Gestational Diabetes at QMH

H

HappyV

Registered User
Does anyone have any experience of delivery a baby through QMH, where the mother has Gestational Diabetes? I am particularly interested in hospital 'policy' when it comes to methods of delivery, and their ideas in regards to when a c-section may be neccessary. Any advice or stories most welcome!
 
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i'm high risk but for a different reason so i can't answer your questions. it may be worthwhile to make an appointment with the private high risk physicians there and ask them all the questions you need answered. i say private because if you go through the public you probably won't meet the senior physicians who can better answer questions until your 2nd or 3rd visit, which was my experience. after you get the answers you can switch to public if needed--the treatment is the same anyway, as are the doctors.
 
I am already a patient through the high risk clinic. The reason I posted, is that the doctors I am seeing are being generally evasive about many aspects of my treatment - as good as they are, they very much adopt a 'do as you are told, and don't ask too many questions.' approach.
When I was diagnosed with GD, I was referred to the QMH dietician, who basically called me fat (even though I am not overweight in general, and have put on inly 16 pounds at 28 weeks) - and said for Western Women GD was mostly caused by a Western diet. She then urged me to eat lots of rice (despite it being a starch food which actually drives UP your BGL) and not to exercise too much. Thank God for the internet, all I would have taken all this at face value.
I know in Australia that the public hospital try to advise GD women with bigger babies to have c-sections at 38 weeks. Yet here they are almost refusing to even consider it. I would like to avoid a c-section if possible, but if it considered safer for me and the baby, (because of the GD and other health complcations) then I would like to push for it.
I have been diagnosed for nearly two weeks, but they are very slow about getting the proper monitoring going - for example, introducing insulin (if needed) - even just the basics of monitoring BGL.

So if there are any ex-GD mothers out there who have QMH stories, I would love to hear them......................
 
Is there any chance you can go "home" to Australia to have your baby? Sounds like you have been given extremely damaging information and I'd have no faith in this system whatsoever. What else will they get wrong?

Having said that, HK has an excellent medical record - first class by world standards. Sounds like bedside manner, provision of information and understanding of western lifestyles in the public hospital system needs improvement.

As I type this, my (Chinese) secretary is sitting outside my office eating McD's for breakfast. I and all my friends NEVER eat McD's and yet they call it a Western Diet???????????? Get real.

I was told by my Drs nurse during my pregnancy that I was fat. At 20 weeks pregnant I had a BMI of 23. My normal BMI is 21. I'm tall, not fat, a healthy weight by anyone's measure. Stupid nurse. Still annoys me.
 
A couple of years ago I was watching the tennis on the Cantonese channel. A female commentator called Venus Williams fat!

Some people in Hong Kong seem to have no understanding of the difference between fat and big.
 
hi, me again. wow. sorry to hear about the abysmal care you've been getting. i know what you mean about the do as you are told approach there. but i'm surprised the senior doctors aren't being more helpful. i am also consulting a private doctor to fill the gaps left by QM, is this an option for you? apparently its done often. well, i hope someone's able to be of help to you!! good luck.
 
I have been seeing a private OB as well as the doctors at QMH - and I have found this a godsend. I say her today, and she basically told me that the diet advice I had recieved was rubbish (as I had read elsewhere, and worked out myself based on by blood sugar levels over the last few days. The more I think about it, the more I am appalled that (a) she gave such bad/incorrect advise, and (b) that she had the audacity to call Western woman in general and myself in particular fat (by the way, if GD is caused in Western women by Western diets, why are 10% of HK women diagnosed with the condition?).
So now I am hoping to control the levels through a sensible diet, and hopefully avoid insulin.

I am still interested to hear of any delivery stories of any GD mothers out there - oarticularly as to how the doctors tell the difference between a 'big' baby and a 'fat' or macrosomic baby?
 
wife got GD

Hi HappyV. Glad to hear that you got a better and sensible opinion from a diff o.b..

My wife Pam (i'm the official spokeperson), had GD diagnosed just before 30th week, i think. Up until that week, she had no problems with pregnancy - though her wieght gain is slightly on the higher side. Though there maybe a lot of reasons her getting GD (diet and medication - could be the oral medicine she's taking to control pre-term contraction, which is sugar based).

Anyways, we went as far as daily blood sugar monitoring and insulin injections (I did the injections - talk about being an involved father with Couvade Syndrome!).

Although the GD was overshadowed by hospitalization due to pre-term contractions (32nd and 35th weeks), we were concerned anyway that our baby would be born big. We agreed to do C-Section (in Manila) due to pre-term labor at 37th week, but our baby still was bigger than us when born (wife and I were six pounders when born - pretty normal for Filipinos). Sabine was almost 8 pounds. At first, OB had slight difficulty taking out the head from the cut she made (I filmed the delivery), and thought for a while she's struggling to do it! I think I saw Sabine's neck being stretched a little farther than normal!
Anyways, She got a very good score (forgot the scoring standard pediatricians use for newborns for appearance,mobility, etc.) - though this was more of a concern from the muscle relaxant Pam was injected with to control her contractions the previous 2 weeks of C-Section.
She's still slightly bigger than her peers of same age and race. Height diff from her cousin of age 4 is minimal (she's three). She's wearing clothes 1 or 2 sizes bigger than her age - clothes that I buy in Hong Kong. Development wise, she's doing well on motor/verbal and analytical skills - more sprightly than her girl cousins when they were at the same age.
 
Thanks everyone, for all of your replies.
Basically, I have been told that my sugar levels can be controlled through diet alone, which I am very relieved about.
However, I recieved much contradictory advice through the various ward doctors, OBs, dieticians and endrocrinologists. One person tells me to make sure I eat 1 1/2 bowls of rice at every meal, despite high-starch meals sending my levels shooting up. Another tells me to eat no rice/bread, and just lots of fresh veggies and lean meat. Another tells me to make sure I snack throughout the day, whilst another says that if I snack through the day, my baby will be 'fat'.
So all I can do is continue to eat sensibly, and take my own levels, and assume that there is no 'right' way and the dogmatic attitudes I have encountered are just part of the 'God/Doctor' complex that seems to rule the public system.
It is very confusing at six months pregnant to be told you have a potentially serious medical condition, but be given such contradictory advice about what to do about it. Common sense tells you that when you are hungry, you eat. That when you are not hungry, you don't eat. Unfortunately, common sense does not seem to play much part in diagnostics in the treatment of GD at this hospital. Thank god for my private OB - she's the only one that has made any sense. And following her low starch/lean protein and lots of veggies and fruits, my levels have been FINE.
 
Gestational Diabetes

my OB suggested that I use a glucose test kit once a week (& every other day closer to term) (although it meant pricking fingers abt 6 times a day!). Wld also suggest keeping a food diary of all the foods consumed everyday so that if there is a sudden hike in sugar levels, then u know why! I'd found it very useful and helped to control the sugar levels. Hope this helps!
 
I don't have any information on GD, but regarding when a C-section might be necessary, I have heard they are very reluctant to plan these in advance. Sounds crazy - maybe it's because so many local women want C-sections even when there are no complications requiring one. I have a friend who gave birth to her second baby at QMH, the first one having been overseas by C-section, and ended up having a C-section again but they refused to plan one in advance.

Anyway on a more positive note, whatever reservations one might have about the prenatal care and lack of information, they are great at delivering babies, the intensive care unit at QMH has a great reputation, emergency cases get sent there from all over HK, so don't lose faith in the system altogether!
 
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