I'm a bit wary of Metformin on pregnancies.
So far there isn't any longitudinal research to ensure it's safe. But am willing to find out more.

New gestational diabetes treatment safe

May 14, 2008

A controversial alternative to insulin injections for pregnant women with gestational diabetes is safe, Australian and New Zealand researchers say.

Gestational diabetes is a complication in about five per cent of pregnancies - and is on the rise.

Where it can't be controlled through diet and exercise, insulin therapy is often used to improve the health of both baby and mother.

But University of Adelaide Clinical Senior Lecturer Bill Hague says insulin therapy can also cause low blood glucose and weight gain in the mother.

A clinical trial of 751 women with gestational diabetes in Adelaide and Auckland compared insulin injections and the oral diabetic drug, metformin.

The results, published in The New England Journal of Medicine, show the babies of mothers treated with metformin were no different from the babies of mothers treated with insulin alone, either at birth or at 6-8 weeks of age.

Dr Hague said no serious adverse effects were associated with the use of metformin, which usually returned blood glucose to normal, rather than dropping it too low, and also is associated with maternal weight loss.

"More than half the women taking metformin could be managed with tablets alone," Dr Hague said.

"If extra insulin was necessary, the dose was less than that required for women taking insulin alone.

"Oral medication therefore can offer considerable advantages.

"Women in this trial certainly preferred to use metformin rather than insulin.

"To date, however, metformin use in pregnancy remains controversial - before this study there were only two reported small randomised trials comparing metformin with insulin."

The children born within the trial were being assessed at two years of age, and further follow up data was still needed, he said.

Taken from The Sydney Morning Herald

DE Visit

DE: Your BSL are good but you're starving yourself, eat 9 serves of carbs a day.
Patient: I'm sure my BSL will shoot up if I do that.
DE: If it does, there's nothing wrong with you or what you eat. It's the baby's placenta and your pancreas at war against eah other.
Patient: Sigh. I've lost 2kgs in a week.
DE: That can be a worry. We don't want you losing any from the baby. If your BSL shoots up high with added carbs before your next ob appointment, call me. We'll arrange a meeting with Dr. Hague and decide if you need treatment with tablets or insulin shots.
Patient: I'll try.
DE: Don't worry too much.. it is temporary. Only 10 weeks to go, then you'll be fine. See your ob and let her know I want you to increase your meal.
Patient: Think I can sneak-in a tiny cake for V-Day?
DE: No. But ask your husband to take you out for a nice dinner and desserts after delivery.
Patient: B, strawberry milkshake once the baby's out!

Now she's monitoring my carbs intake. Great. Another appointment next week.

BSL - Next 2 days

BSL target: <5.5 fasting level, <7.0 recorded 2 hours after meal time, <4.0 is too low, <3.5 hypoglycemic - need sugar/medical attention

10/2
BSL = 4.6
Breakfast - 1/4 apple + 1 thin beef sausage + capsicum + mushrooms + 1/4c baked beans + 1 slice white bread
BSL = 8.7

Lunch - 1/2 egg + 20g yoghurt + vege stir-fry
BSL = 5.1

Snack - veggie stir-fry (garlic + mushrooms + chillies + spinach + beansprouts + tofu + capsicum + cabbage + tomatoes) + 1 piece (25g sweet potatoes)
Dinner - Roast chicken + veggie stir-fry + roast carrots + gravy
BSL = 4.6
Before bed snack - 20g yoghurt + veggie stir-fry + chickpeas

11/2
BSL = 5.2
Breakfast - 1 Chicken wing + 1/4c baked beans + 1/4c soy milk
BSL = 4.9

Snack - 30g noodles + veges stir-fry
Lunch - 1/2 avocado + 1/2 chicken breast + vege stir-fry
BSL = 5.7

Snack - 1/2 avocado + 2 thin rice cake + a spread of cottage cheese + 1/2 apple
Dinner - 1/2 chicken breast + rocket + snow pea sprouts + 2 slices soy-lin bread + 4 grapes
BSL = 6.7
Before bed snack - chickpeas + 1 kiwi fruit + 1 thin rice cake

BSL Recordings - Next 2 days

BSL target: <5.5 fasting level, <7.0 recorded 2 hours after meal time, <4.0 is too low, <3.5 hypoglycemic - need sugar/medical attention

8/2
BSL = 5.6
Breakfast - 1 chicken drumstick + 70g (1/4c) baked beans + 50g strawberry yoghurt
BSL = 7.1

Snack - 1/4 of a carrot
Lunch - 50ml tomyum soup + 1 chicken drumstick + veggies
BSL = 5.1

Snack - handful of chickpeas + 1/2 kiwi fruit
Dinner - tuna + tomatoes + mushrooms + capsicum + lettuce salad
BSL = 5.9
Before bed snack - 1/2 mug Rooibos tea

9/2
BSL = 4.2
Breakfast - chicken + tomatoes + cabbage stew
BSL = 5.1

Snack - 50g strawberry yoghurt + handful chickpeas
Lunch - black pepper beef salad + 1/2 kiwi fruit
BSL = 4.6

Snack - 1/4 apple + chicken + tomatoes + cabbage stew
Dinner - beef + calamari + veggies + 30 g noodles + tomyum soup
BSL = 4.7
Before bed snack - 1 square chocolate + 1/2 mug Rooibos tea

*beginning to wonder if levels are too low

GD Info

Gestational diabetes
Gestational diabetes is a condition characterized by high blood glucose levels discovered during pregnancy. Gestational diabetes is the result of hormonal changes that occur in all women during pregnancy. Increased levels of certain hormones made in the placenta (the organ that connects the baby by the umbilical cord to the uterus and transfers nutrients from the mother to the baby) interfere with the ability of insulin to manage glucose. This condition is called "insulin resistance." As the placenta grows larger during pregnancy, it produces more hormones and increases this insulin resistance. Usually the mother's pancreas is able to produce more insulin (about three times the normal amount) to overcome the insulin resistance. If the pancreas cannot produce enough insulin to overcome the effect of the increased hormones during pregnancy, glucose levels will rise, resulting in gestational diabetes.

High blood glucose levels that are not treated during pregnancy can cause problems for you and your baby. Gestational diabetes does not cause your baby to have diabetes. However, if left untreated, gestational diabetes can cause your baby to produce too much insulin and gain too much weight, increasing the risk of premature delivery.

Usually, blood glucose levels return to normal after childbirth. However, women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life.

From http://www.diabeticmommy.com/34-gestational-diabetes-diet.html

I am trying hard not to beat myself up over this matter. Somehow the harder I try, the more depressing it gets.

BSL Recordings - First 3 days

BSL target: <5.5 fasting level, <7.0 recorded 2 hours after meal time, <4.0 is too low, <3.5 hypoglycemic - need sugar/medical attention

4/2
Lunch - White pita bread + eggplant + lettuce wrap
BSL = 10.6 (after 1 hour)

Dinner - Roast chicken + carrots + broccoli + mushroom sauce
BSL = 6.7

5/2
BSL = 7.0
Breakfast - 2 eggs-omelette + cheese + tomatoes
BSL = 7.0

Lunch - White pita bread + tomatoes + lettuce wrap
BSL = 9.4

Afternoon snack - 1/4 of an apple
Dinner - Chicken + spinach + garlic + onions stir-fry
BSL = 7.3
Snack - 1/4c oats + warm milk + green tea

6/2
BSL = 7.7
Breakfast - 1 thin beef sausage + 1/4c baked beans + spoonful mixed veggies
BSL = 6.2

Lunch - 2 pieces skinless chicken
BSL = 4.9

Afternoon snack - 1/4 apple + 50g strawberry yoghurt + 2 chips
Dinner - Beansprouts + mushrooms + capsicum + onions + garlic + ginger stir-fry + 1/4c of soy milk
BSL = 6.1
Snack - Handful of chickpeas + 3/4 of a carrot

7/2
BSL = 5.2 *yippee!!*
Breakfast - 1 thin beef sausage + 1/2 red capsicum + mushrooms + 1/2 slice white bread + 1/4c soy milk
BSL = 6.4
Snack - handful of chickpeas

Lunch - Noodles + bok choy + broccoli + egg stir-fry
BSL = 8.6
Snack - 2 sips of vanilla coffee @ Gloria Jean's

Dinner - Calamari + coriander + parsley + onions + tomato + chillies salad
BSL = 5.3