How Gestational Diabetes Is Treated

Gestational diabetes is a type of diabetes that develops or is diagnosed during pregnancy. It affects people who did not have diabetes before pregnancy.

Each year about 2% to 10% of pregnant people in the United States are diagnosed with gestational diabetes, typically between the 24th and 28th weeks of pregnancy. Fortunately, gestational diabetes is treatable to ensure a healthy pregnancy and baby.

This article provides an overview of treatments and dietary recommendations for gestational diabetes. 

Home Remedies and Lifestyle 

Lifestyle changes are the first-line treatment for most people with gestational diabetes. Maintaining a healthy weight through diet and exercise helps to keep blood glucose levels in a healthy range. It’s important to note that losing weight at any time during pregnancy is usually not recommended.

Nutritious Diet

A healthy diet can help treat and prevent gestational diabetes. Focus on foods high in fiber and low in fat and sugar. Limiting dietary fat to 30% or less of your daily calories is recommended.

Eat a diet rich in vegetables, whole grains, and lean protein. Limit fruit intake and refined carbohydrates like sweets as much as possible. It may be helpful to meet with a registered dietitian or certified diabetes education specialist to plan which foods to eat, how much, and when to eat.

Physical Activity

Healthcare providers recommend exercising before, during, and after your pregnancy. Aim for 30 minutes of moderate activity most days of the week. Walking, cycling, and swimming are all good choices during pregnancy.

Exercise has been found to lower blood sugar levels and improve insulin resistance. It can also help to relieve minor pregnancy discomforts like back pain, trouble sleeping, and constipation. 

Lifestyle modifications are effective at managing gestational diabetes. One review found that when people with gestational diabetes initiated lifestyle interventions, they were less likely to have a baby born large for gestational size (LGA) and less likely to experience postpartum depression. They were also more likely to meet their postpartum weight loss goals.

Over-the-Counter (OTC) Therapies 

People with gestational diabetes usually need to check their blood sugar level at least four times per day. This includes first thing in the morning and after meals.

A blood glucose monitor can be purchased over the counter from a pharmacy or medical device supply store. Work with your healthcare provider to learn how to use a blood glucose monitor and when to contact your provider. 

A blood glucose monitor uses a small drop of blood to measure your blood glucose level. The recommended daily target blood glucose levels are:

• Before meals, bedtime, and overnight: 95 milligrams per deciliter (mg/dL) or less
• One hour after eating: 140 mg/dL or less
• Two hours after eating: 120 mg/dL or less

Your healthcare provider may also recommend monitoring your blood glucose level after you deliver your baby. Plan to test your blood glucose six to 12 weeks after childbirth and every one to three years after that. Gestational diabetes raises the risk of type 2 diabetes, so monitoring for changes is essential. 

Prescriptions

When diet and exercise are insufficient to manage your blood glucose level, the next step is to consider prescription medications. A small number of people with gestational diabetes require a prescription. It’s estimated that about 70% to 85% of cases of gestational diabetes can be managed with diet and lifestyle changes. 

Usually, if there is no improvement in blood sugar control within one to two weeks of starting lifestyle changes, it is time to consider prescription medication. Both insulin and oral agents are effective and safe for treating gestational diabetes.

Insulin 

Insulin is often the first-line prescription therapy for gestational diabetes. This is because insulin is a category B drug approved for use during pregnancy. Research shows that a clinically insignificant amount of insulin crosses the placenta. Using insulin to treat gestational diabetes has been found to lower the risk of preeclampsia. 

Your dose of insulin is individual and will change throughout pregnancy. Insulin resistance increases throughout pregnancy, so the dose also needs to increase. An average insulin dose is usually 0.8 to 0.9 units of insulin per kilogram of body weight per day. Insulin is administered through an injection that you can perform at home.

Oral Agents 

Oral agents used to treat gestational diabetes include Glucophage (metformin) and Glynase (glyburide). Because metformin may have better clinical outcomes, it is often chosen over glyburide. Pregnant people with gestational diabetes who take metformin are less likely to have a baby who is large for gestational age (LGA). Babies born to parents who took metformin are also less likely to experience low blood sugar levels (hypoglycemia) after birth.

Both metformin and glyburide are available in generic versions and may cost less than insulin. Both oral agents are taken twice per day.

Summary 

Gestational diabetes is a form of diabetes that is developed or diagnosed during pregnancy. Gestational diabetes can usually be managed with diet and lifestyle modifications such as a healthy diet and daily physical activity. If diet and exercise alone cannot manage blood glucose levels, the next step is to consider prescription medications. These may include insulin, metformin, or glyburide. Your healthcare provider will work with you to develop the right treatment plan for you and your baby.

A Word From Verywell

Pregnancy is a time of rapid change in your life. Adding a serious diagnosis like gestational diabetes can feel like too much to take. It may be helpful to remember that most people with gestational diabetes can manage their blood glucose levels with lifestyle changes effectively. Talk with your healthcare provider about any concerns you have and consider connecting with other expectant parents who are experiencing the same challenges.