Treatment for gestational diabetes can often manage glucose levels and prevent complications. Lifestyle approaches and glucose monitoring are the main option, but some people may need medication.
It is essential to follow the plan you make with your healthcare team. Not doing so can increase the risk of pregnancy complications. Managing gestational diabetes can help prevent these issues. Always speak with your healthcare professional before starting, changing, or stopping any treatment for gestational diabetes.
Here, we look at the options for treating gestational diabetes. For a complete guide to gestational diabetes, see our dedicated article here.
Nondrug Treatments
The first-line treatments for gestational diabetes are nonpharmacological, including diet, exercise, and glucose monitoring.
Research suggests that up to 70 to 85 percent of people with gestational diabetes can manage and recover from this condition through these interventions.
Diet
Experts advise people with gestational diabetes to seek counseling with a registered dietitian.
Getting the right nutrients is essential for you and your growing baby during pregnancy, but you’ll have to take extra care to stay healthy if you have gestational diabetes.
You’ll need a balance of macronutrients:
You’ll also need a balance of micronutrients:
- Vitamins
- Minerals
- Antioxidants
Your dietitian can help you balance these nutrients. Experts advise eating three small to moderate meals daily, plus two to three snacks. They may recommend having one of these snacks at bedtime, to prevent ketosis.
The balance of nutrients may vary during the day. Breakfast, for instance, may need to be lowest on carbohydrates, as your carb intolerance may be worst just after waking up.
Your dietitian will help you make an eating plan based on your needs and a gestational diabetes–friendly diet.
Click here for some tips on foods to eat and avoid when dealing with gestational diabetes.
Weight Gain Management
Your dietitian will also work with you to help minimize your weight gain.
Gaining too much weight during pregnancy can increase your risk of:
Exercise
Exercise can help people manage weight gain and blood sugar. Most people will benefit from regular exercise during pregnancy.
Always check with your doctor before starting or changing your exercise plan during pregnancy.
Experts advise getting at least 150 minutes of moderate-intensity aerobic exercise per week. You can divide this into 30 minutes, five days a week. You can do three 10-minute sessions per day.
Suitable activities include:
- Walking
- Swimming
- Modified yoga or Pilates
- Stationary cycling
Here are some tips to bear in mind:
- If you didn’t exercise before pregnancy, start with five minutes per day and build up.
- If you were active before, continue exercising but be prepared to drop activities that might not be safe, such as climbing.
- Don’t exercise if your doctor tells you not to — for instance, if you have placenta previa or certain types of anemia.
- Work with your dietitian team to ensure that you’re getting the right calorie intake for your activity level.
- Speak with your dietitian or doctor if you have any concerns.
There may be special pregnancy exercise classes in your area. Ask your healthcare team if they can recommend something suitable.
You can also try this pregnancy strength workout.
Glucose Monitoring
Your doctor may ask you to monitor your glucose levels with a continuous glucose monitor or with a finger-stick monitor.
The first test will be upon waking up, before eating or drinking. The other three will be one to two hours after each meal. These are the recommended blood sugar levels for pregnant women:
- Less than 95 milligrams per deciliter (mg/dL) when fasting or before eating
- 140 mg/dL one hour after eating
- 120 mg/dL two hours after eating
It’s a good idea to keep a log of your readings to show the doctor and track any developments. Your doctor may need to adjust your targets or treatment over time, and your log will help.
Medication
For around 15 to 30 percent of people with gestational diabetes, diet and exercise are not enough. These people will need medication.
Your doctor may prescribe medication if you follow your diet and exercise plan and your glucose levels are still high after 10 to 14 days.
Here are some options.
Insulin
If you need medication, insulin is suitable during pregnancy, as it can’t cross the placenta. This means it will not directly affect the fetus.
Your doctor will calculate the amount of insulin you need based on your weight and how many weeks you are pregnant.
They will likely give you a daily dose, divided as follows:
- One-quarter as a basal dose, or long-acting dose, for the morning, when fasting
- One-quarter as a basal dose to take a bedtime
- The remaining half divided into three parts to use as a short-acting dose after meals
Using your log of glucose measurements, your doctor will adjust your dose over time.
Oral Medications
Options include metformin (Fortamet) and sulfonylureas, such as glyburide (Micronase). However, these are not usually the first options, as they can pass the placenta and reach the fetus.
Your doctor will weigh up the risks and benefits of drug treatment and discuss your choices with you.
Surgery
Surgery is not a treatment option for gestational diabetes, but gestational diabetes can increase the likelihood that you’ll need a cesarean delivery, or C-section.
The reason for the increased risk of C-section is because high blood sugar levels can result in “overfeeding” of the fetus, which may mean you will have a larger baby.
Managing gestational diabetes can reduce the risk of needing a cesarean delivery.
After Pregnancy
Gestational diabetes starts during pregnancy and often goes away afterward. However, the condition is linked to complications that can linger after delivery.
Postpartum Depression
Anyone can develop postpartum depression, or the “baby blues,” after delivery, but having gestational diabetes may increase the risk.
Doctors don’t know exactly why this happens, whether it’s a physical reaction, a mental health issue, or due to the stress of having and managing diabetes while pregnant.
Speak with your healthcare team if you have any concerns, or call 1-833-TLC-MAMA (1-833-852-6262) to speak with someone who can help.
Type 2 Diabetes
For most people, gestational diabetes goes away after pregnancy.
For some, however, it doesn’t go away but changes into type 2 diabetes. If this happens, you’ll need to work with your doctor on managing this condition.
Having gestational diabetes also means that you will have a higher risk of developing type 2 diabetes later in life.
Experts recommend testing 6 to 12 weeks after delivering and then every one to three years. Your doctor can advise you about how often to test.
Complementary and Integrative Approaches
Some people use complementary therapies during pregnancy, including for gestational diabetes.
They include:
- Meditative activities, such as tai chi, qigong, and relaxation exercises
- Acupressure
- Herbs and spices, such as bitter melon, chamomile, and cinnamon
Always check with your doctor before using complementary therapies, as some herbs and other treatments can have unwanted effects.
Mental Health
Having a diagnosis of gestational diabetes can be worrying. Speak with your healthcare team about any concerns, as they are there to help.
The important thing is to follow your treatment plan. Doing so can significantly reduce your risk of pregnancy complications as well as your risk of developing type 2 diabetes within the next five years.
Your doctor can also recommend counseling services and other options if you experience anxiety, depression, or other mental health challenges during pregnancy.
