29 weeks appointment

wrote in message =
ups.com...


Thanks for this Kathy, it really helps.

Kazh wrote:

"Ericka Kammerer" wrote in message ...
wrote:
snip with respect

But someone with gestational
diabetes should think long and hard before agreeing to
insulin use, and some doctors are very quick to suggest
it.

Best wishes,
Ericka
-------------
They told me if after a week using diet control if it is
still high they WILL put me on insulin. Where can I find more
information on benefits / impartial info on whether it is good
or not during PG ?

There is some information in Enkins et al.'s _Guide
to Effective Care in Pregnancy and Childbirth_. I believe
Henci Goer covers some of it in _Obstetric Myths versus
Research Realities_. Here are some of her online articles,
which have cites so that you can double check the studies
yourself, if you like:

http://parenting.ivillage.com/pregna...,,9cgc,00.html
http://parenting.ivillage.com/pregna...,,9z3m,00.html
http://www.gentlebirth.org/archives/gdhgoer.html
http://www.ahcpr.gov/clinic/3rduspstf/gdm/gdmsum.htm
http://www.cochrane.org/cochrane/revabstr/AB003395.htm

I have to say, this is one area where reading the PubMed abstracts
is very challenging. You'll find a zillion studies that purport
to show that GD treatment in general or insulin in particular
"improve outcomes." BUT, you will also find that those studies
have major methodological flaws, and/or they'll show something
like insulin reducing the incidence of macrosomia, but *not*
the incidence of c-section, brachial plexus injury, dystocia,
etc. (all the things one *really* cares about). They also rarely
look at the potential risks of treatment, so you have little
to compare it with. Personally, I find Henci Goer extremely
persuasive and accurate--and because she gives her cites, you
can always double check her interpretation of the literature.

I have to say, giving you a mere *week* to get things
under control with diet (any mention of exercise?) seems
outrageously aggressive to me. By the way, you only gave
two results for your test. Which test did you have? The
standard oral glucose tolerance test would have had your
blood drawn five times (initial draw, then 30 minutes, 1
hour, 2 hours, and 3 hours after the drink). If you just
had the one hour test, that just isn't particularly reliable.

Best wishes,
Ericka

"Ericka Kammerer" wrote in message =
...
Kazh wrote:
snip
I have to say, giving you a mere *week* to get things
under control with diet (any mention of exercise?) seems
outrageously aggressive to me. By the way, you only gave
two results for your test. Which test did you have? The
standard oral glucose tolerance test would have had your
blood drawn five times (initial draw, then 30 minutes, 1
hour, 2 hours, and 3 hours after the drink). If you just
had the one hour test, that just isn't particularly reliable.

Best wishes,
Ericka

------------
Thanks Ericka, will look in to these.

I had a ''fasting'' GTT. 12 hours fasting overnight, 1 blood taken (6.1) =
then drink 395ml of lucazade and back to be tested in 2 hours (10.2) no =
food in between.

Then I went to the hospital for scan and results 1 week later and bingo, =
I'm testing 7 times a day now - before breakfast, 1.5 hours after =
breakfast, before lunch, 1.5 hours after lunch, before dinner, 1.5 hours =
after dinner and before bed. Levels are ALL over the place right now =
ranging from 5.2 to 14.2 !!=20

She did mention exercise but I have a hernia (mentioned in previous =
posts) which the baby seems to be pushing against and walking more than =
100 yards leaves me in agony. So I am trying to do exercises at home but =
it'd difficult to find effect things to do. Any suggestions would be =
great (sit-ups out of the question as they make the hernia worse)


--=20
Karen
DS 10th Aug 1986 - VB - 9lb 13oz
DD 13th Aug 1988 - VB - 10lb 9oz
EDD 9th May 2005 - It's a girl !!
Sophie's Prediction for us - Girl
--
Our Latest Scan Photo
http://www.freewebs.com/kazh/
--
Unlock codes =A35 only
http://www.freewebs.com/kazh/unlockcodes.htm

Kazh wrote:


I had a ''fasting'' GTT. 12 hours fasting overnight, 1 blood taken (6.1)

Okay...so your fasting level was not at diabetic levels, and you
don't even hit the target for impaired fasting glucose.

then drink 395ml of lucazade and back to be tested in 2 hours (10.2)
no food in between.

So your 2 hour result is just barely over the true diabetic
cutoff, and without the other values from blood draws at other times,
it's even harder to know if it's a spurious result. I wouldn't argue
that you don't have any glucose metabolism issues, but is it really
serious enough for insulin? I'd ask a lot of hard questions.

She did mention exercise but I have a hernia (mentioned in previous posts)
which the baby seems to be pushing against and walking more than 100 yards
leaves me in agony. So I am trying to do exercises at home but it'd difficult
to find effect things to do. Any suggestions would be great (sit-ups out of
the question as they make the hernia worse)

What about swimming or a pregnancy water exercise program
or something like that?

Best wishes,
Ericka

Leg lifts, holding cans while moving the arms about in different
directions, riding a stationary bike.

KC

In article , "Kazh"
wrote:

I had a ''fasting'' GTT. 12 hours fasting overnight, 1 blood taken (6.1) then
drink 395ml of lucazade and back to be tested in 2 hours (10.2) no food in
between.

Ericka, I am wondering if the Cochrane results you mention say much about how
these tests are done?

The one-hour glucose test is used here as a screening tool in mid-pregnancy.
I've passed both times, so I don't know what the protocol is for the
subsequent test, but my test protocol was:

No fast, drink the icky sweet stuff, wait for an hour with no exercise except
toilet breaks, then have a blood test. I am pretty sure that the cutoff
result is 8 mmol/l, not 6 as Kazh's appears to be.

This is plainly rather different from Kazh's test, but of course I had not had
glucose appear in my urine.

The only person I know well who had GD found that dietary control made her
miserable with fatigue and had no effect on her blood sugar, so she went on to
insulin. Perhaps our definition of GD is rather strict here, but she was
informed that people with GD have (IIRC) a 50% chance of developing Type II
diabetes within 5 years... and that is in fact what has just happened to her.
She could tell it was coming on, too.

I agree that a week is aremarkably short time to try dietary control before
hitting the insulin, especially as they don't appear to have given much
information about what Kazh ought to do!

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"In Melbourne there is plenty of vigour and eagerness, but there is
nothing worth being eager or vigorous about."
Francis Adams, The Australians, 1893.

Chookie wrote:

In article , "Kazh"
wrote:


I had a ''fasting'' GTT. 12 hours fasting overnight, 1 blood taken (6.1) then
drink 395ml of lucazade and back to be tested in 2 hours (10.2) no food in
between.


Ericka, I am wondering if the Cochrane results you mention say much about how
these tests are done?

The one-hour glucose test is used here as a screening tool in mid-pregnancy.
I've passed both times, so I don't know what the protocol is for the
subsequent test, but my test protocol was:

No fast, drink the icky sweet stuff, wait for an hour with no exercise except
toilet breaks, then have a blood test. I am pretty sure that the cutoff
result is 8 mmol/l, not 6 as Kazh's appears to be.

This is plainly rather different from Kazh's test, but of course I had not had
glucose appear in my urine.

One of the problems with this whole mess is that there *isn't*
consistency or consensus on what tests, when, how to administer them,
and what the cutoffs should be. Glucose in the urine is a very
unreliable indicator. Lots of people have it with perfectly normal
glucose metabolism, and others spill no sugar and have very wonky
glucose metabolism. Yours is a somewhat more orthodox way of doing
the 50g oral glucose challenge test, and your cutoff is more the
cutoff for true diabetes. In other parts, there are many who keep
pushing the cutoffs lower and lower.

The only person I know well who had GD found that dietary control made her
miserable with fatigue and had no effect on her blood sugar, so she went on to
insulin. Perhaps our definition of GD is rather strict here, but she was
informed that people with GD have (IIRC) a 50% chance of developing Type II
diabetes within 5 years... and that is in fact what has just happened to her.
She could tell it was coming on, too.

Yes, about the only clear result of all the research is that
a diagnosis of GD makes it more likely that you'll get type II diabetes
in the future. It *is* likely that pregnancy is a sort of stress test
that gives you a peek into your future. If you do get diagnosed with
GD, it's a heads up that you ought to do what you can WRT lifestyle
factors (e.g., diet and exercise, mainly) to tip the odds in your
favor. Still, overweight and obesity is pretty tightly linked to
a diagnosis of GD, and also to type II diabetes ;-) A lot of these
confounds are not very well accounted for in the research.
Of course, that still doesn't say much about what the risks might
be for mother or baby related to the pregnancy.

Best wishes,
Ericka

Thanks everyone for the advice, I am still undecided on whether to allow =
them to give me insulin or not and I'd like one final piece of advice on =
the results of my Blood sugars tests I've done over the past week.

This is going on the test they say it *should be* lower than the =
following -=20

Before Breakfast =3D 5.5
1.5 hours after breakfast =3D 8
Before lunch =3D 5.5
1.5 hours after lunch =3D 8
Before Dinner =3D 5.5
1.5 hours after dinner =3D 8
Before Bedtime =3D 6-7

Day 1 -=20
Before Lunch =3D 6.8
1.5 hours after lunch =3D 7.5
Before Dinner =3D 6.5
1.5 hours after dinner =3D 7.9
Before Bedtime =3D 8.2

Day 2 -
Before Breakfast =3D 6.1
1.5 hours after breakfast =3D 11.2
Before lunch =3D 6.4
1.5 hours after lunch =3D 6.3
Before Dinner =3D 6.8
1.5 hours after dinner =3D 14.1
Before Bedtime =3D 8.2

Day 3 -=20
Before Breakfast =3D 5.2
1.5 hours after breakfast =3D 9.5
Before lunch =3D 7.6
1.5 hours after lunch =3D 7.9
Before Dinner =3D 5.8
1.5 hours after dinner =3D 11.6
Before Bedtime =3D 6.9

Day 4 -=20
Before Breakfast =3D 5.9
1.5 hours after breakfast =3D 7.9
Before lunch =3D 3.8
1.5 hours after lunch =3D 12.4
Before Dinner =3D 13.6
1.5 hours after dinner =3D 10.2
Before Bedtime =3D 7.2

Day 5 -=20
Before Breakfast =3D 6.3
1.5 hours after breakfast =3D 9.7
Before lunch =3D 4.1
1.5 hours after lunch =3D 10.6
Before Dinner =3D 8.6
1.5 hours after dinner =3D 9.7
Before Bedtime =3D ........

Day 6 -=20
Before Breakfast =3D 5.2
1.5 hours after breakfast =3D 7.8
Before lunch =3D 5.1
1.5 hours after lunch =3D 7.5
Before Dinner =3D 6.1
1.5 hours after dinner =3D 8.7
Before Bedtime =3D 7.4

Day 7 - TODAY
Before Breakfast =3D 6.2
1.5 hours after breakfast =3D=20
Before lunch =3D=20
1.5 hours after lunch =3D=20
Before Dinner =3D=20
1.5 hours after dinner =3D=20
Before Bedtime =3D=20

If anyone knows what they would indicate to a doctor / dietician please =
advise.

Karen


--=20
Karen
DS 10th Aug 1986 - VB - 9lb 13oz
DD 13th Aug 1988 - VB - 10lb 9oz
EDD 9th May 2005 - It's a girl !!
Sophie's Prediction for us - Girl
--
Our Latest Scan Photo
http://www.freewebs.com/kazh/
--
Unlock codes =A35 only
http://www.freewebs.com/kazh/unlockcodes.htm

Kazh wrote:

Thanks everyone for the advice, I am still undecided on whether
to allow them to give me insulin or not and I'd like one final
piece of advice on the results of my Blood sugars tests I've
done over the past week.

By the way...what dietary advice did they give you, and
what have you been eating?

Also, did you ever mention whether you have been tested
when not pregnant?

Best wishes,
Ericka

Kazh wrote:

Thanks everyone for the advice, I am still undecided on whether to
allow them to give me insulin or not and I'd like one final piece of
advice on the results of my Blood sugars tests I've done over the past week.

Also, did they do an HbA1c test?

Best wishes,
Ericka