Getting diagnosed with gestational diabetes may come as a shock but learning you have it is really important. With the right treatment and support from your healthcare team, it is possible to go on to have a healthy pregnancy and baby.
If your blood sugar levels are outside of the targets you discuss with your healthcare team, this can cause problems for you and your baby.
It is very common to need blood glucose lowering medication, including insulin, to help you achieve your target blood sugar levels when you have gestational diabetes.
Watch Rei's story below to hear about how she managed her gestational diabetes.
Treatments for gestational diabetes
Treatments for gestational diabetes include medication, diet and exercise, all with the aim of managing blood glucose levels.
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 more effectively. It’s taken with, or after, a meal.
Insulin is a hormone that allows glucose (sugar) 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 that goes in just under the skin.
Is my medication suitable during pregnancy?
Your diabetes and antenatal health care team are best placed to decide on the treatments that are appropriate for your gestational diabetes. Even though the patient information leaflets for metformin says that it shouldn’t be used during pregnancy, it's used in the UK to help manage diabetes in pregnancy and while 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.
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?
Try to take regular physical activity that is appropriate for you, such as:
- Going for regular walks after lunch or dinner
- Pregnancy yoga – you can look for videos to follow online, or go to a class
- Swimming or water aerobics – if you have other children, ask for support with childcare
- Dancing in the kitchen
You should try not to sit after a meal. We know being active for 15-20 minutes within 30 minutes of a meal will help get your post meal sugar level in the target range you have been recommended.
If you weren’t active before pregnancy
If you weren’t active before you became pregnant, do not suddenly take on strenuous exercise. Get advice from your healthcare team and start gradually to work your way up, such as a regular 15-minute walk turning into a 30-minute walk when you feel ready.
You could also try joining an exercise class or doing physical activity with a friend to make it more fun and create a routine. Let an exercise class instructor know you’re pregnant and how many weeks along you are. Always discuss your exercise plans with your midwife or doctor and listen to your body.
What is the best treatment for gestational diabetes?
There is no right or wrong way to treat gestational diabetes. Every woman is different and the treatments you’re offered will vary depending on your blood sugar levels and your own preference.
What is the first line treatment for gestational diabetes?
For many people with gestational diabetes the first treatment you’ll be given is support with following a healthy diet and exercising regularly. You may then be given medication if needed.
Can you fix gestational diabetes during pregnancy?
Usually, gestational diabetes goes away after the birth of the baby and having a blood glucose test at 6-13 weeks post birth will confirm this. But in some cases, the pregnancy reveals existing diabetes, and this means treatment will continue.
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 bedtime.
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
Do I need to take medication?
But some women will also need to start diabetes medications, such as injecting insulin, straight away. This will be because their blood sugar levels are very 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.
If you have gestational diabetes and have severe hypos (regardless of your awareness) or if you are finding it difficult to manage your blood sugar, your care team may consider a continuous glucose monitor for you under NICE guidelines. Find out more about continuous glucose monitors.