Conference moira::parenting_v3

    Hi, this is Dave....gonna let my wife answer directly on my account...
    
    Hi! This is Wendy!
    I have been through one diabetic pregnancy, and am now 4 months into
    another one. First of all.....everything will be FINE!!!!!!!! Follow
    your doctor's and your dietician's suggestions, and the pregnancy will
    feel completely normal (as normal as one can feel when pregnant!), and
    the baby will be *FINE*!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
    
    Now, the diet....not awful, just takes some getting used to. You are
    right that any of the refined sugars is forbidden. Natural sugars, as
    in fruits are allowed in small quantities. Usually, there will be no
    fruits allowed for breakfast at all (this lets out your orange juice,
    any type of all-fruit spread on your toast, banana on you cereal,
    etc.).The reason for this, is that with GD, your blood sugar will be
    highest and hardest to control in the morning ("regular" diabetics have
    more problems in the evening). Basically, the more refined and procesed
    a food, the worse it is for you. With my last pregnancy, I was diet
    controlled for about 1 month, and then went to insulin. Now, believe
    me, it's not the worst thing in the world! It is hard to get used to
    the idea of sticking oneself regularly with a needle, but the insulin
    needles are super slender, and you truly don't feel them going in. The
    finger sticking to test blood is much more painful, and needs to be
    done much more often. This pregnancy, I am on insulin for 3 weeks
    already, and am just 4 months pregnant! It's a nuisance, nothing more.
    If your blood sugars are well controlled (which is the point of the
    diet, and, if necessary (let's hope it won't be!) the insulin), the
    baby will be just great! Daniel was born as healthy as a horse! He was
    big, but not as big as they thought he'd be (they though between 9.5
    and 10 lbs....he was 8 lb. 15 oz.).
    
    The trouble with going astray from you diet (I know how tempting
    something sweet can start to look!), is it directly affects the baby.
    This is basically how it works:
    
    Under normal circumstances, when you ingest sugars, your body produces
    insulin which breaks it down. So your baby gets just the right amount,
    not too much. Baby's also making it's own insulin to take care of the
    sugar it does get. Now, if you become diabetic, your insulin producing
    capabilities go a bit whacko, and you don't make it properly to break
    down the sugar. So you end up with more sugar in your blood. And this
    goes through the umbilical cord to your baby. Now the baby's little
    pancreas starts cranking out tons of insulin to take care of it all,
    and does a creditable job at it. But, just like with you and me, if
    baby "eats" too much sugar, baby gets too big. And no one wants to
    deliver a too big baby! Left totally uncontrolled it can be dangerous
    to the baby's immature metabolism, but controlled, the risk to the baby
    is absolutely minimal...almost nil. And *that* is why diet is so
    important (and insulin, too, if you need it).
    
    You will likely be advised to stay on a very low-fat diet, also, as fat
    is a very concentrated source of calories, and has a direct bearing on
    the diabetes (can't remember exactly how, though). Even milk is fairly
    high in sugar, but you will likely be encouraged to drink it for it's
    calcium value (but likely skim milk only). Fatty meats are best
    avoided, lean meats, chicken and fish are best (sounds like a lot of
    just plain good health advice, doesn't it?) Actually, a diabetic diet
    is one of the healthiest and best diets for you and your baby, even if
    you were not diabetic! You will likely be told to eat three meals and
    three snacks per day (Snacks at mid-morning, mid-afternoon, and before
    bedtime....bedtime snack usually advised to contain a protein, like
    meat or cheese). Drink lots of water. If you are overweight, they may
    restrict you calories somewhat so that you gain little or no
    weight....that's up to your doctor....it's kind of a new concept, I'm
    told (didn't do this with my pregnancy 2 years age, they are doing it
    now).
    
    Chief problem at birth is that, since the baby has been producing
    mega-doses of it's own insulin (remember, baby has no problem, just
    you), baby doesn't gear down this production too quickly due to
    immaturity of internal organs. So the baby *may* overproduce for the
    now normal amounts of sugar it gets, and it's blood sugar may drop too
    low. This would simply mean an IV with a glucose solution for the baby,
    and maybe a day or two extra in the hospital....IT IS NOT REALLY
    SERIOUS, JUST SOMETHING TO TAKE CARE OF! It never happened with Daniel,
    and my endocrinologist told me that the tighter the control we can keep
    on the sugar throughout the pregnancy, the less chance of it happening.
    I found that extemely good incentive to stick to my diet and insulin. 
    
    Take heart! This problem, once very serious, is now very treatable, and
    if controlled, not likely to incur any problems for you or baby.
    
    If you have any questions, go immediately to your doctor about them.
    And if you just want to ask me some questions, feel free to send mail
    to Dave, and he'll be sure I see it.
    
    Good luck! It's more of a nuisance and a pain in the neck, than a real
    true "problem".
    
    Wendy
    

    Hi Nancy,
    
    I can't believe your doctor couldn't give you some sort of tidbits of
    info until you see the dietician next week!  Bummer, I can't believe
    you have to wait till next week (being pregnant and all) usually these
    sort of things are taken care of almost immediately during a
    pregnancy......  your level musn't be too high otherwise my guess is
    that you'd be looked at right away.  Unfortunately, I don't have any
    diets/foods which are safe for you.  Just wanted to tell you I
    sypmathize with you on this condition and hope it only lasts short
    term.
    
    Hang in there,
    Mel :^)

    I had gestational diabetes while carrying my son and it really wasn't
    too bad until the last couple of months when I because insulin
    dependant (don't worry, it's usually controlled by diet).  My dietician
    put me on a 1800 calorie a day diet which was split up into 6 mini
    meals a day.  I was allowed to eat pasta, rice, bread, grains, fruit,
    milk, vanilla wafers, Lorna Doone cookies, beef, poultry, fish and
    quite a few other things.  The following is what my normal daily
    intake consisted of.
    
    Breakfast:
    
    english muffin w/butter or margarine
    8oz. milk
    piece of fruit (usually an apple or an orange)
    
    mid morning snack:
    
    6 vanilla wafers
    8oz. milk
    
    lunch:
    
    3oz. beef/poultry/fish
    1 slice of bread
    8oz. milk
    salad w/dressing (I was allowed 1 tablespoon)
    
    mid afternoon snack:
    
    2 Lorna Doone cookies
    8 oz. milk
    
    dinner:
    
    Same as lunch but substituting tea w/lemon or low calorie soda for the 
    milk (my dietician didn't like the fact that I was drinking the soda
    because of the nutrisweet, but I refused to give up the soda)
    
    bedtime snack:
    
    This varied alot and I usually ate what ever was left on my menu
    for the day that I didn't eat.  Usually I'd have an 8oz. glass of
    milk if I didn't have 4 glass yet that day, or I'd have 2 Lorna
    Doone cookies or 6 vanilla wafers if I hadn't eaten those yet.
    
    It's very important not to skip a meal or not to eat too much in
    one sitting.  I like jello, so I would make the diet jello and eat
    that every once in a while.  You might want to watch your nutrisweet
    intake if your OB/GYN or dietician is really dead set against it.
    I ate a lot of things with nutrisweet and I delivered a very healthy
    baby boy.  By the way, he only weighed 7lbs. 5�ozs. which is small
    for a gestationally diabetic mom.
    
    IMO the best thing to do before you see your dietician is to do
    exactly what you've been doing all along, just omit anything that
    has a lot of sugar in it (cake, cookies, candy...) and break it
    down into six small meals instead of three larger meals.  Don't worry 
    about the natural sugar in the fruits, I was allowed to eat bananas
    and oranges which contain the highest amount of natural sugar.
    
    Good luck, don't worry, and let us know how everything works out.
    
    Lori B. 
    

    Nancy,
    
    I'm sorry to hear that you're so upset.  Gestational diabetes is quite
    common, and doesn't need to have an impact on your baby if you take
    care of yourself.  I am diabetic, and have 2 very healthy boys, and my
    blood sugars were terribly out of control at first.  
    
    I think the biggest key to controlling this is to be aware of what
    you're eating.  Naturally sweet foods are okay, but that's not ALL you
    want to eat.  The reason that sugar is worse than naturally sweet foods
    is because table sugar is a very simple sugar, requires almost no
    digestion and is rapidly introduced to your blood stream.  Natural
    sugars (such as fructose, found in fruit) are more complex, take longer
    to digest, and enter your blood stream more slowly, thus giving your
    body more time to properly deal with the additional sugar.
    
    Your dietician will most likely ask you what you typically eat during
    the day, and then will try to adjust that to a diet that is in line
    with what you are 'allowed' to have.  Be conscious of things you add to
    food - ketchup is loaded with sugar, so if you can do without it,
    you're better off, creamy salad dressings usually have lots of extra
    sugar - Italian or oil and vinegar is your best bet.  'Salad Dressing'
    is a lot sweeter than 'Mayonaisse' (sp?)
    
    Big no-nos are things like candy bars, ice cream, regular soda, syrup
    and that kind of stuff.  There ARE lots of substitutes for these
    things, so you don't need to be too depressed.  There is sugarless
    almost everything, and most of it tastes pretty good (though the
    sugarless sugar-wafers are TERRIBLE!!!).  If you cheat now and then,
    you aren't going to drop dead, but as I said, you must be aware.  I
    wouldn't sit down and eat a giant Sundae, but you could squeeze by with
    a Hershey's Kiss if you were having a chocolate attack.
    
    There are lots of 'free' foods available, which are foods that you can
    eat as much as you want to of.  Mostly fresh vegetables. (Peas and corn
    are technically in the carbohydrate group - not veggies!)
    
    Keep in mind that cooked vegetables and/or fruits contain more simple
    sugars that when raw, so raw is better.  Starchy foods contain a lot of
    carbohydrates, which breakdown into simple sugar moderately fast, so
    you don't want to load up on them.  High-protein foods (meat, cheese,
    peanut butter) contain a lot of protein and take a long time to digest,
    therefore release the sugars  more slowly into your system.  So, cut
    that spaghetti in half, and eat more meatballs if you're still hungry!
    
    There's also lots of tricks.  If you like flavored yogurt, you can buy
    plain, unsweetened yogurt and add fresh fruit.  Same for cottage
    cheese.  You can use sugarless syrup instead of brown sugar,
    nutra-sweet instead of sugar (but don't cook it!!), or make your own
    popsicles out of unsweetened fruit juice or lemonade.  IF you smoke,
    you should be aware that in order to enhance the flavor, cigarettes are
    laced with sugar.  If you haven't quit already, now's a good time!!
    If you're a chocolate addict (like me!), use the powdered cocoa mix and
    add sweet-n-low instead of sugar to make the chocolate confection of
    your choice!
    
    I haven't been following this notesfile for long ... how far along are
    you??  I wouldn't be too concerned about your baby - this is something
    that happens to women ALL the time, and there's millions of babies who
    are baby's of diabetic moms (gestational or not), and are perfectly
    fine!!  If you'd like to talk about this more off-line, feel free to
    give me a call (dtn 381-0877), or send mail.
    
    Good Luck!
    Patty

    Nancy,
    
    until you see your dietician, it would be best to not eat any kind of
    cookies.....I have seen several doctors and several dieticians and
    *none* would allow *any* kind of cookie, or the ever-present angel food
    cake, which "regular" diabetics are allowed. And *never* any fruit for
    breakfast. Yours may differ, but one week of not having cookies or
    fruit for breakfast, will probably not kill you! And I'd rather see you
    safe than sorry!
    
    (No offense, Lori! Your situation may have been somehow different, or
    ideas may have changed somewhat since yours was born...don't know. But
    I know others who have been GD, who had to follow the no cookies, no
    breakfast fruit routine.)
    
    Wendy

    I hate to enter this because of Nancy's initial plee of "don't tell me
    what might happen", but I think that it's very important to point out
    that the reason that you don't want a diabetic mom to have a fat baby
    is because in the 'diabetic baby' the fat tends to deposit in the organs, 
    which can cause other problems.  Not just because you don't want to 
    deliver a 10 lb baby (which is a very good reason in of itself!).

    Thanks for taking the time to enter all of your thorough responses so
    far.  
    
    I can reply to some of the things:
    
    1)  I'm 28 1/2 weeks along
    2)  I won't eat cookies until I'm told if I can. I did, however, buy a
    bag of those Estees candies for diabetics.  I only eat about 2 a day.
    3)  I guess my Dr. figures that a few days won't be crucially
    detrimental to the baby's or my health.  
    4)  I hate Nutrasweet and won't go near anything that has it. I guess
    this is a good thing.
    
    
    My sugar levels peaked at around 178 during the test.  The good thing
    is that my fasting sugar level is normal, and the Dr. said that this is
    good also.  In his words, "your body is having a more difficult time
    handling sugar."  I asked him if the baby would be okay, and he said
    that as long as we control this, there should be no problem.  My
    problem though is that I want a different kind of answer, like "don't
    worry Nancy, everything will be fine."  I hate these "as long as" type
    things.
    
    I don't think that skipping out on sweets will be totally difficult for
    me.  The ironic thing of this is that I have always been extremely
    underweight.  I have very small bones and a fast metabolism, and
    weighed about 100 pounds (and I'm 5' 5").  I never was a sweets lover.
    
    When I got pregnant, I was concerned that I was too underweight and
    thought that gave me license to eat anything.  I've gained 31 pounds so
    far, but it's mostly in my belly (some in the butt, thighs, and chest). 
    But as far as I'm concerned, I needed and wanted this weight anyway.  I
    wouldn't mind keeping on at least 15 of these pounds afterwards.
    
    Anyway, I guess maybe I overdid it for my own particular system.  See,
    I literally gorged on foods that I thought were good for me (like lots
    of OJ, apples, oranges, pineapple juice, grapefruit juice, raisins,
    etc.)  I allowed myself to eat sweets in moderation, but now that I
    look at it, maybe it wasn't always moderate.  I had cravings for devil
    dogs and funny bones.
    
    I have been really good about not doing other things that are
    supposedly bad for you during pregnancy:  I don't smoke and will not
    even stay near anyone who is smoking.  I even turn off my vents in the
    car if I'm behind a diesel car or truck.  I don't drink (at least not
    during this pregnancy).  I've had one non-alcoholic beer the whole time
    - they contain less that .5% alcohol).  I avoid MSG.  I only eat foods
    with nitrates in moderation (i.e., ham).  I eat between 75 and 100 mgs
    of protein a day like the books say to (eggs, lean beef, fish,
    chicken).  I do, however, load on the fatty stuff (salad dressing,
    butter).
    
    My typical daily diet goes like this:
    
    Breakfast
    ---------
    12 oz. lactaid milk (I'm lactose intolerant)
    8 oz. OJ (I have the milk at 6:00 and the OJ with the food at 7:30)
    A bowl of plain oatmeal with 3 tablespoons of wheat germ (I put honey
    on this until last week, another no no I guess)
    An apple on the way to work
    
    Lunch
    -----
    Main course in the cafeteria or a sandwich (Usually tuna)
    Starch
    Veggie or Soup
    
    Dinner
    ------
    Main course (meet, chicken or fish)
    veggie
    starch (noodles, rice or potatoes)
    
    Any comments on this?  Are potatoes okay?  Why is my fasting sugar
    normal if the sugar is supposed to be worse in the morning?
    
    Thanks again for your responses.  I'm glad that you've all had healthy
    babies.  I hope I don't sound neurotic about this, but I think that I
    kind of am.  I've worried so much through this pregnancy because two
    of my friends who were also pregnant with me lost their babies at 18
    weeks and at 22 weeks (a freaky thing, I know), but I got really upset
    about it and just when I was starting to calm down, this happened.
    
    Nancy

    I forgot to add to my daily diet that besides the 12 oz. of milk at
    breakfast, I drink the remainder of a quart of milk throughout the day
    (32 oz. total, which is what the books recommend for normal
    pregnancies).  The lactaid milk is 1%  milkfat.
    
    Nancy

    Don't know why your fasting sugars are normal, but I'd say that is an
    excellent sign that you can probably maintain control through diet
    alone, at least for the majority of the pregnancy.
    
    Except for heavy on fruit sugar in the morning (which may be okay for
    you if fasting sugars are okay), it looks good. I am told to drink 4-5
    glasses of milk, so that is 32-40 oz. per day...usually only drink 4.
    Potatoes are okay, but are one of the starches which is broken down
    more easily and gets sugar into your blood quicker. Rice, pasta, bread,
    crackers, cereal, corn, tortillas, legumes, vegies, and bread are the
    recommended slow-absorbing (more complex) carbohydrates. The list of
    simpler, quicker-absorbing starches includes: all the sugars and
    desserts you already know about, fruits (worse if dried fruits or fruit
    juices), bagels, potatoes,rolls, tonato products with tomato paste, and
    milk.  This doesn't mean youcan't have 'em, just means eat them inmore
    moderation.
    
    My diet now consists of following:
    Breakfast:
    2 slices of toast very lightly buttered
    one egg (scrambled or hard-boiled, usually)
    8 oz. skim milk
    
    mid-morning:
    6 whole wheat crackers
    1/2 cup OJ
    
    lunch:
    two slices bread
    tuna with a bit of mayo *or*
    cheese *or*
    turkey or turkey ham
    lettuce
    piece of fruit (12 grapes, 1/2 banana, 1/2 c. unsweetened applesauce)
    
    mid-afternoon snack:
    8oz. milk or a glass of water
    6 wheat crackers
    slice of cheese
    
    supper:
    4 oz. meat
    1 cup starch (rice or past, usually)
    vegie, or salad with little bit of dressing
    8 oz. milk
    fruit
    
    evening snack:
    crackers and cheese *or*
    a turkey hot dog and a slice of bread *or*
    air-popped popcorn and a slice of cheese
    8 oz. milk
    
    
    I was told proteins are important at night as they take longer to
    digest and don't load up your blood as quickly.
    
    This is about a 1500-1700 calorie diet. Add more protein and carb.'s
    and one more fruit for a 2000 calorie, which is probably what you'll go
    on. If you are still seriously underweight, it may be more.
    
    Just because they had you wait till next week doesn't necesarily mean
    it isn't important or time-sensitive. It was almost 4 days before I saw
    one with last pregnancy, cause all were absolutely booked solid! He
    would have preferred I went that very day!
    
    Wendy

    
    Nancy,
    
    Just to let you know that my wife gave birth to 2 babies while she had
    Gest. Diabetes, one 12 pounds and the other 11.2 pounds. Make sure you
    have the regular Ultrasound scans to check on the size of the baby. Our
    second was delivered by C.Section due to the size, first was not and
    the birth was difficult. Also bear in mind that the baby will PROBABLY
    be but into an incubator for the first day, this is normal and nothing
    to worry about, it's just to keep things checked while the babies
    sugars normalise......
    
    Try to think of the condition as an illness , it's not a disease.
    
    BTW My wife was insulin dependant , diet could not control it......
    
    Rgds,
    
    --John
    

    re:615.10  12 pounds.  Oh my god. I shudder at the thought.  I wouldn't
    be able to have a normal delivery with that anyways. Even before I
    found out about the diabetes, my Dr. said that my pelvic width was
    average and that as long as the baby didn't weigh over 9 lbs, that I
    could have a regular delivery.  So 12 would be out of the question.
    
    I trust my Dr. very much and he is very thorough.  I'm sure that he'll
    do the ultrasounds if he thinks they are necessary.  He will be
    checking my blood at every visit.  I tend to think that since my
    fasting sugars are okay, that I won't have to go on insulin and should
    be able to control this by diet.  Let's hope.
    
    By the way Wendy, thanks for all of the information you've given me.  I
    tried to eat sensibly this weekend according to what everyone has told
    me so far.  I didn't have my OJ until the afternoon, and I ate lots of
    protein.  I had the hardest time on Saturday.  It was my birthday and I
    couldn't have any cake.  Of course, my husband and everyone else with
    whom we went to dinner didn't order any dessert so they wouldn't
    torture me, but that seemed to be the only thing I could think of.
    
    By the way, I think I know what the noter who mentioned the cookies was
    talking about.  Estee makes vanilla wafers for diabetics.  Of course,
    I'm not so sure about the Lorna Doones, but I would think that the
    Estee cookies would be allowed occasionally.
    
    Oh  by the way, where do Apples fall in the sugar/carbohydrate area? 
    Are they better than citrus fruits?
    
    Thanks.
    
    Nancy

    I'm sure that your birthday was tough...no birthday cake! Somehow,
    fruit just doesn't cut it on your birthday....
    
    Apples are slightly better than oranges as far as sugar, but apple
    juice is higher than orange juice! 
    
    You will almost certainly have several ultrasounds near the end. With
    Daniel, I ended up having a total of 8, and that began at 31 weeks.
    With this one, I expect more. Daniel only weighed 8 lbs. 15 oz, which
    is not out of line for me (my first was one month early and 7 lbs. 2
    oz., and the second, boen on my due date, was 8 lbs. even), considering
    the diabetes. BTW, don't panic if ultrasounds tell you the baby is
    bigger. They told me with my last ultrasound that he would be nearly 10
    lbs.! I'm thankful they were wrong. I was induces one week early, to
    keep him from getting any bigger, not because he was in any kind of
    danger. My dr. said to expect to be induced one to two weeks early this
    time, depending on the baby's growth and size. They may also do some
    non-stress tests near the end (I had two per week) to make certain baby
    is still doing fine.
    
    BTW, they do say to "count" on the baby spending some incubator time,
    because of the hypoglycemia problems that can come up (I mentioned this
    in a previous reply). Daniel did not have to go into one at all. He was
    also born with meconium staining, so considering all the potential
    problems, we felt particularly blessed that he was as healthy as he
    was! (Actually, the meconium stain was a *far* more potentially serious
    problem than the diabetes, as it could lead to pneumonia, which can be
    *very* serious....the diabetes coudl hav ecaused the baby to have low
    blood sugar, which is not particularly serious, and which is readily
    treatable). I had developed toxemia with my second pregnancy, and my
    doctor told me that that was a whole lot more dangerous and serious to
    both mom and baby than diabetes is (when detected and controlled, which
    is the case with yours).
    
    It's truly not as awful as you might think, andyour baby will be fine.
    My doctor told me that a properly controlled diabetic has as much
    chance of delivering a healthy baby, as any other "normal" pregnancy.
    The key is in controlling and not cheating (if you can pass up your
    birthday cake, you can handle anything!)
    
    Here's hoping the next 12 weeks will fly by for you!
    
    Wendy

    Re: .12.  Good, I don't like apple juice.  But I do eat an apple every
    day.
    
    I don't know if I mentioned this already, but I told my husband that as
    soon as the baby is born, I'm having a beer and a funny bone.  
    
    I spoke with someone from my office today who had GD with both her
    kids.  In her situation, they actually ended up making her eat fats
    because she lost a lot of weight.  In fact, she had a -2 pound weight
    gain with her first pregnancy, and both her kids were either in the 7
    or 8 pound weight range.  They even told her to have milkshakes.  
    She was insulin dependent.  By the way,
    whoever forwarded my basenote to her, thanks.
    
    I can't wait to see what my diet will be like and how many calories
    they'll let me have.  Maybe I'll be lucky and they'll prescribe
    milkshakes for me too.
    
    I'll let you all know what the dietician says.  By the way, I was
    thinking that it might be a good idea to start a note on recipes or
    interesting meals for people with GD.  Of course, I don't have any yet,
    but maybe someone who knows a good, low fat way to prepare some type of
    meat dish could start a new note.  I would think that eating plain old
    broiled meat 7 times a week would be totally boring.  
    
    Nancy  

    Oh, and thanks for the birthday wishes Wendy.
    
    NT

    Nancy, happy birthday from me too.
    
    I had "abnormal" blood sugar readings with my last pregnancy -- no
    spikes from eating sugar, but dropping off too low.  It wasn't
    abnormal enough to count as gestationally diabetic.  To be on the
    safe side, they put me on the modified GD diet, to make sure my
    blood sugar stayed under control.  I had no problems the rest of
    the way.  Since I wasn't actually diabetic, some of what they
    advised for me might not apply to you.
    
    I had to eat 3 meals, 2 snacks, and a bedtime snack of protein and
    complex carbohydrates (usually a peanut butter sandwich) that was
    bigger than the lunches I'm used to having.  The diet was
    specified in terms of standard servings of protien, carbohydrate,
    dairy product, etc.  It called for more calories than I had been
    consuming, yet oddly enough I gained weight less quickly and at a
    much more steady pace on this diet. 
    
    Rather than telling me all the things I couldn't eat, it
    emphasized the things I should be eating (like whole grain
    cereals, lots of raw veggies, etc. ).  Which helped
    psychologically if not medically.
    
    I won't go into more detail since I didn't actually develop GD and
    my experience is probably only of peripheral interst.   Please
    feel free to send me mail if you have questions I could answer.
    
    --bonnie

    Nancy, 
    	My son Shayne (15 months) is diabetic, since he is starting to eat 
    table foods I have gotten several good cookbooks on diabetic cooking at
    our local bookstore.  
    	I'd be more than happy to share some of the recipes, so far the
    chocolate cake and banana bread seem to be the favorites.  I have books
    for every course of a meal.  
        I'm sure it's hard dealing with the diabetes now, just remember
    though, the hardest part is the unknown and be thankful that you will 
    probably return to a "normal" life after your pregnancy and this will 
    not be a permanent part of your lifestyle. 
    
    Malinda

    BTW, Happy Birthday, Nancy....
    Have you checked the cooking conference? I haven't been in it for a
    long time, but I seem to remember some recipes for diabetics there. 
    Its TURRIS::COOKS unless its changed lately.
    
    I'm having my gloucose tolerance on Friday... I'm starting to
    really wonder what the outcome will be....(will I get a migraine from
    the test? will I turn out to have GD? maybe the opposite?.....)
    
    Monica

    Re: .17
    
    COOKS is now at PAGODA::COOKS.
    
    		Steve

    Monica, I had a headache (not a migraine) with the first glucose
    tolerance test.  I felt fine with the 3 hour test.  Go figure.
    
    Last night my husband and I went to our Care of the Newborn class at
    Winchester Hospital.  The woman who teaches it is a labor and delivery
    room nurse.  I asked her if they always put babies born to GD mothers
    in incubators and she told me something interesting.  She said that
    they put absolutely every newborn baby in an incubator.  The only thing
    they do differently with the GD babies is a blood sugar test.  If their
    sugar is low, they feed them a bottle of sugar water.  She told me not
    to worry also.  She said that now that the testing for GD has become
    routine (I guess this is fairly recent), a lot of pregnant women have
    it.  She said there were probably thousands of women who had it during
    their pregnancies and never knew because they weren't tested.  
    She said the risk is extremely minimal and more likely applies to
    women who have diabetes prior to pregnancy whose systems may already be
    compromised.
    
    To Shayne's Mom (I'm sorry, only two notes ago and I forgot your name),
    I would love that chocolate cake recipe.  Maybe you can post it in this
    note at your convenience for everyone to have.
    
    By the way, I bought a bottle of Estee Italian Salad Dressing and tried
    it last night.  It's actually good.  One serving = free food exchange. 
    It's 2 calories per serving, contains fructose, and doesn't have any
    oil.  My husband and I decided we'll use this even after the baby is
    born.  They had other flavors too.
    
    Later.
    
    Nancy

    Okay.  I got my diet.  It's not that bad, although the portions are
    somewhat skimpy compared to what I'm used to eating.  And I have to be
    sure to eat my meals/snacks around the same time each day.
    
    By the way, Lorna Doones, vanilla wafers, graham crackers and a whole
    slew of other goodies are okay for me.  I get to have them at snacktime
    as my starch.  I have a chart that says how many I can have that would
    be equivalent to 80 calories and 1 starch.  The chart comes from the
    American Diabetes Association, so it's not negligence on my dietician's
    part or anything.
    
    I can also have 4 oz. of OJ in the morning, a midmorning piece of
    fruit, and afternoon piece of fruit, and an evening snack piece of
    fruit.  Each of these fruits is accompanied by a starch and a protein,
    like milk.
    
    My caloric intake is 2000 per day.
    
    It seems that everyone's diets are really tailored individually.  
    Let's hope this works.  11 weeks and counting....
    
    Thanks to all who responded to me.  While I don't wish any
    disease/illness on anyone, it's comforting to know that I'm not alone.
    
    Nancy

    Nancy,
    
    I'm glad to see that you listed your "diet".  I felt kinda put down
    when I listed what I was able to eat and got a lot of negative
    responses.  Your diet is very similar to what I was allowed (as
    I stated).  Another plus is that you'll probably gain little to
    no weight for the remainder of your pregnancy.  I had gained a total
    of 16 lbs. before they diagnosed my diabetes and I only gained 2
    more lbs. during the remainder.  The doctor said what was happening
    was the baby was gaining and I was loosing so the two were cancelling
    out each other.
    
    Good luck, it's really not that bad and it'll be over before you
    know it!
    
    Lori B.

    Re: -1
    
    Lori, 
    	In response to your feeling put down in some of the responses after
    you listed your diet, I may be way off, but I'm not sure everyone 
    understands diabetes.  When I first found out Shayne had diabetes, I 
    thought that meant he could NEVER have anything with sugar in it. 
    After many hours of diabetes education I have found that it is not so,
    you will find this out in the following note where I am including a 
    recipe.  Sugar intake is a concern and diabetics must watch it but it
    is not taboo.
    
    FWIW, 
    Malinda
    

    Nancy, 
    	Sorry it's taken so long to get this recipe in here, but I've been
    real busy.  The recipes in this book are for a Low-Fat,
    Low-Sugar,Low-Cholesterol,Low-Salt,High-fiber diet.
    
    	Printed from "The New Diabetic Cookbook by Mabel Cavaiani, R.D."
    without permission. 
    
    		WACKY CUPCAKES
    					Yields 12 cupcakes-12 servings
    
    1 1/2 cups cake flour
    1/4 cup sugar
    1/4 cup cocoa
    1 teaspoon baking soda
    1/2 teaspoon salt
    1 cup water at room temperature
    Liquid sugar substitute equal to 1/2 cup sugar
    1 tablespoon vinegar
    2 teaspoons vanilla
    1/2 cup vegetable oil
    
    	Place flour,sugar,cocoa,soda, and salt in mixer bowl and mix at low
    speed to blend. 
    	Beat together remaining ingredients with a fork to blend.  Add all
    at once to dry ingredients and beat at medium speed until smooth. 
    Paper-line 12 muffin tins or grease with margarine and flour.  Fill
    muffin tins about 1/2 full and bake at 350 degrees for about 30
    minutes, or until a cake tester comes out clean from the center of the 
    cupcake.  Serve 1 cupcake per serving. 
    
    Nutritive values per serving:	
    
    Calories (CAL)  Carbohydrates (CHO) Protein (PRO)   Fat	Sodium (NA)
    158		    17 (gm)             2 (gm)          10 (gm)	188 (mg)
    
    Food exchanges per serving:	1 bread, 2 fat
    Low-sodium diets:		Omit salt.	
    
    
    			FLUFFY FROSTING
    
    				Yields about 3 cups frosting-16 servings
    
    1/2 cup sugar
    2 tablespoons water
    2 packets Sweet'N low
    2 large egg whites
    1/4 teaspoon cream of tartar
    1/2 teaspoon vanilla
    
    	Combine sugar, water, Sweet'N Low, egg whites, and cream of tartar
    in top of a double boiler and beat at high speed for 1 minute.  Set
    over simmering water in the bottom of the double boiler.  Continue to
    beat at high speed for 4-5 minutes or until soft peaks form.  Remove
    from heat. 
    	Add vanilla to frosting and continue beating at high speed 1-2
    minutes or until thick enough to spread on a cooled cake. Use about
    2 1/2 tablespoons per portion if frosting individually; or use this
    amount to frost a 2-layer cake or a 9-inch square cake, both of which
    would then be cut into 16 equal servings. 
    
    Nutritive values per serving:
    
    CAL		CHO		PRO		Fat		Na
    23		6 (gm)		negl. (gm)	negl (gm)	negl. (mg)
    
    Food exhange values per serving:
    	1 vegetable (1-1 1/2 tablespoons may be used as a topping for cake
    or pudding without counting it as an exchange)
    
    Low-sodium diets:	May be used as written.  

    Thanks Malinda for the cupcake and frosting recipes.  I'm going to
    treat myself one of these nights soon.
    
    Nancy

    Nancy,
    Glad you finally got your diet and its one that's so easy to live with
    9relatively speaking!).
    
    Lori,
    If I am the one who made youfeel put down, I do apologize, but I
    suspect you misunderstood me (probably my fault!). I have known several
    others who were Gd, and none were allowed sugar at all, and my diet is
    incredibly restricted. I just felt it would probably be easiest and
    best for Nancy, if she followed a very restricted diet at first, before
    she saw her dietician. It's almost always easier to relax the diet than
    to make it more strict! I never doubted that you were on a "real" GD
    diet, or ever meant to question your accuracy or your dietician or
    physicians advice on diet. If it came across that way...again, I
    apologize!
    
    As a GD, I was put (even last time, and it was much less severe then)
    on a *very* restricted diet. I was given a preprinted list of food
    exchanges, and the dietician vehemently crossed out stuff like vanilla
    wafers, angel food cake, ketchup, etc. I am allowed absolutely
    *nothing* with added sugar (includes corn syrup, fructose, etc.). Only
    sugar I can have is that which is naturally occurring, as in fruit or
    milk. And this is severely limited. But....they want to keep a much
    tighter rein on GD sugar levels, as they affect the baby so very much.
    I am not allowed to go over 140 glucose count *ever* and not over 90
    fasting in the morning. This is *extremely* tight control, much tighter
    than a "regular" diabetic. But my levels were alarmingly high, and got
    that way quickly. My endocrinologist said that if we hadn't had
    evidence of normal glucose levels at my 6 wks gestation visit, he would
    have thought I had been diabetic all along, before I was pregnant,
    that's how bad it was. And this was by 12 weeks gest.
    In my last pregnancy, the most insulin I ever took was 34 units of NPH
    at night. Now, at less than 20 weeks, I am already on 55 units a night,
    and he is certain I will be on morning and possibly afternoon insulin
    by the time I deliver. So it is very serious this time, and they want
    to keep ultra-strict control so as to affect the baby the least
    possible.
    
    So, while those recipes sound terrific, for me they are out of the
    question, at least right now. Now if they can just get my calories
    adjustd so I stop losing weight (lost 4.5 pounds in the first two weeks
    on diet and insulin), then we'll be doing great! Baby is growing and
    kicking up a storm.....now if June would just hurry up and get
    here.....
    
    Wendy

    I went for my 28 week checkup today, and my morning urine sample 
    indicated that my sugar was high.  They had me do another sample
    while I was there, and it still showed high.  I was then "pricked" 
    in the finger and they said my blood level was 120 (?).  My doctor
    wasn't worried.
    
    What I'm wondering is, are there any signs I should watch for??  
    It kind of makes me nervous that my urine showed up high, and I 
    wont be seeing my doctor for another month.  
    
    Any input would be appreciated.
    
    - Janice

    According to my wife, she never had any "symptoms". If she hadn't been
    tested she'd never have known!
    
    How long after you ate breakfast was the 120 blood reading? If it was
    within 2 hrs or so, that reading is perfectly fine (actually within 2
    hrs or so of any meal...your note made it sound sort of like you went
    in the morning). If your doctor isn't worried, and you are, why not
    call him and talk about it?
    
    --dave--

    Assuming that GD and diabetes shows the same in symptoms (and it should
    cuz diabetes is diabetes...), here are the major symptoms;
    
    o Increased thirst and Urination
    o Weakness, abdominal pains, generalized aches
    o loss of appetite, nausea and vomiting
    o heavy labored breathing
    o rapid weight loss
    o dizziness/confusion
    
    These symptoms show differently, depending on HOW bad off you are. 
    When I was finally diagnosed as being diabetic (after walking aroung
    like that for about 6 mos cuz I was afraid to go to the dr. )-: ), my
    body had been so bad for so long, that rather than having no appetite,
    I had an insatiable appetite because I was essentially starving to
    death.  A little insulin, some education, and I was fixed up in a
    couple of weeks.  
    
    The biggest thing that I noticed was when I lost ~10 lbs (and I was 18
    and SKINNNY as it was), and about 1/2 hour after I'd have a drink w/
    sugar in it (tea, soda), I'd be 10 times thirstier than I was before.
    And anytime after I ate I felt nauseaous. 
    Unfortunately, you feel a lot like this during a normal pregnancy,
    which may be why some didn't notice/have any symptoms.
    
    Also .... Wendy, I don't know if they told you, but while you're
    pregnant, your hormones (or it might be the placenta - I forget now)
    interfere with the absorption of insulin, so you can probably expect
    your insulin requirements to continue to increase throughout your
    pregnancy.  If you're still losing weight, it sounds like they don't
    have your insulin high enough .... they'll get it!!  Be aware (cuz they
    never told me till it was almost too late!) that if for some reason,
    particularly later in your pregnancy, your blood sugars should drop
    suddenly, there is reason to be concerned.  If you notice you're having
    lots of reactions one day, or that your BS is unusually low (by lots),
    CALL YOUR DOCTOR ASAP!!  
    
    Patty
    
    

    re: .28
    
    Gestational diabetes can injure the fetus long before it produces
    any symptoms.  That's why the testing during pregnancy is becoming
    routine for women feeling perfectly normal and healthy.
    
    I don't know whether women with more advanced or severe cases have
    more symptoms.  I didn't notice anything -- but then when you're
    in the bathroom every hour from the pregnancy, it's a little hard
    to tell whether you're urinating too often. 
    
    --bonnie

    Wendy had absolutely no symptoms either pregnancy and was told that
    that is the norm with *gestational* diabetes. They told her it was
    likely that there are no symptoms because they catch it when the
    diabetes is still in initial stages. They "allow" much higher sugars in
    a reg. diabetic than in a GD, and it is the excess sugar that causes
    the symptoms. She was told that the only time GD experience symptoms
    (usually) is either they were unknowingly diabetic before they became
    pregnant, or if it goes undetected and unchecked during the pregnancy.
    
    Yes, she was told that basically, unlike reg. diabetes, her body still
    produces insulin just as it always did. They are not sure (still
    researching it) if its the insulin that is subtly altered so as to be
    largely inaffective, or if its the absorption of the insulin which is
    affected, or a little of both. So it actually does differ from reg.
    diabetes. Also the notable fact that in reg. diabetes, the most
    difficult time to control BS is late in the day (usually), and with GD
    it is reversed, and the most difficult time to control is fasting in
    morning. Last word she got was "I don't know why, and no one else seems
    to either!".
    
    No, they do not have her insulin high enough yet, but are raising it
    slowly and cautiously. The tough part here seems to be getting her
    fasting sugars routinely below 90. Seems to hit and stick there no
    matter how much they up the insulin.She is currently on 55 units a nite
    (NPH, which has greatest effect about starting about 10 hrs after you
    take it). The wieght loss is being attributed to the curtailed
    calories, by the endocrinologist. Bacause she is overweight, he cut her
    from the standard 2000 cal. GD diet to 1500, which is apparently too
    low for her body. They are upping it gradually.
    
    She is also having more difficulty controlling the breakfast
    post-prandials (BS measured one hour after you begin the meal) They
    should be below 140, and they had hovered right around there, and them
    jumped to 150's. Her dr. hopes that by lowering the fasting he can
    cover some of that. But concedes that morning insulin is just a matter
    of time, and will probably be within 2 weeks.
    
    We do know insulin needs will increase as pregnancy progresses. But
    exactly what is the danger in rapidly dropping BS's? I mean, more
    precisely, what danger does it signify? She will ask at next appt., but
    what were you told? She has heard nothing of this.
    
    --dave-- 

    What happened to me was one day my blood sugars were INCREDIBLY low ALL
    day.  The placenta (I'm pretty sure that's it) normally interferes with
    effective absorption of insulin.  What had happened was that the
    placenta was on a rapid deterioration course, thus no longer inhibiting
    the absorption of my insulin, thus lowering my blood sugars
    dramatically.  They delivered the baby that night, and sent the
    placenta to the lab.
    
    When it came back, the OB said if we'd waited 1 more day, the baby
    would have died.
    
    Also, the other danger is to the mother because you have TONS of extra
    insulin floating around all of a sudden, and if you can't keep up with
    the reactions, it could be fatal. (Meant to caution, not scare!)
    
    Also, I suspect that the reason that you are seeing the different
    'difficult' blood sugar times between GD diabetes, and regular
    diabetes is because regular diabetics start with a morning shot, and
    add an evening shot, if necessary.  It sounds like GD does it opposite,
    so you would expect difficult BS at opposite times.
    
    GD doesn't sound that different than 'type II' diabetes, in that in
    type II you don't produce enough insulin.  The disease is the same -
    you don't have enough insulin to meet the amount of food intake.
    
    Finally .... I don't think it's that they 'allow' higher BS for
    diabetics than GD, but it's more that when you're pregnant, your BS is
    lower than normal (in a non-diabetic), and no one ever bothers to tell
    a 'regular' diabetic that they need to be shooting for much lower BS.
    At least that was true for my 2 ....!
    
    Good Luck!

Gestational diabetes and the other forms of diabetes are similar in that
they involve imbalances between insulin and blood sugar, but my OB 
stressed quite strongly that they are NOT the same disease -- and warned
me against making analogies from diabetic women who are pregnant.  The
risks and treatments are similar, but not identical.  I didn't follow 
up with questions because I never fell over the border into GD.    

As dave points out in .30, research is unclear about whether a pregnant
woman with gestational diabetes is producing insulin that doesn't work, 
or whether the overload prevents her from using it efficiently, but in
most cases she is producing what should be enough insulin for her needs.   
Some doctors think all women with gestational diabetes should be treated
as if they were diabetic, with very strict blood sugar monitoring for the
kind of late pregnancy problems Patty talks about in .31, while others 
think that controlled diet and periodic monitoring are adequate for all 
but severe cases.

--bonnie

    The dr. who took care of Wendy for our last pregnancy (her first with
    GD) has transferred her to an ob/gyn (he is a family practitioner)
    because her GD is so severe. She saw the ob monday. He says he wants to
    treat it as regular diabetes...as if she'd had it before becoming
    pregnant (which, according to early blood tests, she did not). This
    brings many things into action. She has to have an EKG for herself, and
    do a 24 hr. urine collection to test for possible toxemia (more common
    in diabetic preg.'s). Then an eye exam to check for diabetic
    retinopathy (eye changes as a result of being diabetic). Then
    *frequent* non-stress tests for the baby, and regular bio profiles
    (specific type of ultrasound). Also an EKg of the baby, as congenital
    heart problems are not uncommon in reg. diabetic preg.'s (which he is
    classifying her as now....*not* a problem in "normal" gest. diabetes).
    If there is any indication of heart problems, then delivery will be in
    Boston not Worcester, so that immediate open heart surgery can be done
    on baby if necessary. Sugars still not under control, and up to 65
    units NPH at nite. Post-prandials getting higher. And 4 mos. to go.
    This is getting scary, actually. They are now talking inducing her at
    the end of May or a bit earlier (due date is 16 June), to prevent baby
    from getting huge, and to cut the risks somewhat, as the farther into
    the pregnancy she goes, the more difficult it will be to contol
    everything. He told her she'd be good and sick of seeing him and that
    office by the time the baby was born, and we believe it!
    
    So, we take it one day (or one appt., as the case seems to be) at a
    time.  At this point, diet control is even more important, so it gets
    tougher and tougher. This has definietly convinced us (even more so
    than we were!) that this will be our last!
    
    --dave--

    Dave,
    
    	I have mixed emotions about what you write .... I'm sorry to hear
    that you are going through all of this, but am actually relieved to
    hear that she will be getting the treatment and attention that is
    necessary.  There are several things that you can do besides just sit
    and wait.  For example, at 5 mos preg., they can do a 'more complex'
    ultrasound and actually look at the baby's heart to be sure that it is
    fully formed and appears functional.  We had this done with Jason
    because my blood sugar was so bad when he was conceived.  Just a
    regular ultra-sound as far as the experience goes - TONS of information
    available though!  It cannot detect such things as if the blood is
    flowing backwards through the heart, but can detect any major
    abnormalities that would demand immediate surgery.
    
    As far as delivering early, I thought of that as a benefit!!  The only
    real downside to this is that baby's that are premature take a couple
    of years to catch up to full-term babies in development.  They might
    walk/talk/toilet trained a little later, but after a few years, the
    affects are negligible.  I don't know the reason for this.
    
    At about 6 mos I started weekly visits with non-stress tests.  It's
    just a hassle.  It does end up being a comfort to hear your baby's
    heart beat and listen to them move around.  I will caution you to make
    sure that your wife always see the same Dr., especially if any
    condition(s) should develop that her Dr. is currently monitoring.
    When I was pregnant with Jason his heart would occassionally stop,
    which showed most notably during the non-stress tests.  My Dr said was not
    unheard of, so not to worry.  One time I had a different Dr., and he
    ***COMPLETELY*** freaked out over this.  It didn't matter to him that
    we went through this every week, he was completely convinced that my
    baby was dying (and that's what he said!), and _DEMANDED_ that I go to
    the hospital and have a stress test done.  He got me scared enough that
    I believed him, and that was one of the worst things I've been through.
    Basically, they start an IV with a small amount of Pitocin (sp?) until
    you have minor contractions, and then they monitor how the baby reacts.
    He was quite fun, and my Dr. was quite upset when she found out after
    wards.  There is also a new school of thought on the stress test that
    contractions can be induced through nipple-stimulation (save you from
    the I.V.!!)  It may be worth a try if it needs to be done.
    
    As far as the Insulin .... I was taking 2-4 shots per day, and is
    probably what will end up helping Wendy get under control.  I can't
    imagine having to struggle through it with 1 shot a day.  If the Dr
    doesn't suggest that, you might want to ask.
    
    If you are interested in finding out more information, Joslin Diabetes
    Foundations has open-classrooms every day, that are free.  You can call
    them for details.  Every day is a different subject, and the classes
    are quite full of very valuable information.  I know they do them in
    the Boston clinic, not sure about Framingham (but I would imagine they
    do)  One day they may cover what you should do if you're sick, another
    how to eat in restaurants, another what's coming up in the future etc
    etc.  I can't recommend the classes enough!!
    
    Try not to be scared - but be concerned (I know, easier said than
    done!).  I've been there twice and have 2 healthy boys.  It's a pain in
    the butt, but you can make it through!!  
    
    Finally .... 
    
    >At this point, diet control is even more important
    
    Yes, it's important, but if you can get those extra shots, and get
    exercise, you can lighten up a little on the diet (since the 3 will
    then be working together), and she may not feel like such a prisoner to
    diabetes.  If you want to talk, or have any questions, feel free to
    call or send mail.
    
    Patty
    DTN 381-0877

    Patty an others,
    
    Well, here's how it goes....
    Wendy had the fetal echocardiogram (a spohisticated ultrasound showing
    the heart very clearly) and everything they could see lookd just fine.
    She's had her vision tested (fine) and her heart checked (fine), so
    most major worries are out of the way.
    
    The doctor told her that between 24 - 28 weeks was a critical time, and
    the blood sugar often skyrockets out of control very suddenly then.
    Precisely at 26 weeks, it did just that. Not so much the fasting sugars
    (she is up to 70 u. NPH at bedtime), but the after meal ones. So she is
    now on insulin 4X daily, before meals and at beditmes. That immediately
    brought the lunch and supper ones down, but the  breakfst one is a bit
    more stubborn. He had initially dropped her nightime NPH, because she
    was getting these awesome drops in blood sugar just before lunch
    (dropping down into low 50's). But that didn't helpthe fasting sugars
    so she's back up to 70, just has to take it at 8 p.m. instead of 10
    p.m..  Still too soon to see how that's working. Today was the first
    day of it, and her sugar was till high this morning and after
    breakfast.
    
    She hasn't been feeling great...kind of weak and lightheaded a lot of
    the time, even when she knows her sugar isn't low (having just checked
    it). Her OB feels this may be low blood pressure, as hers has been
    running about 110/60 at office visits. Better, I supose, than high
    blood pressure, but difficult for her with taking care of three little
    ones all day. Ob visits are still bi-wekkly, and she has another
    "regular" ultrasound this coming Wednesday. She was "warned" by the OB
    that the last trimester (which officially begins tomorrow) will bring
    much more frequent testing, both non-stress tests and ultrasounds.
    Early delivery is strictly dependant on the baby's health and size.
    Her major concern now is that the baby is breech. It was at last
    ultrasound, and she feels sure it still is...all the kickking and
    movement is very low, and it just (according to her) *feels* so much
    different form any of the other three who were all head down by this
    point. Hopefully this little one will turn before delivery, but she is
    resigned to accepting a C-section if he/she dows not.
    
    We'll keep everyone posted, as things get more fun here!
    
    --dave--

    I had GD when I was pregnant with Chase (3 years ago), and had to take
    insulin to control it.  I'm 22 weeks pregnant, and my doctor hasn't
    given me the glucose tolerance test yet at all!  I asked at the
    beginning of my pregnancy, and he said I wouldn't be tested for it
    until week 28 of the pregnancy because he said that before week 28 it
    wouldn't be harmful to the baby!
    
    When I was diagnosed with GD last time, I went to an Internist that my
    OB recommended.  Should I call the Internist and ask him if I should be
    screened?
    
    I just accepted what my OB said, until I started reading these
    responses.  It appears that some of you have been treating GD for
    several weeks prior to week 28.  Is it that your OB's detected it
    through the normal monthly urine test?
    
    Sorry for all the questions, but I'm starting to worry that I just may
    have it again, and am not being treated.
    
    Please tell me not to worry, otherwise, I'll get my doc to test me
    sooner!
    
    Dale

    Dale,
    
    	If you were before, you probably are again .... I'd insist on being
    tested - for the sake of your baby!!  It may be a pain in the butt, but
    it's worth it!  Does your Dr know that you had it before??  Don't count
    on anyone else relaying that message, or that it's even in your charts
    (unless it's the same Dr.).  ASK AGAIN!!
    
    Dave,
    
    	I've been meaning to send mail .... Glad to hear that Wendy is at
    least having slightly better luck with her GD ... I know what a
    struggle it can be!!  Does the great news of the ultrasound mean she
    won't have to deliver in Boston?  I hope so!  At least that's a big
    relief!!  The NPH insulin that should probably be adjusted for her
    high sugars is the shot that is taken 12 hours previous to the high
    sugars - but that's up to the Dr. of course!!  The one 12 hours
    previous is the insulin that would be peaking at that time.  You didn't
    mention if she's taking Regular insulin yet or not - it's curious to me
    how differently they seem to be acting towards this then they were with
    me - but I guess all Drs are different!  Good luck to you and Wendy -
    and tell Wendy to keep her chin up - at least she won't have to be poking
    herself FOREVER!! (though it probably seems that way now .... )
    
    Patty
    

    Patty,
    
    I have the same doctor that I had last time.  When he confirmed that I
    was pregnant, I immediately asked what would be done to check on the GD
    possibility.  He said that I would be checked for it around week 28. 
    When I asked "Why wait so long?", he replied "Because it's not dangerous to the
    fetus before the 28th week."
    
    Since some of these noters have been tested and are being treated before
    week 28, I'm getting more and more aprehensive.  Again, is it possible
    that sugar is screened with the monthly urine test, and that because
    it's "normal" I'm not being asked to take the glucose-tolerance test
    early?
    
    Dale

    I've asked this once before, but never got a clear answer.  Does any
    one here know the answer to this:  Are women who have diabetes
    genetically in their family more prone to gestational diabetes?  
    
    As you may know, my oldest sister is insulin-dependent and has a
    rather severe case of diabetes.  My youngest sister just had her second
    child, and she did develop gestational diabetes.  I'm just wondering if
    the fact that it is in the family makes you statistically more prone to
    the gestational type.  It would make sense that that is the case, but
    then again, gestational and genetic diabetes could be very different...

    Dale,
    
    	I would guess that since your urine sugars are coming back normal
    (sorry I must've missed that before), that that is why he's not
    concerned.  If you think it's just a coincidence that they're coming
    back normal you could sort of 'force' them to be high if they were ever
    going to be high by eating something real sweet a few hours before your
    next appt.
    
    re: .39  There is currently no conclusive proof that diabetes is
    hereditary, but it doesn run in families (you figure out the
    difference!).  The male tends to carry/pass on diabetes stronger than
    females do, and it tends to skip a generation.  Whether you develop
    insulin-dependant or non-insulin dependant does not seem to be
    'predictable' at all. 
    
    It IS known that (I think it's about 80%) women who develop gestational
    diabetes develop non-gestational diabetes later in life.  At least you
    get a little warning.  Given that your sister has diabetes, and another
    had GD, it APPEARS that your family is genetically prone towards it
    (does a grandparent on your dad's side have it?), and yes, it would be
    a concern - or at least something to look for - if you were to get
    pregnant.
    
    I keep reading in here that GD and Diabetes are not related and are
    completely different.  I don't believe it for a minute.  While it's
    true that some cause of GD may be from hormone imbalances or insulin
    absorption inefficiencies because of the pregnancies, MOST of the
    problem still remains that MOST of the women who develop GD are
    developing it because of the increase in their body mass, and the
    inability of their body to produce a sufficient amount of insulin to
    deal with the extra mass that requires it.  The same reason that
    overweight individuals are more prone - the same reason that LOSING
    weight can actually 'reverse' the condition in overweight people.  And
    in keeping in mind the large percentage of GD women who later develop
    diabetes 'for real', it all makes too much sense to keep brushing
    aside.
    
    So anyway, I'm not a Dr., but I've been diabetic for 10 years, and
    through all my experience and training and reading and Drs and
    research, I'd say that Yes, GD and diabetes can usually be genetically
    linked to a relative whose passed it on.  You'll never convince me that
    they're NOT the same - the biggest difference is the circumstances that
    surfaced the condition.
    
    But don't be worried about it .... it's just a nuisance, and how bad it
    is depends on how seriously you take care of it and yourself.  The
    hardest part is learning to accept that part of you is 'busted' -
    Forever.
    
    patty

    Patty,
    They are and "are not" the same. Same because both are basically an
    inability in the body to produce the insulin needed to cope with sugar
    in the blood. Different because GD goes away when the pregnancy is
    over, the sugar tends to be at peak at different times of day (Gd peaks
    in morning, reg. peaks at nite/evening).
    The statistic I have read and Wendy has been quoted, is that 60% of GD
    go on to develop reg. diabetes later in life. Losing weight, or
    maintaining an ideal body weight, reduces that percentage. There dows
    definitely appear to be a familial link. They do not say "hereditary",
    because no definite genetic marker or link has been dixcovered, but it
    absolutely and undeniably runs in families. Never heard anything about
    whether having regular diabeties in the family predisposes one to GD,
    but I wouldn't be in the least surprised if it does.
    
    Wendy is on NPH (the 12 hr. one) at 8 pm, and regular before each meal.
    Her endocrinologist is now satisfied that she will remain fairly stble
    for the rest of the preganancy, and it is fairly well controlled right
    now. Yes, the good cardiac results mean we will deliver in Worcester,
    not Boston! (yeah! that is something we were all thrilled to hear!)
    
    
    Dale,
    Don't know how you stand on the testing now, since you must be nearly
    (if not already) 24 weeks now. They tested Wendy at 12 weeks, and it
    was positive then. She was originally told they would first test at
    20-22 weeks, but then told current thinking has it to test at 12-15
    weeks initially. If that one is negative, they retest of 20-22, and a
    negative there results in retesting at 28 weeks (where it would
    normally be tested for the first time in a not-at-risk pregnancy. I
    have no idea why you weren't tested yet....I'd be worred, too, frankly.
    Wendy was told that the risk of subsequent pregnancies being Gd after
    you've had one Gd is between 30% - 90%....the 30% being if you were
    diet controlled and not insulin dependent, and the 90% being if you
    were insulin dependent! It definitely affects the baby long before 28
    weeks, if you hav eit before 28 weeks. The baby is getting all that
    sugar for all that time, and gets *big* (harder to deliver), and it can
    cause congenital problems if it is severe very early (as Wendy's was).
    keep in mind, she was not diagnosed with her last pregnancy until 28
    weeks, at the routine test, was diet controlled alone until 34 weeks,
    and then just a low dose of insulin at nite until delivery....not
    considered a very severe case, really. At 12 weeks, this time, her
    sugar levels were already higher than at delivery with her previous
    pregnancy!
    
    No, it was not picked up in the urine, and *may never be!!!*. It was
    through tfirst the 1 hr. and then the 3 hr. Glucose Tolerance test. To
    show up in urine it must be a blood level above 180.....takes a lot of
    sugar before your test to pump it up to that. So it may never be picked
    up by urine alone. Personally, I would demand at lest a 1 hr.
    screening, and *now*. For absolutely no other reason than peace of
    mind! That's important to that baby, too! Please, Dale, keep us posted
    as to what is going on!
    
    BTW, Wendy's doctor mentioned to her that we are avoiding
    hospitalization *so far*. She got a little concerned at that (no
    kidding!), and questioned him. He said many women who were as severely
    GD as she is end up in the hospital for lengthy stays before giving
    birth. But, he says it is not something he thinks will happen to her.
    The most recent sonogram showed the baby to  be about 2.5 pounds, which
    he said was slightly high for that point (average was 2.0), so we do
    need to keep a close watch. Delivery will almost certainly be early
    (not necessarly a bad thing, according to Wendy!).
    We'll keep you all posted, too!
    
    --dave--

    I need to just relate a story of how quickly the body starts recovering
    from both the delivery and GD.
    
    While we were waiting for the CSection room to be readied for me, the
    woman in the next bed apparently had *just* delivered (naturally), and had 
    had GD. Apparently she had not eaten for several hours while in labor. 
    At that time the staff arranged for her to have a meal tray, and upon
    it's arrival they found a standard "regular" tray.  The woman, quite
    concerned refused to eat it, in light of her GD condition.  The doctor,
    also my OB stopped by to tell her she could eat anything she wanted
    now, since she was no longer pregnant and the GD is (I guess) no longer
    an issue upon delivery.
    
    I guess that's another good thing about delivery!
    
    Lyn
    

    In something like 95% of all GD, it goes away immediately (within 24
    hrs.) after delivery. The more severe during the pregnancy, the lower
    that statistic, but it still remains over 90%. When Wendy was GD with
    Daniel (our last child, and first one she was GD with), they kept her
    on insulin for about 12 hrs after delivery, and then, even though all
    sugars were coming back totally normal, kept her on the diabetic diet
    (the food was simply *awful*! She hadn't eaten in well over 24 hrs, and
    couldn't even manage to down half of the first meal they brought her!
    It was that bad!). I snuck her in a cookie, and that didn't touch her
    blood sugar, as a matter of fact it was that day when they thought her
    sugars were dropping *too* low! 
    
    --dave--