When you have gestational diabetes, you need to check your blood sugar levels regularly. You might also need to take medication, including insulin, to help you achieve your target blood sugar levels.
Every woman is different and the treatments you’re offered will vary depending on your blood sugar levels and your own preference.
Why check blood sugar levels?
Everyone has glucose (sugar) in their blood, but if your blood sugar levels aren't at the right level, this can cause problems for you and your baby.
How do I check my blood sugar levels?
Checking your blood sugar levels involves pricking the side of your finger with a special device called a lancet, and putting a drop of blood onto a test strip. This is then read by a blood glucose meter which tells you your blood sugar levels.
You should be given a blood glucose meter and taught how to check your blood sugar levels. If this hasn’t happened, ask your care team for one straight away.
Your care team will tell you when to check. This is likely to include when you wake up in the morning (fasting) and one hour after meals. If you’re having two or more insulin injections, you’re likely to be told to check before meals, one hour after meals and also at bed time.
What to aim for:
- Fasting: below 5.3mmol/l
- One hour after meals: below 7.8mmol/l
- If you’re not able to check until two hours – rather than one hour – after a meal, you should aim for below 6.4mmol/l.
Your care team should agree an ideal blood sugar level that’s right for you, and is manageable without causing hypos – low blood sugar levels.
To help you keep all your results in one place, you can download our handy resource – My Blood Sugar Targets (PDF, 104KB).
“The testing becomes second nature and, because you know it’s for the welfare of you and your baby in the short term and long term, you just get on and do it.”
Nicole, read her story
If you have gestational diabetes and have severe hypos (regardless of your awareness) or if you have unstable blood sugar, your care team may consider a continuous glucose monitor for you under NICE guidelines. Find out more about continuous glucose monitors
But some women will also need to start diabetes medications, including injecting insulin, straight away. This will be because their blood sugar levels are too high or they have high blood sugar levels and are experiencing complications.
Even when medications are needed, you’ll still need to make changes to your diet and physical activity levels. This will help you manage your blood sugar levels – you’ll be referred to a dietitian to help you with this.
“As my pregnancy progressed, no matter what I ate, I couldn’t manage my gestational diabetes. My blood sugar levels became very unstable – I found that foods which were ok one day would make my blood sugar level soar the next. My diabetes healthcare team then put me on metformin, which helped a lot and really took the pressure off.”
Reena, read her story
How do the medications work?
This tablet helps to reduce the amount of glucose (sugar) produced by the liver, and to make your insulin work properly. It’s taken with, or after, a meal.
This tablet works by stimulating your pancreas to make more insulin. It’s taken with, or straight after, food.
Insulin is a hormone that allows glucose (sugar) – the body’s main fuel – to enter the cells and to be used for energy.
Insulin can’t be taken orally because your stomach will digest it. It’s given as an injection using a small needle just under the skin. The places to inject are usually the thighs, buttocks and abdomen (belly). Your care team will teach you how to inject safely.
Is my medication suitable during pregnancy?
Even though the patient information leaflets for metformin and glibenclamide say that these medications shouldn’t be used during pregnancy, both are used in the UK to help manage diabetes in pregnancy and breastfeeding. There’s strong evidence for their effectiveness and safety. Your diabetes care team will consider the benefits to your blood sugar against any potential harm. Talk to your care team if you have any worries.
Can I inject insulin into my abdomen?
You may be worried about injecting into your belly while you’re pregnant. But with a short (4-6mm) needle, you can inject insulin into the fatty layer safely. Avoid the area too close to your belly button and speak to your care team if you have any concerns.
Don’t be put off by the word exercise or physical activity. You don’t have to take out a gym membership if you don’t want to. But, making time to be active and making that a priority is more important now than ever. But do:
• Speak to your maternity team
• Choose activities that reflect your exercise level before pregnancy
• Listen to your body
• Choose group exercises with qualified instructors and tell them how many weeks pregnant you are.
For more guidelines, see the Physical activity for pregnant women infographic on the GOV.UK website.
Benefits of physical activity
Activity helps to manage your gestational diabetes because it increases the amount of glucose (sugar) used by your muscles for energy, so it helps to lower your blood sugar levels. Also, being active helps the body use insulin more efficiently. And, regular activity can help reduce the amount of insulin you need.
There are lots of other health benefits of being active with gestational diabetes too.
What should I aim for?
Women with gestational diabetes should aim to take regular physical activity, such as 30 minutes of walking after lunch or dinner, to improve blood sugar levels.
Walking is a great activity when you have gestational diabetes. We have lots more information and advice on walking with diabetes here.