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post-birth diabetes 2 worries

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  • post-birth diabetes 2 worries

    - I was diagnosed with GD late in my pregnancy and it was controlled with diet.
    - I was gutted with the diagnosis because I passed the before and 2 hour after tests and was only slightly too high with the 1 hour after - in the oral glucose tolerance test.
    - In my first trimester I was drinking apple juice all the time because I had terrible nausea and could barely eat anything at all. My OB claimed this was fine and I wouldn't get GD because of my size - I am tiny, 5'2" and currently weigh 43kg. He was wrong.
    - After my birth I ate whatever I liked wrongly assuming I didn't have diabetes anymore, then at about 3 weeks I decided to test a large bowl of porridge with fruit and received a massive result of 11 mmol/ higher than any test result I'd received while pregnant.
    - I went to an old GP I trust who said I should have seen a dietician during pregnancy and that my endocrinologist was a bit remiss.
    - He also said that the one hour after eating test was controversial - that it used to be just the fasting and 2 hours after that was tested in the OGTT - and he claimed that with the 1 hour after eating - that researchers were attempting to get more grant money from the government by picking up more women with diabetes during pregnancy.
    - In any case, he recommended I start a new diet for 2 weeks, followed by 2 weeks of home finger prick testing, then wait one more week, and then undertake the HBA1C test.
    - He said if my home test results are low and the results of the HBA1C test are good that I should be fine - but that if the results are not good he will refer me to a new endocrinologist and I will have to take the OGTT.
    - I am now at that point when I should take the HBA1C test.
    - My baby is 10 weeks this week.
    - While the GP seems to think I won't have a diabetes diagnosis, my OB who I saw today says that a normal person can eat bread and pasta and not have elevated test results.
    - My home tests are low but that's because I'm eating a very restricted diet.
    - My current diet - 3 eggs and berries and nuts for breakfast, meat + vegetables for other meals, and snacks are yoplait forme zero or else spelt crackers (3mg carb only) with sardines. 2 fruits a day. Plus cheese and nuts. Suffice to say I am hungry often (but I was before the diet as well due to breastfeeding).
    - Earlier, when I tested Sprouted wheat bread with peanut butter I got 8mmol 1 hour after eating. But 5.5mmol 2 hours after eating. As a result of similar results for pasta/rice I cut out all grains apart from those spelt crackers.
    - The GP says he's only interested in 2 hours after eating results. So I tested 1 hour anyway, and if I got anything over the limit I then would test 2 hours after. If only 2 hours after eating are relevant I am fine - but if 1 hour after testing is the crucial measure, I would appear to have diabetes.
    - Around the 6 week mark after I had recovered from the caesarian I started walking daily with the baby to settle him, but I doubt this will help me - since I'm not obese.
    - My GP says that diabetes 2 is reversible with diet. But today my OB said that is only the case for really overweight/obese people - and that given how small I am, it could be I have diabetes genetically (not yet having a conclusive diagnosis).
    - I have also heard from another diabetic friend that once you cut carbs/sugar from the diet and do this for several weeks it gives the pancreas a "rest" and then when you retest pasta etc. your results will be lower. My GP agrees that diabetes 2 is dynamic - contrary to my OB who thinks you either have it or you don't.
    - I haven't taken the risk of testing anything like pasta following the new diet because I don't want to jeopardise the A1C test results.
    - I have also heard that the birth, and shock of having a newborn, the sleep deprivation, the stress, and the breastfeeding itself - could all elevate my blood sugar levels.

    So my questions:
    - if the above is the case, is it just not the right time to have any of these tests or investigations? My GP says if I fail the A1C test I can continue the diet and retest in a month because it tests the sugar in the blood for the last 3 months and I haven't been on the diet 3 months yet. But even if I pass the test - aren't the results artificial since I am on such a restricted diet?
    -What are people's views of my situation? This diet is killing me - and the idea I might have to eat like this permanently is terrible to me. For me eating a bowl of pasta or a piece of cake with friends is what makes me happy in my life. Shame if I have to be this spartan for the rest of my life.

  • #2
    OP, where are you located?

    I thought a follow up OGTT at 12 weeks was standard practice in Australia after GDM?


    • #3
      Your diet sounds pretty healthy really, however, if you are not satisfied on it perhaps you could look at introducing some of the low carb/paleo/keto recipes around. There are delicious low carb cakes and biscuits made from alternative flours that are very easy to source, almond meal for example, that are sweetened with natural sweeteners and are high protein and very filling. There are also low carb pizza bases, flatbreads etc. You might also want to ensure you are getting adequate fats, sardines are excellent as is yoghurt however I'm not sure on the brand you have mentioned, if it reduced fat it will be higher in sugars and you might be better off with a quality, plain greek yoghurt.

      Many people also find that authentic sourdough affects them differently than your average processed bread. Perhaps you have a local traditional bakery you could experiment with. I find a low carb diet very difficult while pregnant or breastfeeding, and include some sourdough every day. Maybe it would be worth trialling and testing your sugars after.

      Walking/exercise will definitely still help your body, regardless of what you weigh. It's an essential mechanism for health, to be upright and moving for a good portion of the day.

      I do think with baby so young your body will be in recovery from pregnancy and birth mode and maybe your focus would be better spent on general health and fitness, balanced diet and rest then getting too caught up in possible diabetes diagnosis. Maybe stick to one doctor - your GP, or OB, and follow their advice as the conflict in opinion sounds very stressful.