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When do you test?


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  #1  
January 24th, 2006, 02:30 AM
Mega Super Mommy
Join Date: Dec 2005
Posts: 1,543
First off, Hi! I just found this board.

When do you all test your sugars? I had GD with my 2nd and 3rd pregnancies, though according to my new Dr here in England, I don't have it (yet). They have a completely differen't system here.

I used to test my sugars 2 hours after meals back in the States, and the OB/GYN wanted it under 130, and my fasting under 100, preferably about 80-90.

Here in England they want me to test BEFORE meals and snacks (6 times a day). They want the numbers to be between 4.0-6.0 mmol's (or whatever the scale is... hehe.. multiply by 18 to get the US scale). They consider you to be diabetic when you have 3 readings per day over 6.0. I maybe have one or two, but only occassionally.

The problem I'm having is my before meals are OK, but I can't get out of the habit of testing after meals. I'm being cautious on what I eat, but admit I'm cheating a lot more than I did with my previous pregnancies. My after meal tests are not too good... always 7.0-8.5. Those still aren't disasterously high, but higher than I want them to be. My Consultant here, who only treats diabetic women, and my midwive, who only treats diabetics, say I am perfectly fine. They are not at all concerned about my after meal sugars. My Hba1c's are all beautiful (I get tested every visit).

But why are after meal readings so important in the States, but not important in England???? I'm so confused. My OB back home would have a stroke if they saw my sugars here! The Consultant here assures me all is well. I just don't know who to believe. Do I trust the system I used the US, and had 2 healthy 7lb babies, or trust the Consultant here and hope I don't have a huge baby? I haven't asked him, but I don't think I'll be getting additional scans towards the last month or two to check on babies size.
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  #2  
January 24th, 2006, 05:57 AM
bright future's Avatar Platinum Supermommy
Join Date: Jul 2005
Location: Vancouver, Canada
Posts: 7,283
Hi Krissin, these are the guidelines in mmol/L that I was given (I'm in Canada)...

Quote:
Fasting: <5.3 mmol/L or <95 mg/dl
1 hour after each main meal: <7.6 mmol/L or <136 mg/dl
2 hours after each main meal: <6.7 mmol/L or <120 mg/dl[/b]
From everything I've read, testing and diagnosis of GD is very controversial and varies from area to area. No one seems to be able to agree on what treatments are beneficial or even if treatment reduces the potential problems. There is a school of thought that as long as pre-meal levels looks like proper fasting levels you're fine. It sounds like that's how your doctor treats this.

I have to test morning fasting, and one hour after the start of each meal.
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  #3  
January 24th, 2006, 06:03 AM
fka teresarunningmommy
Join Date: Feb 2004
Location: Michigan
Posts: 47,594
Quote:
First off, Hi! I just found this board.

When do you all test your sugars? I had GD with my 2nd and 3rd pregnancies, though according to my new Dr here in England, I don't have it (yet). They have a completely differen't system here.

I used to test my sugars 2 hours after meals back in the States, and the OB/GYN wanted it under 130, and my fasting under 100, preferably about 80-90.

Here in England they want me to test BEFORE meals and snacks (6 times a day). They want the numbers to be between 4.0-6.0 mmol's (or whatever the scale is... hehe.. multiply by 18 to get the US scale). They consider you to be diabetic when you have 3 readings per day over 6.0. I maybe have one or two, but only occassionally.

The problem I'm having is my before meals are OK, but I can't get out of the habit of testing after meals. I'm being cautious on what I eat, but admit I'm cheating a lot more than I did with my previous pregnancies. My after meal tests are not too good... always 7.0-8.5. Those still aren't disasterously high, but higher than I want them to be. My Consultant here, who only treats diabetic women, and my midwive, who only treats diabetics, say I am perfectly fine. They are not at all concerned about my after meal sugars. My Hba1c's are all beautiful (I get tested every visit).

But why are after meal readings so important in the States, but not important in England???? I'm so confused. My OB back home would have a stroke if they saw my sugars here! The Consultant here assures me all is well. I just don't know who to believe. Do I trust the system I used the US, and had 2 healthy 7lb babies, or trust the Consultant here and hope I don't have a huge baby? I haven't asked him, but I don't think I'll be getting additional scans towards the last month or two to check on babies size.[/b]
Not sure what to tell you. I know that Hba1c's don't tell you too much during pregnancy unless you've had diabetes the entire time. They tell you the 3 month average basically of your blood sugars and most women don't have problems until the end of pregnancy. I know other countries don't do much about gestational diabetes at all and sometimes I am not sure that all the fuss is necessary. I used a quick online converter for your numbers because I can't do mmol very well. From what I can see your averages are between 125-150 after meals, which is not great, but not horrid either. My doctor's have my goal at 140 or below so you're not too far off. I am not sure why they are checking before meals though. I know with type 1 they check before meals, but that is because you are giving insulin. I have no idea why they are checking before meals. Why don't you ask them at your next visit?

Teresa

ETA: I test fasting in the morning and one hour after meals.
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  #4  
January 24th, 2006, 06:18 AM
JennL
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Hi!

I just started all of the testing around 2 weeks ago, so still kind of getting the hang of things as far as the diet goes. I test fasting in the morning (supposed to be under 100), and then 2 hours after the start of each main meal, when my doc wants me to try to stay under 130. I have to admit the first week was awful, and I was over 180 after each meal. Since meeting with a dietician and setting up a real schedule for eating I don't think that i've been over 130 since so things are definitely getting better.

I'm not sure either why you have to test before your meals and not after? My doc said that the highs & lows are what would cause the baby to start to produce excessive insulin, which is why they want you to try to stay in a smaller range from fasting to after meals. Seems that your doctor would have to see how the meals were affecting you in order to guage if you were under control or not? I definitely would ask them more about it. Good luck!

~Jenn
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  #5  
January 24th, 2006, 06:24 AM
Mega Super Mommy
Join Date: Dec 2005
Posts: 1,543
Just wanted to add a few things. I have asked why they don't seem to care about post-meals, when it was so important in the States, and they keep telling me that sugar levels will go high after a meal with anyone. Which I always thought wasn't true (or so they told me in the States). So I'm really just getting conflicting answers. They want to be sure that even if it spikes, it's not staying high all the time. As long as it comes down, I'm ok... I guess. They also don't care about ketones here. (then why do they still test for them when I have to pee in the cup?!?)

I'm only just 25 weeks atm, but have been being seen at the specialist Diabetic clinic since my pregnancy started. With my 3rd baby, GD showed up in the first month. I suppose maybe it could have been labeled Type 2, but it did go away after his birth. Dr.'s at the practice gave me conflicting reasons there too... since GD is caused by the placenta, and at 8 weeks there's not placenta to cause it. But luckily it went away. Since I was such high risk for it showing up early, they've been monitoring me from the start.

The whole thing just has me so stressed out. I have a friend who had GD with her first son, and had her 2nd here in England. She saw the same Consultant I'm seeing. They told her she never had GD, but her son ended up being nearly 10lbs. She's small, and her first son was only 7.3 lbs. It's just something else that has me worried. Maybe they missed it in her, and are missing it me too.
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