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How To Manage Gestational Diabetes

Posted on November 16, 2023 by Henry Ford Health Staff

Gestational diabetes affects up to 10% of pregnant women in the US. If you recently learned you have gestational diabetes, you might be nervous about what it means for you and your baby. 

“The first thing I always tell patients is this will be okay,” says Neil S. Simmerman, MD, MBA, an obstetrician-gynecologist at Henry Ford Health. “With close observation and good care, the likelihood of having a great outcome doesn’t diminish at all.”

How Do You Know If You Have Gestational Diabetes?

Gestational diabetes is diabetes that develops in a pregnant person who did not have diabetes before pregnancy. Like Type 2 diabetes, it occurs when your body doesn’t make enough insulin—a hormone that helps your body use sugar for energy. Without enough insulin, your blood sugar (blood glucose) levels become too high.

“Gestational diabetes is so common that we screen all pregnant women between 24 and 28 weeks of pregnancy,” notes Dr. Simmerman. “Early diagnosis helps us help you manage it.”

For that screening test—called a glucose challenge—you’ll drink a very sweet liquid in your doctor’s office or at a lab and wait an hour. Then you’ll have blood taken for a blood sugar test. 

If your blood sugar is high after the glucose challenge, you’ll have a glucose tolerance test. For this test you fast overnight and have your fasting blood sugar tested. Then you drink another sugary liquid and have your blood glucose checked after one, two and three hours. If your blood sugar is high on this test, you have gestational diabetes. “It's a bit rigorous, but it's designed so that we don't miss any cases,” says Dr. Simmerman.

Why Is Controlling Diabetes During Pregnancy Important?

Having gestational diabetes can increase the risk of developing hypertensive disorders of pregnancy (high blood pressure and preeclampsia)—particularly if your blood sugar is poorly controlled. Women with gestational diabetes are also 10 times more likely to develop Type 2 diabetes later in life.

Uncontrolled gestational diabetes doesn’t just affect the expectant mom. “If mom’s sugars aren’t well controlled, the baby lives in a high sugar environment for nine months,” Dr. Simmerman says. “This can result in the baby needing extra care in the NICU or interventions such as bottle feeds to maintain their sugars until their insulin levels decrease.”

Other complications of undiagnosed or uncontrolled gestational diabetes include:

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  • Macrosomia, a baby that weighs more than 8 pounds, 13 ounces, which can cause delivery complications
  • Polyhydramnios, too much amniotic fluid around the baby, which can lead to other complications like preterm labor
  • Premature birth
  • Type 2 diabetes later in life

Tips For Staying Healthy With Gestational Diabetes

“I tell all my patients that with close observation and good care, the likelihood of you having a great outcome is high,” says Dr. Simmerman. He notes three main things to focus on:

1. Nutrition

 As a general recommendation, you will eat three meals and two to four snacks a day. “We ask patients to monitor their calorie and carbohydrate intake and focus on complex carbohydrates,” Dr. Simmerman says. “Our patients all get nutrition counseling and we have a nutritionist that's dedicated to people with gestational diabetes. It’s important to eat enough to stay well-nourished as you try to control your blood sugar.”

2. Exercise

 Exercise can help control blood sugar for people with gestational diabetes. Aim for at least 150 minutes of moderate exercise a week (about 30 minutes a day). 

3. Blood sugar checks 

Checking your blood sugar is the only way to know if it’s under control. “Most people do four sugar checks a day—fasting in the morning, and an hour or two after each meal,” Dr. Simmerman says. “That information lets us know if diet and exercise are working.”

Medication For Gestational Diabetes 

“Even if you do all these steps perfectly, your sugars may still be too high,” explains Dr. Simmerman. “This isn’t because of anything you’re doing wrong. Despite your best efforts, your body might need more help.”

If your blood sugar is high even with diet and exercise, your doctor may prescribe a medication to stabilize your glucose levels. 

Delivery With Gestational Diabetes

Gestational diabetes—and how well it’s controlled—may impact your delivery timing, how you deliver and the number of tests you have. 

“We watch the baby's growth closely because it's going to impact mode and safety of delivery as well as baby's early experience after delivery,” Dr. Simmerman says. “If the baby is large, we may recommend a C-section. If you need medicine to help control your sugars, we may recommend an earlier delivery. If your baby is born with low blood sugar, they will probably need a little extra care.”

For most women, delivery is the end of the journey with gestational diabetes. “We consider delivery curative,” says Dr. Simmerman. You’ll have another sugar test about six weeks after delivery to make sure the condition has resolved.

“We know gestational diabetes seems like a daunting uphill battle,” says Dr. Simmerman. “But it’s a well-traveled road that can be navigated successfully with the right team behind you.”

Reviewed by Neil Simmerman, MD, MBA, an obstetrician-gynecologist at Henry Ford Health and Chief of Women's Health Services at Henry Ford West Bloomfield Hospital.

Categories : FeelWell

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