Gestational diabetes and induction - why?

I feel a little confused. And I'm not really sure what to do about it, either - not at this stage anyway. I need to think about it a little further.

I was at the hospital's outpatients clinic yesterday. It was the usual stuff: checking how this pregnancy of mine is going, checking how this diabetes thing is going, checking if I need any help with managing my blood sugars, or whether anything of importance is showing up on tests.

In short, everything's fine: The Girlie is growing well, and is right "on dates" on pretty much every measurement they do, and there are no concerns regarding blood pressures or sugars or proteins or whatever. Everything looks lovely through and through! Except my weight: just as I suspected, I have lost a little weight as a result of my "sickie" a fortnight ago. And, anyway, I haven't been able to put any weight on since getting diagnosed with diabetes to begin with, which was... two months ago?

But back to the topic: where I am a little confused now is that a date for an induction has been set. It's standard practice with women who have gestational diabetes, apparently. I, for example, have been able to manage my sugar levels with diet and exercise alone thus far, and so I've been "granted" - not really the fairest of words here, but this is how it feels, to me - the right to wait until my due date before an induction is due.

Which is cool. Was cool - until The Man started asking what exactly happens after the due date then and I started to do a little reading on what the risk factors are exactly, and why it's standard practice to induce ladies with gestational diabetes by the time they're 38 weeks or 40 weeks or whatever.

And that's where it gets confusing.

From what I had read on gestational diabetes before, I knew that babies tend to come overly large, placentas tend to fail sooner, stillbirth numbers go up compared to "healthy" pregnancies, and so it seemed fair that getting them out a bit sooner was a thing of interest if health of both the mother and the child was important.

But what I kept seeing now that I was doing this reading - wanting to have an answer to The Man's questions, because this is how our relationship works - is that... unmanaged sugar numbers do that. Babies come overly large when mothers carry too much glucose around; and placentas fail sooner when too much sugar is involved; amniotic fluid amounts go down when/if diabetes numbers are unmanaged.

But mine is managed. Technically, if you set aside the fact that when I was given 75 grams of refined sugar on an empty stomach two months ago - a glucose tolerance test - my body wasn't able to clear it as quickly as "healthy" bodies do, I'm not actually any different from a standard, non-diabetic pregnant mother next to me. On a daily basis, I do not carry high sugar levels - I prick my fingers with a needle 6-9 times a day and manage my carb/sugar/protein/fibre intake very closely.

Impressively closely, actually.

But there doesn't seem to be such a distinction when information about gestational diabetes gets printed/published and handed out to ladies at the outpatients clinic, or on internet as a whole.

I have found it impressively difficult, actually, to find information on what are the differences between managed and unmanaged diabetes cases; and from what I can see, I am not alone in that.

I do not have a science degree - so don't even think I consider myself knowledgeable on this topic, because I don't - but I have spent enough time in university doing my various research papers to understand that a difference in sample size and in criteria for how the sample was selected will impact the results. So, say, if someone's making a paper on the effects of gestational diabetes and involves enough women with unmanaged sugars, of course the risk factors go up.

But how do I find information on what the risk factors are for me?? Me, considering that I keep my sugar levels well managed? I want to see risk factors NOT for gestational diabetes in general, but for women who keep a tight control on their glucose levels, which is me.

There seems to be very, very little information out there on that.

I think I might ask them about that when I go to the hospital next week.

Instead of crowding this post with links, I am going to post just one - an article I found to have the most references to actual research. If you want to read more, I suggest you do your own googling.

MidwifeThinking: Induction of Labour: balancing risks at
midwifethinking.com/2010/09/16/induction-of-labour-balancing-risks

3 comments:

  1. As far as I'm aware, the hospital can 'offer' you an induction or induction date but you still have the right to refuse it or at least ask the hard questions until you are satisfied.

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  2. Anonymous9.11.14

    Exactly my situation. Old wives tales get thrown around - often by medical professionals based on very little evidence and expectant mothers are made to feel guilty for even questioning the authority of the medical professionals and putting their babies "at risk". I read (although frustratingly cannot find the article) that the statistical likely increase of mothers with gd having stillbirths is 0.06% but this did not account for managed blood sugars. I am examinig all advice given and if it cannot be shown to be based in evidence then I am still planning to wait until my baby is ready to enter the world naturally instead of being induced by chemicals and increasing the risk of cesarean and all that it brings.

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    Replies
    1. You've probably found this one already, but this is how my "saga" of induction ended :)

      http://newzealanditisthen.blogspot.co.nz/2014/05/induction-postponed.html

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