Gestational Diabetes Treatment
The commonly accepted method of gestational diabetes treatment is with diet and exercise. It is possible to manage your gestational diabetes
with diet and exercise alone.
When diet and exercise are insufficient, you could have insulin injections and/or other medications.
The complications from gestational diabetes can be nullified, if you
take the disease very seriously. Gestational diabetes treatment is
proven and available; it is up to you to implement it.
Many women with gestational diabetes have given birth to healthy babies
doing it this way. The only thing preventing you from the same the
result, is you!
You decide how serious you consider the condition to be. It is your
decision on how much effort you are prepared to put in for a healthy
baby. It really is up to you.
There are a few "players" involved in this "drama", you, your baby and your health care team.
The role of your baby is easy, just grow! You have to do the work to supply your baby with the nutrients to do that.
To better understand what your role is in all this, go to: Managing Gestational Diabetes.
The role of your health care team is to diagnose, guide and support you.
Your health care team will advise you on which gestational diabetes
treatment is best for you.
Your job is to follow their advice, as if your life depends on it.
Wait! your life AND the life of your baby do depend on it!
Click to see who are the members of the health care team.
Testing and Diagnosis
Your doctor will recommend a screening schedule based on your specific
risk factors. This could be on the first prenatal visit, between weeks
24 and 28 or both.
If you have an abnormal test, your doctor will schedule more frequent
prenatal appointments. This is part of your gestational diabetes
Your risk factors and test results will determine which of these tests you should have.
Fasting blood glucose test.
- Plasma glucose level greater than 126 mg/dl (6.93 mmol/L)
- At risk developing gestational diabetes.
- Need to go for some confirmatory tests.
Random blood glucose test.
- Plasma glucose greater than 200 mg/dl. (11 mmol/L)
- At risk developing gestational diabetes.
- Need to go for some confirmatory tests.
Initial glucose challenge test.
- Preliminary test.
- Indicate if diabetes exists.
- Considered the standard test during the second trimester of pregnancy.
- You will be giving a syrupy glucose solution to drink.
- One hour after drinking, you will have a blood test to measure your blood glucose level.
- Blood glucose levels below 130 to 140 mg/dl (7.3 to 7.8 mmol/L) are usually considered normal.
- If your blood glucose level tests higher than normal.
- It only means you are at higher risk of gestational diabetes.
- Your doctor will only diagnose you after you had a follow up test.
Follow up glucose challenge test, also called the oral glucose tolerance test. (OGTT)
- This test is done if you are considered at risk of gestational diabetes.
- A period of fasting before this test is needed, usually overnight.
- You are given a glucose drink and blood samples are taken every hour for three hours.
- You will be diagnosed with diabetes if at least two of the readings are above normal.
- Glucose levels considered to be above normal during the oral glucose tolerance test.
- Fasting blood glucose level greater than 95 mg/dl (5.2 mmol/L)
- One-hour blood glucose level greater than 180 mg/dl (9.9 mmol/L)
- Two-hour blood glucose level greater than 155 mg/dl (8.5 mmol/L)
- Three-hour blood glucose level greater than 140 mg/dl (7.8 mmol/L)
Additional tests when the diabetes not properly controlled.
- You may need additional tests to assess your baby's general health.
- These tests are designed to assess the function of the placenta.
- Uncontrolled diabetes may affect the placenta, endangering the exchange of oxygen and nutrients to the baby.
- One abnormal test result does not necessarily indicate that there is a problem.
- More tests may be needed to accurately assess your baby's condition.
A monitor, connected to sensors placed on your stomach.It evaluates
increases in your baby's heart rate, expected with fetal movement.A lack
of enough oxygen is indicated if these heart rate increases are absent.
- Biophysical profile. (BPP)
A combination of the non-stress test with a fetal ultrasound.It
estimates the age, weight, and health of your baby.It assesses your
baby's movements and breathing.The test also evaluates whether a normal
amount of amniotic fluid is present.It indicates your baby's oxygen
status at the time the test is done.Diminished fluid shows decreased
urination by the baby.Decreased fluid could also indicate that over time
the placenta is working at less than optimum.
- Fetal movement counting. (Kick counts)
- You may perform this simple test at any time. However, it is best at your baby's most active part of the day.
- Count the number of times your baby kicks within a certain period.
- Usually the time it takes to count 10 movements should be within two hours.
- Fewer movements may mean insufficient oxygen supply to your baby.
Home blood sugar monitoring.
- Testing your own blood sugar levels at home several times a day.
- Self-testing greatly assists you in controlling the disease.
- This is a very important part of gestational diabetes treatment.
Testing for ketone.
- The morning urine is used to check for ketone.
- High ketone levels show that your body is using fat reserves for energy.
- Using fat for energy is not recommended during pregnancy.
- You might need to alter your eating habits.
- See managing gestational diabetes for more information.
- Ketone can be very harmful to your baby.
- Your gestational diabetes treatment plan may get adjusted, depending on the results of this test.
Glycosylated hemoglobin test. (HbA1c or HA1c)
- Your doctor might require you to have this test monthly for the duration of your pregnancy.
- This test shows your blood glucose level history of the previous eight to twelve weeks.
- It measures your average blood glucose levels over the past two to three months.
- This test is the best overall assessment of your blood sugar control.
- Inaccurate if a condition that affects the average age of red blood cells is present. Such as:
- Recent blood loss.
- Hemolytic anemia.
- Hemoglobinopathy such as sickle-cell disease.
- HbA1c is not a gestational diabetes diagnostic aid.
- Normal HbA1c results are four to six percent, less than five percent is optimal.
- Fructosamine forms, when a carbonyl group of glucose reacts with an amino group of a protein.
- Fructosamines formed from blood proteins are known as Glycated Serum Protein or Glycated Albumin.
- Glycated Albumin is used to identify the plasma glucose concentration over time.
- Alternative test if the glycosylated hemoglobin test is unsuitable.
- The fructosamine test assesses diabetic control over an intermediate period.
- It reflects an average of blood glucose levels over a period of 2 to 3 weeks.
- Useful in pregnancy, where hormonal changes cause a greater short-term fluctuation in glucose concentrations.
- The fructosamine test is not useful as a screen for diabetes.
- Important if you have Poly Cystic Ovarian Syndrome (PCOS), known for significant insulin resistance.
- These measure how well your body utilizes its insulin, or your level of insulin resistance.
- Excess amounts of insulin may be present in the body despite perfectly normal blood glucose levels.
- Abnormal insulin test results tend to indicate a predisposition to insulin resistance and/or gestational diabetes.
- It is not a required test, but useful for special conditions like PCOS.
- There are different types of insulin tests.
- A fasting insulin test measures how much insulin is in your body when fasting.
- Comparing amounts of insulin secreted and the blood glucose level.
- It is the proportion of these two numbers that can indicate a problem.
- These tests are in the fast developing area of endocrinology.
- Ensure that your provider is informed on the latest developments.
Tests during delivery.
- You and your baby will be closely monitored during labor and delivery.
- Your blood glucose levels will be measured at least every one to two hours.
- If your blood glucose drops too low, you may be given glucose intravenously.
- If your blood glucose gets too high, you may be given insulin intravenously.
- Checking your baby's heart rate and how well your baby's heart responds to movement.
- Monitoring your baby's heart will tell your doctor how your baby is doing during labor.
Blood glucose testing after you give birth.
- After delivery, you and your baby should still be monitored closely.
- For the first few hours, your blood sugar level may be tested every hour.
- Your baby's blood sugar level will be tested several times within the first few hours.
- Your baby might still produce extra insulin to cater for your higher blood glucose levels.
- Excessive insulin in your baby's blood will lead to low blood sugar. (Hypoglycemia)
- Hypoglycemia can quickly be put right, by giving your baby extra glucose intravenously.
- Your baby's blood may be checked for low calcium, high bilirubin, and extra red blood cells.
- Continue to self-monitor your blood glucose daily until you had the test at six weeks.
- One to three days after delivery, you should have a fasting or random blood glucose test.
- Test six weeks after the birth, to ensure your blood glucose levels returned to normal.
- Testing for diabetes should be done annually for the rest of your life.
- If your blood sugar levels indicate diabetes or prediabetes, implement a diabetes treatment plan immediately.
- Breastfeeding helps to prevent your child developing diabetes.
- Eating a healthy diet and getting regular exercise can help prevent type 2 diabetes.
- Get tested for diabetes both before you become pregnant and early in your next pregnancy.
Always get a copy of your tests and keep it permanently in your files.
Your history of diabetes test results can be very helpful in prescribing
treatment. It will assist in establishing your health status down the
It is also nice to know at what age your test results were still normal.
You might also need to show that you've had normal blood glucose levels before pregnancy.
It is important to point out that blood sugar testing is not error-proof. Test results can be affected by stress and illness.
Your tests should have more or less the same results if repeated a few
days later. It is a good thing to have your tests repeated if the
results are abnormal.
The tests are mostly accurate, but still, rule out the possibilities of a random error result.
Gestational Diabetes Treatment and Medications
Gestational diabetes treatment means making healthy choices.
Controlling your blood sugar level is essential to keeping your baby healthy and avoiding complications.
Gestational diabetes treatment involves taking steps to keep your blood glucose levels in a target range.
Your gestational diabetes treatment plan may include:
Monitor your own blood glucose levels daily.
Healthy eating habits.
Monitoring your baby's growth and well-being.
- Kick counts.
- Fetal heart rate monitoring.
- Non-stress tests.
- Watching for excessive growth of your baby.
Regular medical checkups.
- Having gestational diabetes means increased visits to your doctor.
- Your doctor needs to make sure that your blood glucose levels are under control.
- Your gestational diabetes treatment plan may need adjusting.
- Take your journal with you with every appointment.
Medications, when lifestyle changes alone are insufficient.
- Two weeks of nutritional therapy alone should indicate if you would need insulin therapy as well.
- You should reach the recommended blood glucose levels within two weeks with healthy eating and exercise.
- Synthetic insulin can help lower your blood sugar level without harming your baby.
- Insulin dosage may be increased as the pregnancy progresses and insulin resistance increases.
- Low blood glucose reaction (hypoglycemia) can occur if you are using insulin.
Causes of hypoglycemia include:
- When you do not eat enough food.
- When you skip a meal or go too long without eating.
- When you eat at the wrong time of the day or irregularly.
- When you exercise incorrectly.
Symptoms of hypoglycemia include:
- Feeling shaky.
- Sudden hunger.
- Hypoglycemia is a serious problem that must be treated right away.
- People around you, at work and at home, must know what to do about hypoglycemia.
- Check your blood glucose level, if you can.
- If your sugar level is below 60mg/dl. (3.3 mmol/L)
- Eat a sugar rich food, like hard candy, regular soft drink, and honey.
- Check your blood glucose 15 minutes after eating. If it is still low, eat some more sugar rich food.
- Eat a protein-filled sandwich to prevent another reaction.
- Record all hypoglycemic episodes in your journal, including the date, time and how you treated it.
Oral hypoglycemic medication.
- Prescribing oral medications, normally prescribed for non-pregnant diabetics, are not recommended for gestational diabetes.
- Concerns are that the medication crosses the placenta, causing prolonged neonatal hypoglycemia.
After the Delivery
After the delivery, your diabetes might go away, but your gestational diabetes treatment never stops.
You might not need insulin shots anymore, but do you want to go through that again?
Continue with the healthy lifestyle you practiced with your gestational diabetes treatment during the pregnancy.
You are at higher risk to develop type 2 diabetes at a later stage. You
might also get gestational diabetes again in a future pregnancy.
Maintaining healthy lifestyle habits can reduce or even eliminate this
risk. The principles of the gestational diabetes treatment plan can be
applied to a healthy lifestyle.
The accepted recommendation is that you should breast-feed your baby, if
possible. Breast-feeding can help prevent your child from becoming
obese. This could reduce your child's chances of developing diabetes
When you are breast-feeding, be sure to continue checking your blood sugar levels.
A baby with a gestational diabetic mom is at risk for being overweight
and developing diabetes. Encourage your child to eat healthy and
exercise regularly to help preventing the onset of diabetes.
The best way to do this is by leading a healthy lifestyle yourself. Be
an example. Continue practicing the principles of your gestational
diabetes treatment plan.
A Parting Thought
With prompt diagnosis, correct gestational diabetes treatment and good
management, you can expect to have a healthy pregnancy and baby.
Recognize that you are the most important person in promoting a healthy
pregnancy. It is up to you to implement the gestational diabetes
treatment plan prescribed for you. After all, it is your body and your baby. It really is up to you.
Please consult the services of your
doctor and/or other members of your health care team
before implementing any of the advice contained on this site.
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