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Treatments and drugs
By Mayo Clinic staffControlling your blood sugar level is essential to keeping your baby healthy and avoiding complications during delivery. Your treatment plan may include:
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Blood sugar monitoring. Your health care provider may ask you to check your blood sugar level four to five times a day — first thing in the morning and after meals — to make sure you're keeping your blood sugar within a healthy range. This may sound inconvenient and difficult, but it'll get easier with practice. To test your blood sugar, you draw a drop of blood from your finger using a small needle (lancet), then place the blood on a test strip inserted into a blood glucose meter — a device that measures and displays your blood sugar level.
Your health care provider will also monitor your blood sugar level during labor. If your blood sugar rises, your baby may release high levels of insulin — which can lead to low blood sugar right after birth.
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Diet. Eating the right kind and amount of food is one of the best ways to control your blood sugar level. Making healthy food choices also helps prevent excessive weight gain during pregnancy, which can put you at higher risk of complications.
A healthy diet often means including more fruits, vegetables and whole grains — foods that are high in nutrition and low in fat and calories — into your diet and limiting carbohydrates including sweets. Even so, no single diet is right for every woman. You might want to consult a registered dietitian or a diabetes educator to create a meal plan based on your blood sugar level, height, weight, exercise habits and food preferences.
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Exercise. Exercise lowers your blood sugar level by transporting sugar to your cells, where it's used for energy. Exercise also increases your sensitivity to insulin, which means your body needs less insulin to transport sugar to your cells. And there's more. Regular exercise can help prevent some of the discomforts of pregnancy, such as back pain, muscle cramps, swelling, constipation and difficulty sleeping. It can also help prepare you for labor and delivery.
With your doctor's OK, aim for moderate aerobic exercise on most days of the week. If you haven't been active for a while, start slowly and build up gradually. Walking, cycling and swimming are often good choices during pregnancy. Ordinary activities such as housework and gardening also count.
- Medication. If diet and exercise aren't enough, you may need insulin injections to lower your blood sugar level. About 15 percent of women who have gestational diabetes need insulin therapy to reach a consistently safe blood glucose level. For some women, an oral medication, such as glyburide, also is an option.
Your baby will need close observation, too. Your doctor may monitor your baby's growth and development with repeated ultrasounds or other tests. If you don't go into labor by your due date — or sometimes earlier — your doctor may induce labor. Delivering your baby after your due date may increase the risk of complications.
After having gestational diabetes, your risk of developing type 2 diabetes later in life increases. Maintaining healthy lifestyle habits, such as a healthy diet and exercise, can help reduce or eliminate this risk.
- Strehlow SL, et al. Diabetes mellitus & pregnancy. In: DeCherney AH, et al. Current Diagnosis & Treatment: Obstetrics & Gynecology. 10th ed. New York, N.Y.: McGraw-Hill; 2007. http://www.accessmedicine.com/content.aspx?aID=2385290. Accessed Jan. 9, 2009.
- Jovanovic L. Screening and diagnosis of gestational diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed Jan. 5, 2009.
- Jovanovic L. Treatment and course of gestational diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Diabetes. In: Cunningham FG, et al. Williams Obstetrics. 22nd ed. New York, N.Y.: McGraw-Hill; 2005:1172.
- Cheng YV, et al. Gestational weight gain and gestational diabetes mellitus. Obstetrics & Gynecology. 2008;112:1015.
- Gestational diabetes. American Diabetes Association. http://www.diabetes.org/gestational-diabetes.jsp. Accessed Jan. 6, 2009.
- Gilmartin AH, et al. Gestational diabetes mellitus. Reviews in Obstetrics & Gynecology. 2008;1:129. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=19015764. Accessed Jan. 3, 2009.
