Gestational Diabetes Treatment

Blood sugar levels during pregnancy should be lower than in the non-pregnant state. The gestational diabetes treatment goal is to keep blood sugar levels as close to normal as possible, in order to prevent the potential complications for the baby and the pregnancy.

There is no consensus on what the blood sugar goals should be.

The American Diabetes Association (the ADA)’s glucose targets are :

  • Fasting blood glucose concentration ?95 mg/dL (5.3 mmol/L)
  • One-hour postprandial blood glucose concentration ?140 mg/dL (7.8 mmol/L)
  • Two-hour postprandial glucose concentration ?120 mg/dL (6.7 mmol/L)

 

The glucose targets for the American College of Gynecologist (ACOG) are:

  • Fasting glucose concentration ?95 mg/dL (5.3 mmol/L) or
  • One hour-postprandial glucose <130 to 140 mg/dL (7.2 to 7.8 mmol/L) or
  • Two hour-postprandial blood concentration ?120 mg/dL (6.7 mmol/L)
 

Keeping blood glucose levels normal will reduce the risk that the baby will be large (weigh greater than 9 lbs at birth). A large baby can be hard to deliver through the pelvis (leading to a complication called shoulder dystocia). This increases the risk of injuring the infant (e.g. broken bones or nerve injury). A large baby is also more likely to cause injury to the woman during the delivery.

 

Gestational Diabetes Treatment 

 

Changes in Diet – To learn what changes you should make in your diet, you should meet with a dietitian or nurse. Here are some general guidelines for gestational diabetes diet:

 

Blood Sugar Monitoring – You will learn how to check your blood sugar level and record the results. SEE MONITORING YOUR SUGARS

Initially, most women should check their blood sugar level four times per day:

  • Before eating in the morning
  • One hour after breakfast, lunch, and dinner

 

This information can help to determine whether your blood sugar levels are on target. If your levels are consistently higher than they should be, your doctor or nurse will probably recommend that you start using insulin.

If your blood sugar levels are consistently normal, you might be able to test less frequently.

 

Exercise – Moderately increasing your activity level is also a good way to help keep your blood glucose levels within the normal range. If you were exercising before, you can continue after being diagnosed with gestational diabetes.

If you did not previously exercise, ask your doctor or nurse if exercise is recommended. Most women who do not have medical or pregnancy-related complications are able to exercise, at least moderately, throughout their pregnancy.

 

Treating Gestational Diabetes with Insulin – Approximately 15 percent of women with gestational diabetes will require insulin. Insulin is a medicine that helps to reduce blood sugar levels.  Insulin can only be taken by injection. Oral diabetes medicines, such as those taken by people with type 2 diabetes, are not usually used during pregnancy in the United States.

Most women start insulin therapy by giving one shot per day at bedtime, usually an insulin called NPH or Levemir, which was recently approved for use in pregnancy. If your blood sugar levels are high after eating, you may also need to take insulin with each meal with short acting insulin. 

If you take insulin, you should check your blood sugar level at least four times per day. Writing down your results is an important part of your treatment and you should bring that record with you to all of your doctor visits.

Read more about Gestational Diabetes:


 

Reviewed by Dr. Mariela Glandt, Feb. 2013

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