Like type 2 diabetes, gestational diabetes develops when liver, muscle, and fat cells don’t respond well to insulin — a hormone that regulates glucose (sugar) levels in the blood. As its name suggests, gestational diabetes develops only in pregnant women. It’s caused by changes in the body (including changing hormone levels) during pregnancy, and causes high blood glucose levels. If left uncontrolled, the condition may be harmful — or even deadly — to both the woman and her child, and can increase both of their risks of developing type 2 diabetes later in life. The key to treating gestational diabetes is to tightly regulate blood glucose levels through lifestyle changes (diet and exercise) and, if necessary, medications.
Gestational Diabetes Diet
Treatment for gestational diabetes always includes specialized healthy meal plans — often recommended by a registered dietician — and regular exercise, according to the American Diabetes Association (ADA). Generally speaking, diets for gestational diabetes focus on foods high in fiber and other important nutrients, and low in fat and calories. This means they tend to favor vegetables, fruits, and whole grains, and frown on refined carbohydrates (including sugar). According to a 2008 report in the journal Reviews in Obstetrics and Gynecology, a diet that can help most women with gestational diabetes maintain a normal blood glucose level is one in which 33 to 40 percent of calories come from complex carbohydrates, 35 to 40 percent come from fat, and 20 percent come from protein. Eating regular small meals throughout the day can also help keep your blood glucose level stable.
Exercise as Treatment for Gestational Diabetes
Regular physical activity is important to help keep your blood glucose under control. Women with gestational diabetes should get at least 30 minutes of moderate to intense exercise at least five days a week, according to the Centers for Disease Control and Prevention. This can include walking briskly, swimming, dancing, low-impact aerobics, or actively playing with children. Potentially dangerous activities — including basketball and soccer (which can result in balls hitting the stomach), horseback riding, and downhill skiing — should be avoided. During the first trimester of your pregnancy, you should also avoid exercises that require you to lie on your back, which could put pressure on certain blood vessels and accidentally limit blood flow to your baby. Ask your doctor before lifting weights, jogging, or performing other muscle- and bone-strengthening exercises during your pregnancy.
Monitoring Blood Glucose Levels
As with any form of diabetes, it’s important to regularly check your blood glucose level with a glucose monitor. If you have gestational diabetes, you should check your blood glucose level first thing in the morning, and one to two hours after each meal of the day. According to the ADA, your blood glucose levels should read:
95 milligrams/deciliter (mg/dl) or lower when you wake up, and before meals140 mg/dl or lower one hour after a meal120 mg/dl or lower two hours after a meal
If you don’t reach these target levels through diet and exercise alone, you may need to take medication to further lower your blood glucose levels.
Gestational Diabetes Medications
Insulin injections are the standard medication for gestational diabetes. Your doctor may prescribe a fast-acting insulin that you take before a meal, or an intermediate- or long-acting (basal) insulin that you take at bedtime or upon waking. As an alternative — or in addition — to insulin, your doctor may prescribe an oral medication, such as Glynase, Diabeta, or Micronase (glyburide); or Glumetza, Glucophage, Fortamet, or Riomet (metformin). You should know that these drugs aren’t approved for gestational diabetes by the Food and Drug Administration. That said, glyburide and metformin do appear to be effective and safe for gestational diabetes, according to the 2008 report.
