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Women who develop gestational diabetes need to monitor and control their blood sugar level in order to keep the baby healthy and minimize the possibility of complications developing during the pregnancy or during birth. Some of the strategies for controlling blood sugar are described below.
Patients usually need to monitor their blood sugar four to five times a day including first thing in the morning before eating (fasting blood sugar) and after meals (postprandial blood sugar). Blood glucose levels are measured as the amount of glucose millimoles present in one litre of blood, which is expressed as millimoles per litre (mmol/L).
Patients should follow a healthy diet including the correct portions of food to help control the blood sugar level and prevent excess weight gain, a factor that can increase the risk of complications. Weight loss is not advised during pregnancy because the body needs to support the growing baby, but weight goals are set based on the patient’s weight prior to pregnancy. Patients are advised to follow a diet that mainly includes fruits, wholegrains and vegetables because these items are rich in fiber and nutrition but low in calories and fat. The dietary intake of carbohydrates should also be limited. Patients may need to consult a dietician or diabetes expert to formulate an eating plan based on their weight, blood sugar levels, weight gain goals, exercise habits, financial budget and food preferences.
Women are advised to consider exercise as an important health factor before, during and after their pregnancy. Physical activity can lower the blood glucose level by causing the glucose to move from the blood and into the cells so it can be used as an energy supply. This also increases insulin sensitivity, so that less insulin is needed to transport sugar. Women with a body mass index (BMI) of more than 27 before pregnancy are advised to engage in at least 150 minutes (2 hours and 30 minutes) of moderate exercise every week.
In cases where diet and exercise fail to control the blood sugar level, insulin injections may be required. Up to 20% of women with this condition do require insulin to keep their blood glucose under control.
Oral medications are sometimes prescribed, but many doctors believe that more research is needed to confirm that these drugs are as effective and safe to use as injectable insulin.