Sunday, 8 December 2019

Pregnancy 29 week Update and Gestational Diabetes

Here I am at 29 weeks pregnant (now 31 weeks!), in the third trimester and it's been a surprise this time around with various extra issue to consider but then I'm 10 years older than when I had Little Bird.
29 weeks pregnant bump

Firstly at 20 weeks I was told that the placenta was low lying and completely covering my cervix which is a worry as it can lead to ending up in hospital quite early but so far I've had no issue. Most of the time, the placenta will move away as the uterus grows but I'm yet to have the official scan that will confirm whether it has or it hasn't.

Glucose Tolerance Test:
I then went for a glucose tolerance test for gestational diabetes to discover to my dismay that I have it. You fast from midnight the night before the test, have your blood tested before drinking a glucose drink, wait two hours and then have your blood tested again. After two hours my levels were 9.8 mmol/L which is above the recommended 7.8. I was invited to a gestational diabetes clinic the next day.

Gestational diabetes can have implications for the baby and your health during pregnancy such as growing too quickly and cesarean section being required, pre-eclampsia and a deterioration of the placenta leading to premature delivery and worse, read this for more information. It is so important to monitor baby's movements.

The Diet Plan:
At the meeting we had a talk from a dietitian nurse telling us how best to manage the diabetes. I was told no carbohydrates at all for breakfast, just protein and so I now eat cheese and eggs. No dried fruit, cereals or granola as they sky rocket your glucose levels. Even those you think are ok like oats and weetabix.
dairy is great when you have gestational diabetes

For lunch I can have minimal carbs, wholemeal bread is best and I can manage one slice in order to keep my sugar levels below 7.8. Fats and protein are your friend, you can fill up on those. Cheese, eggs, peanut butter are all good. Soup is ok but shop bought can be a nightmare with the sugars in them. A jacket potato is ok but being full of carbs we were told to have one no bigger than our fist but beware the baked bean as the sauce is laden with sugars. Very quickly you realise how it's best to cut these out and opt for cheese or cottage cheese instead.

Fruit is also tricky, bananas are ok when green tinged, fun size apples, satsumas etc, blueberries are good - strawberries are high in sugar and forget grapes which I've seen called sugar bullets. Dried fruit is far too sugary.

Full fat natural or Greek yoghurt is good, as is cream and milk. 

For an evening meal, pasta and rice are out of the window as even if you have wholemeal you can only have two tbsp of them and the shop bought pasta sauces will be full of sugar. No lasagne as you can only have one sheet! This requires some inventive cooking from scratch, perhaps layers of aubergine or courgette instead. Thank goodness that cheese is ok. Other ideas are crustless quiche, halloumi, chickpeas, lentils, mashed cauliflower rather than mashed potatoes, sweet potatoes boiled or steamed rather than roasted. 

Cheese sauce is a favourite of mine so cauliflower cheese is excellent, leeks in cheese and tonight random vegetables in cheese with a vegetarian burger will make a filling meal.

There is a great website and Facebook group for help and recipe ideas:

Daily Testing:
Here is my little testing kit for measuring my blood glucose throughout the day. You prick the side of your finger and touch the blood to a testing strip placed with the small monitor. The reading is then synched to an app on your phone where you add info on what you have eaten. This is all monitored by the diabetes midwives.
gestational diabetes testing kit

My morning fasting result needs to be below 5.3 mmol and one hour after a meal it has to be less than 7.8 mmol. As you can see my first morning results have been over the limit, this is due to the liver producing glucose through the night and is almost impossible to control - there are lots of ideas about how to do this from having cider vinegar in water before bed to a late night snack. Or taking more exercise during the day. As I write this, mine has miraculously started being in the green zone below the limit of 5.3 mmol for the past 5 days. Just as I had picked a prescription up for Metformin tablets which are the first port of call to control so for now I can hold off the tablets. After Metformin the next solution is to inject insulin.
Gestational Diabetes app

This week I have another growth scan, baby is already measuring large on the 90th centile so this is obviously being monitored. Hopefully I will find out if the low lying placenta has moved at all too.


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