First diabetes clinic appointment
A midwife from the diabetes clinic has called to say that they will squeeze me into the usual Tuesday diabetes clinic at the hospital. She's told me where to go, what time to attend and that the receptionists will be expecting me, great!
On arrival I report to reception and I'm asked my name and for my materniy notes. I tell them my name and explain that I have no maternity notes as I have not yet been booked in by the community midwives. As I suspected, this causes a few issues and takes a few phone calls to resolve... so much for the receptionists expecting me 😉
They create some maternity notes for me, they test my urine sample and check my blood pressure and then I'm told to wait to see the consultant. In typical diabetes clinic style all this takes around 1 hour 30 mins, but Finlay and I came prepared with snacks, drinks, books and toys to keep busy.
"you're Type 2"
I get called in to see the consultant. I run through my blood sugar levels and explain that I've just recieved my insulins on prescription via my GP which I plan on starting this evening before bed.
The consultant runs through my history and then says "you're Type 2".... er, no I'm not?! I explain that my HbA1c in November was normal, not even pre-diabetic, so unless I developed Type 2 in December then it is gestational diabetes. The consultant believes that as the placenta has not yet developed, then I must be type 2.
I make it clear that I am aware that Type 2 cannot be diagnosed in pregnancy and as the blood sugar levels are dramatically increasing just like in my previous GD pregnancies, then it looks like hormones are impacting things and that for now I believe it is GD. I could of course be completely wrong, but as I tell many members in my support group, I will cross that type 2 bridge if and when I need to, but for now I am concentrating on my blood sugar levels which is the most important thing, not labelling my type of diabetes.
The consultant agrees that I should start the slow acting insulin straight away (but does not advise on a dose) and also advises that I start 75mg Aspirin daily (which is standard practice in Hull) and that I will also need to start Fragmin blood thinning injections daily, due to a family history of DVTs and other risk factors. This news is no surprise to me, but I hate hearing it. I HATE needles (well, lets face it, not many people like them) but Fragmin injections are real syringes (as opposed to the insulin pen devices), they hurt and they leave terrible bruises on me. Fragmin was one of the worst things I remember from my previous pregnancy, I was given them from 32 weeks and for 6 weeks post birth and every single one was an ordeal for me to inject. Here I am at around 6 weeks pregnant and I have been told I need Fragmin throughout my whole pregnancy this time...gutted!
After seeing the consultant I see the Diabetes Midwife and Dietician. For me, this is the awkward meeting as I'm unsure what advice they will give me and what they will think of me when I mention what I do day to day (run the Gestational Diabetes UK website and social media accounts, research gestational diabetes and admin my GD Facebook support group). Will the DMW remember me from last time? I didn't meet a dietician last time in Hull as I transferred mid-pregnancy and knowing much of the typical NHS dietary advice for GD I disagree with, how do I manage this meeting?
Meeting the DMW and dietician
The DMW does indeed remember me from last time (I must leave an impression on people?!), she also remembers that I have a good knowledge of gestational diabetes and I'm good at managing my blood sugar levels.
She asks what dose I will be starting with my Insulatard that night and I explain that I want to start on 4 units as my levels are already pretty high. She agrees and also suggests taking the same dose in the mornings, which I agree would be a good idea.
After talking about how the website and Facbeook group are going, the dietician asks a bit more detail around the type of dietary advice I use and offer on the website. I explain the basics and she does not agree, nor disagree. She also does not offer any advice herself.
It's all very pleasant and relaxed which is nice as previous appointments at my hospital in Cambridge could be quite tense with the dietician being quite forceful around diet details and 'losing weight' due to high BMI.
I'm given a contact telephone number in case I have any problems and asked to book another appointment after my first scan, where they will review everything. Happy days!
More About me, Jo, owner and author of Gestational Diabetes UK
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