It's essential to monitor and control your blood sugar to keep your baby healthy and avoid complications during pregnancy and delivery. You'll also want to keep a close eye on your future blood sugar levels. Your treatment strategies may include:
April 25, 2014
Monitoring your blood sugar. While you're pregnant, your health care team may ask you to check your blood sugar four to five times a day — first thing in the morning and after meals — to make sure your level stays within a healthy range. This may sound inconvenient and difficult, but it'll get easier with practice.
To test your blood sugar, you draw a drop of blood from your finger using a small needle (lancet), then place the blood on a test strip inserted into a blood glucose meter — a device that measures and displays your blood sugar level.
Your health care team will monitor and manage your blood sugar during labor and delivery. If your blood sugar rises, your baby's pancreas may release high levels of insulin — which can cause low blood sugar in your baby right after birth.
Follow-up blood sugar checks are also important. Having gestational diabetes increases your risk of developing type 2 diabetes later in life. Work with your health care team to keep an eye on your levels. Maintaining health-promoting lifestyle habits, such as a healthy diet and regular exercise, can help reduce your risk.
Healthy diet. Eating the right kinds of food in healthy portions is one of the best ways to control your blood sugar and prevent too much weight gain, which can put you at higher risk of complications. Doctors don't advise losing weight during pregnancy — your body is working hard to support your growing baby. But your doctor can help you set weight gain goals based on your weight before pregnancy.
A healthy diet focuses on fruits, vegetables and whole grains — foods that are high in nutrition and fiber and low in fat and calories — and limits highly refined carbohydrates, including sweets. No single diet is right for every woman. You may want to consult a registered dietitian or a diabetes educator to create a meal plan based on your current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget.
Exercise. Regular physical activity plays a key role in every woman's wellness plan before, during and after pregnancy. Exercise lowers your blood sugar by stimulating your body to move glucose into your cells, where it's used for energy. Exercise also increases your cells' sensitivity to insulin, which means your body will need to produce less insulin to transport sugar.
As an added bonus, regular exercise can help relieve some common discomforts of pregnancy, including back pain, muscle cramps, swelling, constipation and trouble sleeping. Exercise can also help get you in shape for the hard work of labor and delivery.
With your doctor's OK, aim for moderately vigorous exercise on most days of the week. If you haven't been active for a while, start slowly and build up gradually. Walking, cycling and swimming are good choices during pregnancy. Everyday activities such as housework and gardening also count.
- Medication. If diet and exercise aren't enough, you may need insulin injections to lower your blood sugar. Between 10 and 20 percent of women with gestational diabetes need insulin to reach their blood sugar goals. Some doctors prescribe an oral blood sugar control medication, while others believe more research is needed to confirm that oral drugs are as safe and as effective as injectable insulin to control gestational diabetes.
- Close monitoring of your baby. An important part of your treatment plan is close observation of your baby. Your doctor may monitor your baby's growth and development with repeated ultrasounds or other tests. If you don't go into labor by your due date — or sometimes earlier — your doctor may induce labor. Delivering after your due date may increase the risk of complications for you and your baby.
- Caughey AB. Obstetrical management of pregnancies complicated by gestational diabetes. http://www.uptodate.com/home. Accessed Dec. 10, 2013.
- Gestational diabetes. American Diabetes Association. http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html. Accessed Dec. 10, 2013.
- Coustan DR, et al. Medical management and follow-up of gestational diabetes mellitus. http://www.uptodate.com/home. Accessed Dec. 10, 2013.
- Gestational diabetes: A guide for pregnant women. Agency for Healthcare Research and Quality. http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=162&pageaction=displayproduct. Accessed Dec. 10, 2013.
- Greuter MJE, et al. Quality of guidelines in the management of diabetes in pregnancy: A systematic review. BioMed Central Pregnancy and Childbirth. 2012;12:58.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 137. Gestational diabetes mellitus. Obstetrics and gynecology. 2013;122:406.
- Blumer I, et al. Diabetes and pregnancy: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism. 2013;98:4227.
- Coustan DR, et al. Screening and diagnosis of diabetes mellitus during pregnancy. http://www.uptodate.com/home. Accessed Dec. 10, 2013.