Gestational diabetes affects up to 9% of pregnant women, making it one of the most common pregnancy complications. But what is it? Gestational diabetes is high blood sugar that occurs for the first time during pregnancy. And while it can happen at any time during pregnancy, it's most common between 24 and 28 weeks. Although being diagnosed with diabetes during pregnancy can feel overwhelming, it doesn't mean you can't have a healthy pregnancy and baby. To help, consider the following tips on how to manage gestational diabetes.
9 Ways to Manage and Treat Gestational Diabetes
People with gestational diabetes can still go on to have a completely healthy pregnancy without any complications. The most important way to do this is to work with your doctor and create a management plan, which will typically include many of the following components:
1. Regularly Check Blood Sugar Levels
If you've been diagnosed with gestational diabetes, your doctor will explain everything you need to know about it and how to manage it. This will include regularly checking your blood glucose levels. Typically, this involves using a finger-pricking device and glucose test strips, but some individuals may be eligible to use a continuous glucose monitor (CGM). Your doctor will show you how and when to check blood sugar levels, how often throughout the day, and what your target numbers are.
The American Diabetes Association (ADA) suggests the following targets for women who develop gestational diabetes during pregnancy. However, these are merely guidelines, and your healthcare team may recommend more or less stringent goals. Still, the ADA guidelines are:
- Before a meal (preprandial): 95 mg/dL or less
- One hour after a meal (postprandial): 140 mg/dL or less
- Two hours after a meal (postprandial): 120 mg/dL or less
Your doctor will also discuss how to share blood glucose readings with your care team, and what to do when you're outside of your range.
2. Schedule Additional Prenatal Appointments
Gestational diabetes can increase the risk of pregnancy complications, so it's important to work with your doctor to monitor development until your baby is born. You should expect to have more frequent prenatal appointments to help ensure that everything is on track. These extra checkups help monitor your blood sugar levels, and your doctor may want to perform more ultrasounds to track your baby’s growth. Typically speaking, babies of mothers with gestational diabetes are at higher risk of growing larger than average, so regular ultrasounds help ensure your baby is developing as expected.
If you’re feeling overwhelmed with the number of appointments, remember that these visits are essential for your health and your baby’s well-being. Come prepared with any questions or concerns you may have, and use these appointments as an opportunity to talk openly with your care provider about how you’re managing your gestational diabetes.
3. Maintain a Healthy Diet
Another important way of managing gestational diabetes is through diet. Some foods cause your blood sugar to elevate, while others may cause drops. So, understanding how what you eat (and when you eat it) affects your blood glucose can help you create meal plans to stabilize it. Your doctor may give you tips on diabetes meal planning, or you may be referred to a dietitian. Although you should already be eating healthy for your pregnancy and your baby's health, understanding which foods control your blood sugar can further reduce the risk of complications. Some general tips for a diet that supports gestational diabetes management include:
- Eating regular meals and snacks throughout the day
- Never skipping meals
- Eating low glycemic index (GI) foods to help slow blood sugar elevations.
- Counting the carbohydrates in your diet
- Eating lean sources of protein
- Eating plenty of whole vegetables and diabetes-friendly fruits like berries
- Avoiding processed foods
- Limiting sugar (especially added sugars and refined sugars like those in beverages and juices)
You should also continue to avoid the typical non-safe foods during pregnancy, such as unpasteurized products, high-mercury fish, and raw or undercooked animal products.
4. Get Enough Physical Activity
Diet and exercise go hand in hand with a healthy lifestyle, especially when diabetes and pregnancy are involved. Unless directed by your doctor, physical activity can be an effective part of your gestational diabetes management plan, as it helps you control your blood sugar levels. Of course, it's important to always practice pregnancy-safe exercises and never start a new regimen without talking to your doctor first.
Try to get at least 150 minutes of activity per week, ideally spread out across five to six days. Exercise during pregnancy can look different to everyone, but you can start with low-impact exercises such as swimming, walking, or even prenatal yoga. If you have any concerns about your exercise plan, ask your doctor for a referral to a physical therapist specializing in pregnancy exercises.
5. Try to Manage Your Stress Levels
Being newly diagnosed with a type of diabetes while you're already dealing with the stress of pregnancy and parenthood can be challenging. However, it's important to try to keep stress at bay. Stress releases adrenaline and cortisol, which can increase your respiratory rate and the rate of glucose that enters the bloodstream. This, in turn, can lead to high blood sugar. Stress can also impact insulin levels, making it more difficult for your body to address elevations in blood sugar.
Gestational diabetes can be a scary diagnosis, but with the proper care, you and your diabetes team can work to keep your blood sugar levels stable and healthy. Having gestational diabetes does not mean you can't have a healthy pregnancy; it just requires a little more focus on day-to-day care. If you're having difficulty managing stress, talk to your doctor. The more you understand gestational diabetes and manage blood sugar levels, the more in control of the situation you'll feel.
6. Take Medications as Prescribed
Sometimes, diet and exercise alone aren’t enough to keep blood sugar levels within a healthy range. You may need insulin or diabetes medications to stabilize blood sugar levels, which your doctor will prescribe. Insulin therapy is commonly used for gestational diabetes, but some women may also be prescribed oral medications like Metformin. It’s essential to take these medications exactly as prescribed to maintain stable blood sugar levels and reduce the risk of complications. Never view this as a failure on your part. Your body simply needs additional support through the rigors of pregnancy. Most people who begin insulin during pregnancy are able to discontinue it following delivery.
Your doctor will show you how to properly administer insulin injections if needed and explain when to take it throughout the day. Keep in mind that medication is used in conjunction with lifestyle modifications. It doesn’t replace these strategies but works together with them to manage your gestational diabetes. Always communicate with your healthcare provider if you experience any side effects or have concerns about your medication.
7. Talk to Your Care Provider Regarding Your Delivery Date
As your pregnancy progresses, your healthcare team will keep a close eye on how your baby is growing and developing. In some cases, women with gestational diabetes may need to deliver a little earlier than their due date, especially if the baby is measuring large or if there are concerns about your blood sugar levels. This is why it’s important to have an open conversation with your care provider about your delivery plan. Typically, the ideal time to give birth with gestational diabetes is between 38 and 40 weeks. If you have not given birth by 40 weeks and six days, your doctor will try to induce labor or schedule a cesarean section.
Discuss any concerns you may have about labor and delivery, and ask about the possibility of induction or a planned cesarean section ahead of time so you know what to expect. Being informed about your options can help you feel more in control as your delivery date approaches. Regardless, your doctor will work with you to create a safe and healthy birth plan that ensures the best outcome for both you and your baby.
8. Check Your Baby's Blood Sugar
After delivery, your baby’s blood sugar levels will be monitored closely, especially within the first few hours of life. Babies born to mothers with gestational diabetes are at a higher risk for low blood sugar (hypoglycemia), which can lead to complications if not treated promptly. Therefore, the hospital staff will check your baby’s glucose levels and take immediate action if necessary. Sometimes, babies with low blood sugar may need a small amount of formula or glucose water to stabilize their levels. In more serious cases, intravenous glucose may be required. Although this can sound alarming, rest assured that your medical team will monitor your baby closely and provide the care needed to ensure a smooth transition after birth.
9. Attend a Follow-Up Appointments
Gestational diabetes typically resolves after childbirth, but it’s crucial to attend your follow-up appointments to ensure your body has returned to normal. About 6 to 12 weeks postpartum, your doctor will likely test your blood sugar levels again to check for any lingering effects of gestational diabetes. Even if your levels return to normal, having gestational diabetes increases your risk of developing type 2 diabetes later in life. Your doctor may, therefore, recommend regular glucose testing every one to three years to monitor your long-term health.
For additional diabetes support and management, Byram Healthcare has a range of continuous blood glucose monitors. We also have a range of diabetes support and educational materials available to help you access everything you need for comprehensive care.
