar on a more even
    keel.
    
    When controlled as you doctor advises, GD isn't dangerous to either you
    or your baby. It is a "serious" problem, though, and must be monitored
    closely. Yes, 60% of women with GD go on to develop diabetes later in
    life, but there have been no studies indication their children do. The
    primary "complication" in well controlled diabetes, is that the baby
    may experience a drop in blood sugar soon after birth. The baby does
    not develop diabetes in the womb... his (her) little body produces all
    the insulin he needs. But he *does* get extra sugar from mom, while in
    utero. So, when he is born, and now gets "normal" quantities of sugar
    from his milk, it sometimes takes a while for his pancreas to slow down
    the insulin production. So, he produces too much and it makes his blood
    sugar too low. This will be well monitored, and if it is a problem,
    they will give him a bit of glucose water, which will take care of the
    problem right away. There is sometimes a greater problem with jaundice
    in babies from GD moms, but this too can be taken care of with the bili
    lights, if need be.
    
    Moms will *almost* always be non-diabetic after the baby is born. But,
    this is not an absolute guarantee (is anything ever??). They did not
    think my wife would be "normal" after the last baby, but her sugars
    were fine. They were surprised, because she was on super high doses of
    insulin. Now they feel, since it showed up so early in this pregnancy,
    that she is likely already a borderline diabetic, but diet controlled
    when not pregnant. So who knows what will happen after this one?
    
    Diabetic management is more of a comittment to caring for yourself and
    this precious little baby than anything else. It is not "hard" to do,
    but can be inconvenient and time consuming. By and far (according to
    Wendy, my wife), the blood testing finger pricks hurt *far* worse than
    the insulin shots. The needle for the insulin is hair fine, and she
    says she rarely even feels it. Now poking that finger is another thing,
    but you get used to it.
    
    Our kids find it all facinating, and love to wathc the whole process.
    They are real conscious of the content of Wendy's diet and are a real
    blessing through this all.
    
    In short, even if you do end up requiring insulin, you almost certainly
    will have a perfectly normal and healthy baby! Follow your doctor's and
    nutritionist's advice, and you will do great! And the diabetic diet
    *will* help you control your weight. The most Wendy has ever gained in
    any of her pregnancies was 15 lbs., and that was *before* any of the
    diabetic pregnancies!
    
    Lots of people have been there before, you'll do just fine. I'm sure my
    wife would be glad to talk with you , if you want... jsut let me know
    and we can arrange something.
    
    Keep thinking happy thoughts!
    
    --dave--    

    
    The diabetic educator told me for some reason she has seen
    alot of cases where the women who have GD have been over
    30 years old and it's their first pregnancy, or 5 years 
    since their last pregnancy.   
    
    That could be that there are alot of women that are starting
    to have a family after 30???
    
    She also told me that it is onset by hormones.  
    
    Jeanne
    

    Hi Everyone,
    
    I just wanted to say thanks for the information and support you
    provided.  I am at the end of this pregnancy...I will be induced on
    Tuesday if I haven't gone into labor on my own by then.  I've had a lot
    of contractions, just nothing steady.  I was diet controlled through
    to the end, in fact my highest reading was 121.  I've only gained 17
    pounds, and am generally felling pretty good...at least as good as you
    can hope to feel at this point!
    
    It really hasn't been as bad as I thought it might be, and I think that
    is due to your kind words and shared experiences, as well as the low
    readings I was fortunate enough to have.  I am glad however that it is
    just about over.  I will attempt to continue to eat as healthy as I
    have the past few months and hopefully take off the excess weight I
    need to lose.  I think I'll satisfy a couple of cravings first though!
    
    Dave and Wendy...best of luck with the remainder of your pregnancy, if
    I remember correctly, you should be a little past the halfway point?
    Many, many thanks to you both, what an inspiration you were to me. 
    I'll post the birth announcement in the appropriate note when I get
    back home from the hospital.
    
    Thanks again and Happy Holidays everyone, I know ours will be
    especially wonderful this year, and all those to follow...
    
    Von

Ill be starting my 8th month on Dec 21 and had the one hour test last week
which showed I had a level of 142.  I had the 3 hour test yesterday and am
awaiting results.  Is this level considered high?  

Maureen Kane

    
    I'd like to know what the symptoms are for gestational diabetes.
    I just went to Health Services to try and find a pamphlet on 
    diabetes but there wasn't any.
    
    I've been feeling very lightheaded lately (this is with a full
    stomach).  This is my second child.  Usually when I feel really
    lightheaded it's because I haven't eaten but this has been happening
    even after I've eaten and I'm beginning to wonder if I have
    some sort of chemical imbalance.  My son was 9lbs 15oz and 22 1/2
    inches at birth so the dtr. told me that they would be testing 
    me probably twice instead of once for gest. diabetes.  When I feel
    lightheaded and kind of "spacey", I get something to drink or have
    something with some sugar in it, thinking that my body needs more
    sugar.  That doesn't seem to work.  So this morning I brought saltines
    and peanut butter crackers and that hasn't worked either.  I can't
    seem to stop feeling lightheaded.  I will be going to the dtr's
    in two weeks and I'll be talking to him about this.  It seems to 
    get much worse when I am standing up.  I will be talking to someone
    and I will have to sit down because at times I will be so lightheaded
    that I feel I'm going to black out.  Is this a symptom of diabetes
    by any chance?
    
    Thanks,
    Chris

    
    Chris, I can't speak for gestational diabetes, but the symptoms
    you describe is how I feel when my iron is low.  I occasionally
    get this non-pregnant, and I also got this way when I was pregnant 
    and it was because of iron.
    
    Might be something to have them check, if you haven't already.
    
    -Susan

    I had gestational diabetes with my pregnancy ... never felt light
    headed ... or anything for that matter.  I wouldn't have known if they
    didn't tell me.  But then I was only a border line case.
    
    I would be more concerned about your blood pressure or like the
    previous note mentioned, blood count (iron).  Both of these things can
    be tested by the nurse, if you have one on site.  Might be worth
    checking out.  I wouldn't wait 2 weeks.  If nothing else I would at
    least put a call into your doctor and discuss it.  Rather be safe than
    sorry.
    
    Good luck.
    
    Joyce
      

    
    
    I bet that is what it is (low iron)!  I remember with my son that
    they said my iron count was on the low side.  That would explain
    my fatigue too.  I will have the nurse here at my facility check
    my blood pressure (which is low 100/60).
    
    Thanks so much!
    
    Don't know what I'd do without this notesfile! :)

    
    Chris,
    
    I have gestational diabetes.  They decided since I had it
    last time, to test me during the first trimester.  I took
    the O'Sullivan test.  The same time they also tested my
    iron.  I flunked the O'Sullivan but my iron level was high.
    
    I do feel lightheaded, but usually when I am hungry and I
    also get a headache with it.  
    
    Lately I have been following the diet, but my blood sugars
    have been really low.   
    
    If you have any questions, you can write me off-line and
    I also have a book on GD that I could give you if you
    would like to read more on the subject.
    
    Jeanne
    

    
    
    I went to the cafeteria today and got a huge salad with lots
    of spinach in it, hoping that it would make me feel better.
    I did feel better after I ate but about an hour later, I started
    feeling lightheaded again.  I went to the nurse to take my blood
    pressure.  It was 98/40.  It has never been that low before.
    I asked if it could have been my low iron and she said that it
    may but she also recommended that I get the glucose testing earlier
    this time because she was concerned about how I would get lightheaded
    after eating (and still having a full stomach).
    
    I called my dtr's and talked to the nurse and explained to them
    what was going on and my blood pressure, etc..She said for me
    to eat more proteins, like hard boiled eggs and peanut butter.
    I told her that I must have eaten about 10 peanut butter crackers
    this morning and it didn't help at all.  She said my blood pressure
    was fine and that pregnant women feel this way when they are pregnant
    and if they did bring me in to see the dtr's they doubt they will
    be able to do anything for me.  I was pretty frustrated and what
    I've decided to do is take some iron supplements and when I go to
    the dtr's I'll tell him exactly what's been happening.
    
    This is my second child and I have a feeling that something just
    isn't right and it's not just because I'm pregnant.  If the 
    iron pills don't seem to help then I will move up my appointment
    with my dtr..
    
    -Chris

My husband has low blood pressure also and getss light headed when he stands
up too quickly.  He has been told to drink LOTS of water.  If you have a place
where you can lie down, it can also help.  The tips about the iron are also 
good.

Another thing to consider is if you have made any drastic changes in your diet,
due to the baby coming.  For example, if you were used to drinking a lot of
coffee and have stopped because you are pregnant.  Or tea.  Or used to eat a
lot of chocolate and given it up for the duration {:-)   All these things 
contain caffein and giving up cold turkey on these can have similar results.

I know my mother-in-law wasn't allowed caffein EXCEPT when she got light headed.
Then she would have one cup of regular coffee.

Just a few ideas.

ccb

    I had gestational diabetes with my last pregnancy, at around 6 months
    of pregnancy.   Before being diagnosed, I felt spacey and really unglued 
    emotionally.  Also I was incredibly thristy, and inspite of eating alot, I
    began to loose weight. I eventually went on insulin until the end of my
    pregnancy.  (Alexander, was 9 lb 8 oz, born 3 1/2 weeks early)
    
    If you are feeling something isn't right, it seems to me that you
    should see your doctor to help put your mind at ease.  Two weeks can be
    a long time to wait if you are feeling anxious.
    
    susan c. 

    	Feeling lightheaded and dizzy have been two of my greatest
    complaints during this current pregnancy.

    	Whenever I mention it to the midwives they tell (remind) me that:

    	With a developing fetus inside. the mother needs to make sure that
    she drinks a minimum of 8 glasses of water a day (they upped my to 10
    at one point)

    	As the fetus gets larger, it can rest on the major blood vessels
    thereby restricting blood to the brain. Try not to stand too long
    without moving and move your feet/ankles often.

    	I had low iron and started taking supplements. To be perfectly
    honest, although I have noticed a change in stamina I have not noticed
    a change in the dizziness.

    	In fact, the dizziness can get so bad that sometimes I hesitate to
    go shopping because I'm not sure if I will be able to tolerate the
    standing in lines.

    	Lastly, when you lie down make sure that you are resting on your
    left side. I can not lie on my back anymore and in fact, during my last
    visit, they did an ultrasound and one hour of monitoring and I ended up
    passing out right there on the table because of the babies pressure on
    my blood vessels.

    			Wendy

    I too had GD with my last pregnancy, which ended in a beautiful,
    healthy baby girl in Dec.  She was 7 lbs 2 1/2 oz. at birth which 
    I thought was great for the circumstances.  I had none of the
    symptoms the last several responses have been talking about, in
    fact I wouldn't have known I was diabetic if they hadn't tested.
    My biggest problems were migraine headaches and sciatic (sp?) nerve
    pain, both of which I have no idea if they were related to the GD,
    my doctor didn't seem to think so.  If either, I would say the
    headaches may have been.
    
    Chris, have you seen the doctor yet?  Just curious to see what his
    interpretation was.
    
    Von

    
    
    I went to my last checkup (Feb. 12th) and talked to the doctor
    about how I was really lightheaded and that the nurse at work
    checked my blood pressure and it was 98/40 and she/I thought
    that it was low.  He said that it wasn't low and to just 
    drink a lot of water (basically, he blew it off saying not
    to be concerned, everything was fine).  I'm schedule for
    my glucose test shortly and once I find out the results of
    this I'll feel much better.  Hopefully, it will be negative!
    
    Chris

    Chris, a diastolic pressure of 40 is a "low" reading, in general
    clinical terms. 98 is low but still within "normal" limits.  
    BUT... the important part is what is YOUR normal blood Pressure?  What
    is your normal blood pressure, both before pregnancy and during THIS
    pregnancy.  If your BP has suddenly taken a nose dive, then yes you've
    got a real reason for feeling light headed, what's more important is
    *if* it has taken a sudden nose dive, what has caused it?  That's the
    part that needs to be answered.  I would tend to agree with the nurse
    that you should try to increase your fluid intake.  But just so you can
    feel more assured, call your OB (or even your general doctor if he has
    any records of your blood pressure from the past) and tell him what the
    nurse got for a reading, and ask them to compare how it's been running
    with your normal prenatal visits.
    
    Just for kicks, have the nurse check it again.
    
    Then again, the nurse may not have heard it correctly.  I've run into
    this many times due to external noise.  (it's not always easy to hear a
    BP in the back of an ambulance with sirens blaring!)
    
    Lyn
    (the EMT)

    Here I go again.  Since I had GD last time they decided to screen me
    early this time.  My 1 hr test came back at 191 so I had to go see a
    diabetic educator last Wednesday.  I thought they were just going to
    talk to me about diet (I went on my diet as soon as I knew this time)
    but surprise, surprise, I get to prick my finger 5-6 times a day.  I
    was a little upset with this.  I wish I had been forwarned before the
    appointment so I could have prepared myself for it.  I'm a real baby
    when it comes to needles, etc.8((  I've only been doing it for 4 1/2 
    days but I already feel like a pin cushion.  I keep telling myself 
    that it will all be worth it for a healthy baby but it's just one 
    more thing to add to the list of worries.  I'm just keeping my fingers
    crossed that I can keep it under control with diet.  Only 170 days to
    go and the count down has begun! 8*)

    Well, I went back to the doctor's yesterday morning and she thought
    that my sugar levels in the morning were a little higher than she'd
    like so I get to give myself a shot of insulin each night.  Oh boy, me
    who can't look when they're drawing blood.  I started last night.  It 
    doesn't really hurt at all but watching the needle go in makes me feel
    a little woozy.  I hope it gets easier the more I do it.  I did feel
    better this morning however when my sugar reading was about 30 points
    lower.  I'm just hoping that it won't get worse as the pregnancy
    progresses.  Only 160 more days to go........

    I have been treating GD with diet since the beginning of April. The
    diet is breakfast, snack, lunch, snack, dinner, snack for a total of
    2200 calories. I've gained 4 pounds since on the diet. I also have to
    prick my finger 2 hours after breakfast, lunch, and dinner. My  numbers
    have been mostly in the 90-110 range. I have seen the doctor twice
    since on the diet, they looked at numbers and said they were looked
    good. They also have a mini-sonogram machine in the office and looked
    at baby both times, first time I was concerned about big baby but I
    was assured that the baby was normal size as was my belly. I was also
    concerend about now becoming a 'high-risk' preggo but again was
    assured 'not unless the sugar levels can't be regulated'. The last
    time I saw DR, again the size and movement of the baby was ok. I feel
    good on the diet and seem to have more energy. I have done a bit a
    research on GD and the sugar levels should fall in the range between
    60-120 for a GD'er which is well within the range of my numbers.  
    
    On Tuesday of last week I went for what they call a panel test. I went
    to lab at 8am where they took blood before breakfast. This is the
    fasting blood sugar count. I also used the machine to record the number
    in order to test the accuracy of the machine. I then went home, ate
    breakfast, and went back to lab 2 hours later, where they took more
    blood and I also pricked finger to test machine. I received a call
    Monday of this week and was told that the doctor  wanted to talk to me
    about taking insulin. I was a bit taken back since my numbers 'looked
    good' for the past 5-6 weeks. I asked her what the lab readings were and
    they were within the normal ranges but a little bit higher than the
    home testing machine which I'm was given to use. I did not talk to the
    dr. on the phone but a nurse. I asked her why were they considering
    insulin when my numbers were well within the range. She told me they
    were looking at the glycol number (?) which was 6.7 and should be 5.0.
    I have no idea what this number is...so I need to question them on
    this.. I then asked well why are we even bothering with the finger
    pricking if those values are not being considered....pause and then
    really didn't answer my question. So I have an appointment to talk to
    doctor tomorrow (Thursday).  
    
    I'm not convinced AT ALL that I need to go on insulin given the current
    numbers of finger pricked blood sugars. I also found out since my panel
    test last week that I should have done something (gone for a walk/swim)
    after breakfast....were I just sat and read until time to go back to
    lab. I have been taking more finger pricked readings, they told me to
    take a before breakfast reading and at least one at 3AM. I've been
    taking them before ALL main meals and one last night at 3am. These were
    yesterday's numbers...BeforeBreak.-88, 10am-98, BLunch-95, 2PM-76,
    BSupper-73, 8PM-115, 3AM-88. I'm very suspicious of all this....Does
    anyone know what happens if you take insulin when you really don't need
    it. I have called for info from Joslin re: GD and they are sending
    something in the mail. 
    
    I also found a book at Barnes & Noble yesterday that had a section with
    some useful technical information about GD. The book was expensive
    ($35 & softcover!) and I only was concerned about GD. One thing that I
    need to go over again with my DR is my 3 hour glucose tolerance
    numbers. According to the book, Manual of High Risk Pregnancy &
    Delivery by Gilbert & Harmon, the 'normal serum values of a 3 hour
    glucose tolerance test in pregnangy are: 
    
    Fasting - 105
    1 hour - 190
    2 hour - 165
    3 hour - 145
    
    I remember my fasting count was 99 and they said the norm was 90, but
    the book says 105!!!????? I feel like I'm being treated in order to
    protect them and not me and my baby.... 
    
    Opinions....sorry this is a bit long winded....
    
    Mrs �
    

    Hi!
    
    I am diabetic (not just GD), and have 3 children, so I hope to answer
    your more technical questions.
    
    First and foremost, based on what you wrote, is that they're concerned
    primarily with the "glycol" test that you referred to.  It's actually
    called a glycosylated hemoglobin.  When your blood sugar is higher than
    "normal", the sugar actually sticks to your blood cells.  After a
    period of time, more and more sugar sticks to more and more cells. 
    This test gives a VERY good indication of what your REAL blood sugar
    level has been for the past ~6 weeks.  This test causes much fuss in
    the medical industry.
    
    The differences between your glucometer and the tests the Dr took can
    easily be explained.  You test capillary blood.  They test venous
    blood.  The difference in results can be up to a 10% swing, either way.
    It's not necessarily that your machine is "wrong", but you're using
    different samples, so don't expect the results to match.
    
    For a pregnant women, I believe that your BS levels are higher than a
    normal pregnant woman would be.  They're NOT higher than a normal
    non-pregnant person.  When your pregnant, blood sugar levels tend to
    run a LOT lower.  For example, when not pregnant, they want my fasting
    BS to be around 90.  When pregnant, they want it BELOW 70.  There were
    times when I was have a low blood sugar reaction, measured BS of low
    20s.  In a non-pregnant state, I've never measured a level below 47.
    
    Another reason for the insulin .... the "more pregnant" you become, the
    more the body resists the use of your own insulin.  The placenta
    actually interferes with the absorption of the insulin, and will
    therefore usually cause your insulin needs to increase as the pregnancy
    increases.  I suspect that your Dr is trying to "prepare" for a little
    later time when you will REALLY need the insulin.  He's not going to
    send you home one day with some syringes and bottles of insulin and say
    "Have at it!", it should be a more gradual "Here, try taking a small
    dose of regular insulin at xx time" - for you it looks like you need it
    before dinner time, and probably 2 SMALL shots of NPH (longer-acting),
    once in the morning, once in the evening, to keep your sugars more
    stable.  A better time to measure is 1-1.5 hours after you started
    eating a meal.  THIS is the time when your BS is going to be highest,
    and this is probably the reason your glycol seems skewed.
    
    I know it's hard.  By the time Jonathan was born, I was up to 4
    shots/day, sometimes more if a test came out high.  But I've been doing
    this since I was 18, so I'm more used to it.  And even with 12 years
    experience of managing myself, they STILL wanted me to call every day
    and a bunch of other stuff.
    
    The potential dangers may not seem great, and you may feel just fine.
    
    The biggest danger is a "large" baby.  The concern is that the
    "largeness" of the baby tends to be fat, and that fat tends to be
    concentrated around organs - more internally - than just chubby legs
    etc.  The reason this happens is .... if your blood sugar is high, the
    baby is passed that additional sugar.  The baby makes more insulin to
    "use up" that extra sugar, and takes it on as fuel.  The baby is
    already getting more than enough fuel from other sources, doesn't need
    the additional "fuel" and stores it as fat.  If you keep your sugars
    LOW, you make a much healthier baby.
    
    The other complication, is because the baby is producing more insulin,
    the baby gets "used" to producing this amount.  When the baby is born,
    it continues to produce roughly the same amount.  At this point it's
    *WAY* to much for the baby alone, and can cause low blood sugar
    concerns with the child, that usually need to be treated with an IV. 
    If you've ever seen them trying to give a newborn an IV, you'd do
    anything to avoid it.  If you're only going to pick one time to be
    REALLY careful about your BS, at least do it right before the baby's
    born, to help avoid those complications at birth.  The other time that
    it's most critical is shortly before, during and the first 16 weeks
    after conception (but if you're just GD, this wouldn't apply to you).
    
    If you take too much insulin .... that's a hard question to answer. 
    Mostly it depends on how educated you *and the people around you*! are!
    If you're put on insulin, it is VERY important that you let someone
    know, and preferrably more than a few people know, that you're taking
    insulin, and how to help you in the event of a low blood sugar
    reaction.  They will give you tons of literature and explanations, but
    it's up to you to pass this info on to people around you.  You've
    probably experienced the feelings of a "low blood sugar" reaction at
    some point in your life.  Tend to feel weak, shakey, irritable,
    confused, sometimes blurred vision - those types of things.  Different
    types of insulin, and different people react differently.  It can range
    from a feeling that you know AS SOON as it starts to get too low, to
    the point of some people never feel it.  The onset can be immediate and
    intense (in 5 mins go from fine to awful), or can be gradual, over the
    course of an hour or so.  For myself, I notice it pretty quick.  A
    reaction from REGULAR insulin is immediate and amazingly intense.  A
    reaction from NPH insulin is very gradual and I can "hold off" for
    about 1-1.5 hours before treating it.  Of course the sooner I treat it
    the better I feel, faster.  If I WAIT, it takes much, much, much longer
    to feel "right" again, and the confusion can last as long as an hour or
    so.  Typically within 10-15 mins everything is fine again.
    
    REGULAR insulin is a fast acting insulin that is absorbed by the body
    quickly, acts quickly, and dissapates quickly.  It starts to work
    within 15-30 mins, it's peak effectiveness is in about 2 hours, and
    within 4 hours it is flushed.  This is usually used just before meals
    (because you know your BS will go up a lot from eating), or any other
    time to "drop" an unusually high BS.
    
    NPH insulin is a slower acting insulin that is usually used to maintain
    a constant level of insulin in the body.  It starts to work in 4-6
    hours, peaks in 10-12 hours, and is usually gone within 24 hours.  It's
    a little less precise, but is necessary to maintain balance.
    
    Of all the "dangers" of adjusting your BS, the worst situation to get
    into is either to have a CONSTANTLY very high BS (in excess of 150), OR
    to get into a situation where you're bouncing all over the place - one
    minute it's 30, the next it's 200.  And talk about making you feel
    AWFUL!
    
    I don't want to scare you, but would be irresponsible to not mention
    .... in either case, extremely high, or extremely low blood sugar can
    cause a diabetic coma.  If left untreated, could lead to death.  You
    DON'T want to mess around with this, and you really should do whatever
    you need to to make sure that people know how to help you, or what to
    look for.  There were a lot of times with my 2nd pregnancy, when my BS
    would just plummet.  I'd be sitting doing my work, and "poof" couldn't
    do anything else.  I shared an office w/ 2 other people, and they'd
    drag me up to the caf (usually against my will), and make me eat
    something, and then I'd be fine and thankful etc etc.  They were happy
    to help.  I also kept candy or glucose tablets nearby, no matter where
    I was.
    
    If you have "time", Joslin also offers free training courses during the
    day - they'll send you a schedule and you can try to make it in on the
    days that seem to most apply.
    
    It's hard, but it CAN be done.  I have 3 beautiful boys to prove it.
    Their birthweights were;
    6lbs 2 oz - 4-5 wks early (they thought 2wks till after he was born)
    5lbs 2 oz - 2 wks early
    7lbs 15 oz - 1 wk early (and a different/Larger dad)
    
    They try to deliver them earlier because the insulin also causes the
    placenta to deteriorate a little faster, BUT they have to try to wait
    because babies of diabetic Mom's lungs tend to develop slower. Tick
    tick tick.
    
    If you have any questions, please feel free to contact me.  SORRY this
    got so long!
    
    Patty

    Don't apologize for a long note--I appreciated the detail
    and the sense of what it's like to be diabetic, and I'd
    bet others will, too!
    
    		-John Bishop

    THANK YOU!! Patty!
    
    That is the most information I have had about my condition and it is
    really helpful. I did the doctor yesterday and she has me reporting top
    the lab for 3 fasting blood sugar draws, first was this AM, and
    subsequent ones will be Mon & Tues with an ultrasound on Tuesday and a
    another meeting with the doctor Tuesday afternoon to discuss the
    results. 
    
    After yesterday's discussion with the doctor, she told me to prepare
    myself mentally for the insulin, because it looks like I'll more than
    likely be on it. After reading your note, I'm more convinced that I
    will be going this route.....it's just that I'm a bit phobic about
    needles, but the more I self talk myself about this the more
    comfortable I feel. 
    
    Thanks again,
    
    Rachelle �
    

    Rachelle,
    
    Well, for what it's worth, after doing this for 13 years now, I still
    can't STAND when I have to get a shot or have blood drawn, but giving
    myself shots doesn't bother me at all.  I think it's knowing that I
    have the control, and if it really starts to hurt, I can "stop".
    
    And the faster you can do it, the less it hurts.  Different injection
    sites will hurt more/less, depending on your nerve endings and fatty
    deposits.  The most common sites are the back of your arms, where the
    "flabby" part is, top of your thighs, and stomach.  Stomach sounds the
    worst, but is usually the most comfortable, since there's usually the
    greatest amount of fat.  My arms are too skinny to use, and one of my
    thighs always got really red and swollen.  I've been using my stomach
    for years (yes, even when pregnant, though baby kicks were a little
    unsettling).  Once you get over the psychology of it, it's usually
    painless.
    
    Also remember for your fasting ... don't eat/drink ANYthing!  Even a
    glass of water will affect your blood sugar levels.
    
    Good luck, and feel free to write/call if you have any questions.
    
    Patty
    381-0877

    Hi,
      I've read all the notes in this topic, but I still have one question
    and was wondering if anyone out there knows.  I tested positive on
    monday for GD with a count of 161.  I have another test this monday
    to verify.  I've read about the diets and self testing, but not
    too much was mentioned about delivery. I've heard that they try
    or most times have to take the baby early. Not sure why. I read
    in my medical book that diabetes can cause pre-eclampsia during
    labor. Is that why they take the baby early or because of high
    birth weight (which is another one I've heard)?  I'm only supposed
    to be 29 weeks, but I measure 31 and I've gained already 19 pounds.
    
    I also didn't have this with my other three girls. This ones a boy
    and the first time I've tested high.  
    
    Rose

    Rose,
    
    it depends.  The OB-from-hell who diagnosed me as GD, had biophysical
    profiles done weekly on my kid to make sure that there weren't problems
    requiring early delivery.  (OB from hell comment surrounds her bedside
    manner or lack thereof, and her treatment of pregnancy as a disease
    rather than a natural process.  Needless to say "cold day" before I
    recommend her to anyone.)  
    
    the BPP's showed nothing amiss, other than proof that my suspicion
    around the position of all my kids prior to onset of labor is
    posterior.  Had they shown a problem we would have discussed options,
    such as immediate delivery.  
    
    footnote:  I had two pregnancies where GD was suspected.  Both children
    went full-term and were under 7 pounds.  Either rigid diet control
    works or my usual reactive hypoglycemia prevented a normal response to
    the tolerance test.  
    
    meg

    
    Let me see if I can remember how it was last explained to me (I'm
    diabetic all the time...)
    
    It depends on how you're being treated as well .... as a simple result
    of being pregnant, your body absorbs/uses insulin less effectively. 
    This requires more insulin.  The additional insulin, and higher blood
    sugars, cause the placenta to deteriorate.  AND when the placenta
    begins to deteriorate, the body suddenly becomes more able to process
    insulin properly.
    
    So, (one of) the PROBLEMS that they need to be very concerned about, is
    the viability of the placenta.  The major symptom that there may be
    problems, would be a sudden, sustained drop in blood sugars.
    
    When I was pregnant with Chris (my first), for one whole day (at
    ~8mos), I felt no movement whatsoever.  And I also kept having low
    blood sugar reactions. I kept eating and eating, and "crashing". 
    Finally down to the Drs, and they did an emergency c-section.  Turns
    out the dates were messed up, and I was only at 35 wks, not 38, as they
    thought, but he was perfectly fine.  They sent the placenta to the lab,
    and found that, in fact, it had begun to deteriorate.  They estimated
    that within 1-2 days, it would not have been able to support life.  So,
    whatever you do, don't be too brave.
    
    If you're taking insulin, I believe that this all can happen quicker.
    (BUT, it's also more evident).
    
    Other reasons for early delivery are to prevent high birth weight, and
    to help the BABY.  Diabetic babies tend to be born "fatter" (because
    the baby also makes insulin, and is using your 'high blood sugar', as
    fuel, and stores it as fat, on the baby), but the problem with these
    babies, is that the fat tends to be more in deposits, in areas where it
    can potentially do the baby some harm.  So, the reasoning behind
    "preventing a huge baby" isn't such a concern with delivery, as it is
    for the health of the baby.  Bigger is NOT better. (mine were 6lbs, 2
    oz; 5lbs, 2oz; and 7lbs 15oz) .... you can guess which one I had the
    worst "control" with (-:
    
    ALSO, since your baby is producing insulin, if your blood sugars are
    high, the baby will produce MORE insulin to try to help balance things
    out.  It takes a few days for the baby to become accustomed to only
    producing enough insulin for itself.  Sometimes, it requires that the
    baby is on an iv for added glucose, to make up for the additional
    insulin they produce, until the baby can settle out it's system. 
    Therefore, if you're going to be "naughty" about your control, MAKE
    SURE that at the very least, within the week before your child is born,
    you take extra careful measures to keep yourself under control, which
    will help the baby adjust its insulin level while still in utero ....
    save you the heartache of seeing that IV.  
    
    Good Luck!
    

    
    	My sister, GD through 2 pregnancies, carried both kids full
    	term.
    
    	Karen