Gestational diabetes (GD) is a form of diabetes unique to pregnancy and can affect anyone. Insulin is a hormone that regulates the amount of sugar in the blood, but sometimes pregnancy hormones interrupt the way insulin works. Some women’s bodies adapt and make more insulin to manage the higher blood glucose levels, but some don’t, resulting in a diagnosis of gestational diabetes. Luckily, there are several ways your medical provider can help you manage GD.
A: If the fetus receives too much sugar during pregnancy, babies can gain a lot of weight, which increases the risk of labor abnormalities, birth injuries or trauma, and the rate of cesarean delivery. Mothers with gestational diabetes are at a higher risk of developing preeclampsia, which is a serious blood pressure condition.
A: The overall goal is keeping blood sugars at a normal level, which may be achieved with a combination of dietary changes and exercise. We monitor how well this is controlled by checking your levels at various times during the day, typically after meals.
A: Your medical providers may decide that you need medication to help control your blood sugars more closely. Typically this is managed with a self-injectable form of insulin.
A: A registered dietician can make a personalized meal plan to help you manage the amount and type of carbohydrates in your diet to help keep your blood glucose levels steady. Your individual plan will be designed around your specific levels.
A: Checking your levels is an important way to monitor the degree of blood sugar fluctuations, and to track if diet and exercise changes or medications are working. Ideally, you would check your levels just 4 times a day: 1 time in the morning before your first meal (called a fasting test), and 3 more times throughout the day either 1 or 2 hours after having a meal.
A: Your fasting glucose test goal is to be below 95 mg/dL (milligrams per decilitre). One hour after a meal, your goal is less than 140 mg/dL, and 2 hours post-meal should be less than 120 mg/dL. Your medical provider will help you make sense of your levels and if your mitigation strategies are working.
A: You’ll get a few additional ultrasounds throughout your pregnancy to see your baby’s growth and overall health. Depending on how well your gestational diabetes is controlled, these extra ultrasounds will vary from weekly to every 4 weeks.
A: In pregnancies where your diabetes is well controlled, the recommended time frame is delivery between 39 weeks and 40 weeks, 6 days. In pregnancies where GD isn’t as easily controlled, delivery may be recommended earlier. Your medical provider will discuss these recommendations with you.
A: Women with gestational diabetes are at higher risk of developing diabetes after pregnancy. At your postpartum visit, you will be tested again for diabetes, and your medical provider will review your results with you.