Gestational Diabetes Treatment

The doctor has made a referral to the Diabetes Clinic for you. Please expect a phone call from them in the next 1-3 weeks. 

After you are diagnosed with gestational diabetes, you will need to make changes in what you eat, and you will need to learn to check your blood sugar level. In some cases, you will also need to learn how to give yourself insulin injections. 

The goal of treatment for gestational diabetes is to reduce the risk that the baby will be large (weight greater than 9 lbs at birth). A large baby can be hard to deliver through the pelvis. 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.

Changes in diet

To learn what changes you should make in your diet, you will meet with a dietician or nurse. The following are some general dietary recommendations:

  • Avoid high-calorie snacks and desserts, including pop with sugar, fruit punch, candy, chips, cookies, cakes and full-fat ice cream.
  • You can use artificial sweeteners, such as aspartame (Nutrasweet), sucralose (Splenda), stevioside (Stevia) or acesulfame potassium (Sunnet).
  • Eat a lot of vegetables and fruits–at least five servings a day. Some fruits (like grapes, dried fruit) can increase your blood sugar level significantly and should be eaten in limited amounts. Limit starchy vegetables (e.g., potatoes), but eat as many nonstarchy fruits or vegetables as you like.
  • Choose foods with whole grains. This includes whole-wheat bread, brown rice or whole-wheat pasta instead of white bread, white rice or regular pasta.
  • Eat a limited amount of red meat, and choose lean cuts of meat that end in "loin" (e.g., pork loin, tenderloin, sirloin). Remove skin from chicken and turkey before eating.
  • Choose low- or fat-free dairy products, such as skim milk, nonfat yogurt and low-fat cheese.
  • Use liquid oils (olive, canola) instead of solid fats (butter, margarine, shortening) for cooking.
Blood sugar monitoring

You will learn how to check your blood sugar level and record the results. Instructions for choosing a blood sugar meter, checking blood sugar levels at home, and ways to record the results are discussed at the Diabetes Clinic.
 
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. You should discuss this with your doctor or nurse at each visit, because you might need to test more frequently later in the pregnancy.

Exercise

Although exercise is not a necessary part of gestational diabetes treatment, it might help to control blood sugar levels. If you were exercising before, you should 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.

Insulin

Approximately 15 per cent of women with gestational diabetes will require insulin. Insulin is a medicine that helps to reduce blood sugar levels and can reduce the risk of gestational diabetes-related complications.

You must give insulin by injection because it does not work when it is taken by mouth. Most women start by giving one shot of insulin per day at bedtime. If your blood sugar levels are high after eating, you may need to give a shot two or three times per day. Instructions for drawing up and giving insulin shots are available separately. 

If you take insulin, you should check your blood sugar level at least four times per day. You also need to write down your results and how much insulin you give and review these records at each prenatal visit. Keeping accurate records helps to adjust insulin doses and can decrease the risk of complications.

Source: Up To Date