Carby snacks without spiking - help!

[cevans1]

Hi everyone, I am new the forum and hoping to get a bit of help. I'm 24 weeks pregnant and have been diagnosed with GD since 12 weeks. I'm currently diet and excercise controlled and keen to keep it that way as long as I'm able (I know that it can go beyond my control as the insulin resistance ramps up), but finding the advice from the dietcian and diabetes nurse to be unhelpful. For note I had it with my last pregnancy (hence the early diagnosis) and was diet and exercise controlled through that.

Today I had my wee tested and it showed ketones, which they said indicates I'm burning fat and not eating enough carborhydrates. I feel I'm eating a reasonable amount, but they won't give me a guide on what weights to strive for in grams per meal which doesn't help me judge, they just say "medium sized new potatoes" or "a quarter of your plate", but these terms are really subjective depending on how big your plate is, how big your spuds are etc. Can anyone say what they go with? I understand that everyone is different, but a general guide that I could tinker with would be great.

I also asked if it would help for me to eat some carborhydrate snacks paired with some good fats or protein throughout the day, so that I can have lots of regular carb top ups to avoid spiking my blood sugar, but they just said eating fats would raise my cholesterol (which is low if anything), so again not very helpful!

They just kept saying things like "You shouldn't be restricting the amount of carbs you eat, just cut down on sugar - if you can't tolerate carbs you'll just have to go on medication it doesn't mean you've failed, you just need it." For me it's not about "failing", there's no stigma about needing medication and of course I would take it for the sake of the baby and me if needed; it's more about trying to avoid a medication in a way that could be doable with the right diet advice - does anyone have experience with this and have any pearls of wisdom to share?!

Sorry for the long post!! Thanks in advance 🙂

 

[SB2015]

Welcome to the forum @cevans1. I have no experience of GD but your post throws up some questions which some others may be able to answer.

Do you have a BG test meter? If so what are your levels?
My only experience of ketones is when my BG has been very high.
Adding more carbs would seem to then push your BG even higher and lead to more ketones.

The advice that they have given you seems to be based on the ‘Eat Well plate’, but I am not sure that this is still considered very helpful. As for a target number of carbs, for me it would depend on how many grams I can tolerate without spiking. However I am injecting insulin, whereas you are trying to use the insulin that your pancreas is making. Again the only way I can think that you would know what is happening is by testing both before and a coupe of hours after meals.

As I said at the start I have absolutely no experience of GD or even pregnancy with diabetes, so I hope that someone with a lot more experience and/or knowledge will come along soon.

 

[cevans1]

Thanks for replying, SB2015! My levels are pretty stable, with just a few post-meal spikes that go above 7.8, and I can almost always trace it back to having too many potatoes, and my fasting levels are good (with GD you test fasting levels and the levels one hour after eating breakfast, lunch and dinner). I have started checking my levels before meals as well, just to check what change certain foods trigger in me, although this isn't the advice and guidance given (seems a little silly to me, as how else do you manage it without medication?!). Thanks for taking the time to reply 🙂

 

[SB2015]

Thanks for replying, SB2015! My levels are pretty stable, with just a few post-meal spikes that go above 7.8, and I can almost always trace it back to having too many potatoes, and my fasting levels are good (with GD you test fasting levels and the levels one hour after eating breakfast, lunch and dinner). I have started checking my levels before meals as well, just to check what change certain foods trigger in me, although this isn't the advice and guidance given (seems a little silly to me, as how else do you manage it without medication?!). Thanks for taking the time to reply 🙂

It sounds like you have got your head round things, and I agree that without testing it is impossible to know what impact different foods have on you as an individual. Porridge is a prime example. Some can tolerate it others can’t. We have to find what suits us and we can only do that by testing.

 

[PhoebeC]

Yes my knowledge of ketones is its too much crabs if anything.

And again it seems trying it out is the best thing to do, weird they are saying having more carbs though that seems like the wrong advice for any diabetic to get the numbers down.

Did they not retest it at the appointment? I thought they did with pregnant ladies and weird things? Are you booked again soon?

Welcome. Congratulations and please ask a way, we will will try and help as much as we can. Sometimes just hearing you are doing the right things already can help! Take care x

 

[ianf0ster]

I too have no experience of GD.
With Ketones, they can be good if Blood Glucose is well controlled within target range, or very bad if Blood Glucose is going through the roof!
Unfortunately many Health Care Professionals only know about the 'bad' ketone situation which is called Diabetic KetoAcidosis.
The good ketone situation is called Nutritional Ketosis and occurs when somebody eats low/very low carbohydrate meals.

As a diet controlled Type 2 Diabetic, I am in and out of (nutritional) ketosis on a daily basis.
Once your body gets used to being in ketosis then you will stop weeing them out and so the medics will be none the wiser.

Please pay little attention to their mistaken advice about increasing Carbs. It seems like you could eat a few more (hopefully Low GI) Carbs if you wish, but it sounds like you're doing just fine as it is - provided you aren't going hungry.

 

[cevans1]

I too have no experience of GD.
With Ketones, they can be good if Blood Glucose is well controlled within target range, or very bad if Blood Glucose is going through the roof!
Unfortunately many Health Care Professionals only know about the 'bad' ketone situation which is called Diabetic KetoAcidosis.
The good ketone situation is called Nutritional Ketosis and occurs when somebody eats low/very low carbohydrate meals.

As a diet controlled Type 2 Diabetic, I am in and out of (nutritional) ketosis on a daily basis.
Once your body gets used to being in ketosis then you will stop weeing them out and so the medics will be none the wiser.

Please pay little attention to their mistaken advice about increasing Carbs. It seems like you could eat a few more (hopefully Low GI) Carbs if you wish, but it sounds like you're doing just fine as it is - provided you aren't going hungry.

Thanks so much - I think they just see "ketones" and panic. I specifically said how do you know if this is the diabetic one to be concerned about, and the answer was "what other kind do you think there are?"... but concerning!! My sugars are in good ranges except the odd spike, so I think I'll carry on as I'm going in that case - and maybe have some toast as a snack if I want it!

 

[Lisa66]

Hello. Ketones, aargh!

Like most people I always thought, high blood sugars can lead to ketones, so therefore get the sugars down and the ketones will come down. That was my understanding until a 3 years ago.

I had an evening of being sick, next morning I still couldn’t keep anything down and decided to test for ketones as although the highest at any time my blood sugar had gone was 11, I had the feeling I get with much higher levels. I was surprised levels weren't higher , but given the colour on the stick was the darkest it could go my husband took me to A&E. They were brilliant lots of tests, fluids, xrays, testing of sugars, all good...but still high ketones. Moved to a side ward in the evening a young doctor asked if I’d had anything to eat. All I’d had all day was water. Nurse was sent to get me a sandwich and dr said by the time you get home (20 mins away) I’m certain your ketones will be coming down. I had starvation ketones. Sure enough, an hour later the level was near enough back to normal. I can’t tell you how relieved I was.

A few weeks later we were on a weekend away, lots of walking, great sugar levels and not much snacking. As I was still paranoid about ketones I’d taken some strips with me and each evening before dinner I had a moderate amount of ketones, so I was a bit concerned and puzzled. Fortunately I had an appointment with consultant on my return and he explained that my body just hadn’t had adequate carbs for the exercise.

So this is obviously what Ian is talking about, but I do understand the panic when you (we) see ketones. I really can’t advise whether this is any different with regard to being pregnant. I don’t know what level ketones you have or how often, but I wonder if something like a plain oatcake, about 5g carbs, would be enough to keep the ketones at bay if you have a while without carbs. So this is really something to discuss with your team.

It sounds like you are doing really well managing your levels, it’s not easy so well done. Congratulations and welcome along.🙂

Sorry for ramble.