Gestational Diabetes

Topic Overview

What is gestational diabetes?

If your blood sugar level first becomes too high when you are pregnant, you have gestational diabetes. It usually goes away after the baby is born.

High blood sugar can cause problems for you and your baby. Your baby may grow too large, which can cause problems during delivery. Your baby may also be born with low blood sugar. But with treatment, most women with gestational diabetes are able to control their blood sugar and give birth to healthy babies.

Women who have had gestational diabetes are more likely than other women to develop type 2 diabetes later on. You may be able to prevent or reduce the severity of type 2 diabetes by staying at a healthy weight, eating healthy foods, and increasing your physical activity.

What causes gestational diabetes?

The pancreas makes a hormone called insulin. Insulin helps your body properly use and store the sugar from the food you eat. This keeps your blood sugar level in a safe range. When you are pregnant, the placenta makes hormones that can make it harder for insulin to work. This is called insulin resistance.

A pregnant woman can get diabetes when her pancreas cannot make enough insulin to keep her blood sugar levels within a safe range.

What are the symptoms?

Because gestational diabetes does not cause symptoms, you need to be tested for the condition. This is usually done between the 24th and 28th weeks of pregnancy.¹ You may be surprised if your test shows a high blood sugar. It is important for you to be tested for gestational diabetes, because high blood sugar can cause problems for both you and your baby.

Sometimes, a pregnant woman who has symptoms has been living with another type of diabetes without knowing it. If you have symptoms from another type of diabetes, they may include:

• Increased thirst.
• Increased urination.
• Increased hunger.
• Blurred vision.

Pregnancy causes most women to urinate more often and to feel more hungry, so having these symptoms does not always mean that a woman has diabetes. Talk with your doctor if you have these symptoms, so that you can be tested for diabetes at any time during pregnancy.

How is gestational diabetes diagnosed?

Almost all women are tested for gestational diabetes between the 24th and 28th weeks of pregnancy. If your doctor thinks you are more likely to get gestational diabetes, you may be tested earlier.

Gestational diabetes is diagnosed with two blood tests. In the first test, your blood sugar level is tested 1 hour after you drink a small cup of a sweet liquid. If your blood sugar is too high, you will need to do a longer, 3-hour glucose test. If your blood sugar is still above a certain level, you have gestational diabetes.

How is it treated?

Many women with gestational diabetes can control their blood sugar level by changing the way they eat and by exercising regularly. These healthy choices can also help prevent gestational diabetes in future pregnancies and type 2 diabetes later in life.

Treatment for gestational diabetes also includes checking your blood sugar level at home and seeing your doctor regularly.

You may need to give yourself insulin shots to help control your blood sugar. This man-made insulin adds to the insulin that your body makes.

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	Gestational diabetes: Checking your blood sugar
	Gestational diabetes: Counting carbs
	Gestational diabetes: Dealing with low blood sugar
	Gestational diabetes: Giving yourself insulin shots

Frequently Asked Questions

Cause

During pregnancy, an organ called the placenta develops in the uterus. The placenta connects the mother and baby and makes sure the baby has enough food and water. It also makes several hormones. Some of these hormones make it hard for insulin to do its job-controlling blood sugar-so the mother's body has to make more insulin to keep sugar levels in a safe range. Gestational diabetes develops when the organ that makes insulin, the pancreas, cannot make enough insulin to keep blood sugar levels within a safe range.

Symptoms

Because gestational diabetes does not cause symptoms, you need to be tested for the condition. This is usually done between the 24th and 28th weeks of pregnancy. You may be surprised if your test shows a high blood sugar. It is important for you to be tested for gestational diabetes, because high blood sugar can cause problems for both you and your baby.

Sometimes, a pregnant woman has been living with diabetes without knowing it. If you have symptoms from diabetes, they may include:

• Increased thirst.
• Increased urination.
• Increased hunger.
• Blurred vision.

Pregnancy causes most women to urinate more often and to feel more hungry, so having these symptoms does not always mean that a woman has diabetes. Talk with your doctor if you have these symptoms, so that you can be tested for diabetes.

What Happens

Most women find out they have gestational diabetes after being tested between the 24th and 28th weeks of their pregnancy. After you know you have gestational diabetes, you will need to make certain changes in the way you eat and how often you exercise to help keep your blood sugar level within a safe range. As you get farther along in your pregnancy, your body will continue to make more and more hormones. This can make it harder and harder to control your blood sugar. If it is not possible to control your blood sugar with food and exercise, you may also need to give yourself shots of insulin.

Just because you have diabetes does not mean that your baby will have diabetes. Most women with gestational diabetes give birth to healthy babies. If you are able to keep your blood sugar level within a safe range, your chances of having problems during pregnancy or birth are the same as if you didn't have gestational diabetes.

In rare cases, a mother or her baby has problems because of high blood sugar. These problems include:

• High blood pressure in the mother caused by preeclampsia.
• A baby that grows too large. If an unborn baby receives too much sugar, the sugar can turn into fat, causing the baby to grow larger than normal. A large baby can be injured during vaginal birth and may need to be delivered surgically (C-section).
• After the baby is born, extra insulin may cause the baby's blood sugar level to drop below the safe range. If the baby's blood sugar level drops too low, he or she may need to be given extra sugar. Babies can also develop other treatable problems after birth, including low blood calcium levels, high bilirubin levels, and too many red blood cells.

Most of the time, gestational diabetes goes away after a baby is born. But if you have had gestational diabetes, you have a greater chance of having it in a future pregnancy and of developing type 2 diabetes. More than half of women who develop gestational diabetes will develop type 2 diabetes later in life.²

What Increases Your Risk

You have an increased chance of developing gestational diabetes if:

• You are 25 or older when you become pregnant.
• You have had gestational diabetes before.
• You have given birth to a baby who weighed more than 9 lb (4 kg).
• You weighed more than 9 lb (4 kg) when you were born.
• You have a parent or sibling who has type 2 diabetes.
• You are not physically active before pregnancy.
• You are obese (your body mass index [BMI] is 30 or higher).
• You are a member of a racial/ethnic group that has a high risk of developing diabetes, such as Latin Americans, Native Americans, Asian Americans, African Americans, or Pacific Islanders.
• You have polycystic ovary syndrome.
• You have a dark skin rash on the back or your neck or in folds on your body.
• You take corticosteroid medicine.
• You have a history of pre-diabetes.
• You have a history of problems during pregnancy.

When to Call a Doctor

Call 911 or other emergency services immediately if a woman who is taking insulin for gestational diabetes:

• Is losing consciousness or becomes unconscious.
• Has symptoms of low blood sugar and her symptoms do not get better or go away after being given sugar.

  Gestational diabetes: Dealing with low blood sugar

• Has a low blood sugar level (less than 50 milligrams per deciliter, or mg/dL), and is not able to keep food down.
• Is becoming more and more sleepy and has a blood sugar level of less than 60 mg/dL after following steps for dealing with low blood sugar.

Call your doctor if you have gestational diabetes and:

• You notice a change in the pattern of fetal movements called kick counts, or you stop having them.
• You are taking insulin and you have not talked with your doctor about how to deal with low blood sugar levels.
• Your blood sugar level does not rise above 60 mg/dL after following the steps for dealing with low blood sugar.
• Your blood sugar level is above normal and you have not talked with your doctor about how to deal with high blood sugar.
• You are taking insulin and your blood sugar level stays high after taking a missed dose of insulin or taking an extra dose of insulin (if prescribed by your doctor).
• You have problems with high or low blood sugar levels. If you are taking insulin, you may need to change how much you are taking.
• You are sick for more than 2 days (unless it is a mild illness, such as a cold) and you:
  • Have been throwing up or have had diarrhea for more than 6 hours.
  • Think your symptoms, such as feeling very thirsty and weak, are being caused by high blood sugar.
  • Have tried the home treatments suggested by your doctor, and they have not worked.
  • Have blood sugar levels consistently above 150 mg/dL.

You should also call your doctor if you think you have symptoms of high blood sugar, such as increased thirst, increased urination, increased hunger, and blurred vision.

For information about when to call your doctor for other pregnancy-related issues, see the topic Pregnancy.

Watchful Waiting

Watchful waiting is a wait-and-see approach. If you get better on your own, you won't need treatment. If you get worse, you and your doctor will decide what to do next. Watchful waiting is not appropriate if you are pregnant and have risk factors for or symptoms of gestational diabetes.

Watchful waiting also is not appropriate if you are taking insulin and have symptoms of low blood sugar that do not go away after following the steps for dealing with low blood sugar. Call your doctor or seek emergency medical care.

Who to See

Health professionals who can diagnose and treat gestational diabetes include:

• A specialist in the care of pregnant women (obstetrician).
• A family medicine doctor or general practitioner who has an interest or training in gestational diabetes.
• A nurse practitioner who has training in the care of pregnant women.
• A physician assistant who has training in the care of pregnant women.
• A certified nurse-midwife or certified professional midwife.

If you need insulin shots, you may see a specialist called an endocrinologist or a doctor who specializes in high-risk pregnancies called a perinatologist. After a visit with a specialist, you can usually return to the care of your regular doctor.

After you are diagnosed with gestational diabetes, you may be referred to other health professionals who can help you understand what gestational diabetes means. These may include:

• A certified diabetes educator (CDE). A CDE is a registered nurse, dietitian, doctor, pharmacist, or other health professional who has training and experience in caring for people with diabetes. A CDE can help you understand how to take care of yourself and help you adjust to living with gestational diabetes.
• A registered dietitian. All women who have gestational diabetes need to see a dietitian for help choosing the best foods. Follow-up visits with a dietitian are helpful if you need to change your eating habits.

Exams and Tests

Almost all women are tested for gestational diabetes between the 24th and 28th weeks of pregnancy. If your doctor thinks you are at increased risk for developing gestational diabetes, you may be tested earlier.

Gestational diabetes is diagnosed with an oral glucose tolerance test. Your blood sugar is tested 1 hour after you drink a small cup of a sweet liquid. If your results from this test come back high, you will need to do a second test-a longer, 3-hour glucose test. In this test, you cannot eat or drink anything except water for at least 8 hours. After fasting, your blood sugar level will be tested. Then you will drink a small cup of sweet liquid and have your blood sugar tested every hour for at least 3 hours. If your blood sugar levels come back high on two or more of these tests, you have gestational diabetes.

Tests during pregnancy

If you have gestational diabetes, your doctor will check your blood pressure at every visit. You will also have certain tests throughout your pregnancy to check your and your baby's health. These tests include:

• Home blood sugar monitoring. Testing your blood sugar at home every day helps you know if your blood sugar level is within a safe range.

  Gestational diabetes: Checking your blood sugar

• Fetal ultrasound. This test may be used to see if you need insulin or to estimate the age, weight, and health of your baby. The ultrasound test also can measure the size of your baby's abdomen, and this measurement along with other information can be used to help your doctor decide on your care. If your doctor thinks your baby is bigger than normal for his or her gestational age, then your doctor may decide you need to start taking insulin. Taking insulin when you have gestational diabetes will stop your baby from growing too big. Keep in mind that ultrasounds cannot always accurately estimate how much your baby weighs or whether there are other problems.
• Nonstress test. A nonstress test can help you know how well your baby is doing by checking your baby's heartbeat in response to movement.

Some doctors may recommend you have a hemoglobin A1c (glycosylated hemoglobin) or a similar test every month during your pregnancy. The A1c test estimates your average blood sugar level over the previous weeks to months.

Tests during labor and delivery

During labor and delivery, you and your baby will be monitored very closely.

• Fetal heart monitoring is used to see how well your baby is doing while you are in labor.
• Blood sugar tests are done at least every hour to make sure your blood sugar level is within a safe range.

Tests after delivery

After your baby is born, your blood sugar level will be checked several times. Your baby's blood sugar level will also be checked several times within the first few hours after birth. One to 3 days after delivery, you will have a fasting or random OGTT.

Most likely, your gestational diabetes will go away after your baby is born. But because you are at risk for developing type 2 diabetes, you should have a glucose tolerance test about 6 weeks after delivery and a fasting blood sugar level at least once a year. Your doctor may recommend that you have additional glucose tolerance testing if your fasting blood glucose levels are normal, or only slightly elevated.

Early detection

The first time you see your doctor after you become pregnant, your doctor will determine your risk for gestational diabetes. If you are considered high risk because you have had gestational diabetes before, are obese, have a strong family history of type 2 diabetes, or have sugar in your urine, you will be tested right away.

Most women are tested between the 24th and 28th weeks of pregnancy. But you may not benefit from testing if:

• You are younger than 25 when you become pregnant.
• You have not had gestational diabetes before.
• You have no family history of type 2 diabetes.
• Your body mass index [BMI] is less than 25.
• You are not a member of a racial/ethnic group that has a high risk of developing diabetes, such as Latin Americans, Native Americans, Asian Americans, African Americans, or Pacific Islanders.
• You do not have polycystic ovary syndrome.

Some pregnant women are at low risk for developing gestational diabetes and may not need to be tested. Experts debate whether all pregnant women need to be tested for gestational diabetes. The U.S Preventive Services Task Force has found insufficient evidence to recommend screening women with no risk factors for gestational diabetes.³ But most doctors routinely test all pregnant women who are in their care.

After delivery

Even though your gestational diabetes will probably go away after your baby is born, you are at risk for developing gestational diabetes again and for developing type 2 diabetes later in life. More than half of women who develop gestational diabetes will develop type 2 diabetes later in life.²

To make sure your blood sugar level stays within a safe range, your doctor may instruct you to continue checking your blood sugar levels at home for a while. You will also have a follow-up glucose tolerance test 6 to 12 weeks after your baby is born or after you stop breast-feeding your baby. If the results of this test are normal, you will still need to have a fasting blood sugar test at least every 3 years. Even if your sugar level is normal, you are at increased risk of developing diabetes in the future. Eating a healthy diet and getting regular exercise can help prevent type 2 diabetes.

Women who had gestational diabetes and use progestin-only birth control pills may have a greater chance of developing type 2 diabetes. Combination birth control pills that contain estrogen and progestin are not linked with an increased risk of type 2 diabetes. Talk to your doctor about the best kind of contraception for you.⁴

If you want to get pregnant again, you should be tested for diabetes both before you become pregnant and early in your pregnancy.

Treatment Overview

Finding out that you have gestational diabetes can be scary. It can be reassuring to know that most women who have gestational diabetes give birth to healthy babies and that you are the most important person in promoting a healthy pregnancy.

Treatment for gestational diabetes involves making healthy choices. Most women who make changes in the way that they eat and how often they exercise are able to keep their blood sugar level within a safe range. Controlling your blood sugar is the key to preventing problems during pregnancy or birth.

You, your doctor, and other health professionals will work together to develop an treatment plan just for you. You do not need to eat strange or special foods, but you may need to change what, when, and how much you eat. You also do not need to start a fancy exercise program or join an expensive gym. Walking several times a week can really help your blood sugar.

The lifestyle changes you make now will help you have a healthy pregnancy and prevent diabetes in the future. As you start making these changes, you will learn more about your body and how it reacts to food and exercise. You may also notice that you feel better and have more energy.

During pregnancy

Treatment for gestational diabetes during pregnancy includes:

• Eating a balanced diet. After you find out that you have gestational diabetes, you will meet with a registered dietitian to develop a healthy eating plan. You will learn how to limit the amount of carbohydrate you eat as a way to control your blood sugar. You may also be asked to write down everything you eat and to keep track of your weight.
• Getting regular exercise. Try to do at least 2½ hours a week of moderate exercise.^{5, 6} One way to do this is to be active 30 minutes a day, at least 5 days a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week. Regular, moderate exercise during pregnancy helps your body use insulin better and helps control your blood sugar level. If you have never exercised regularly or were not exercising before you became pregnant, talk with your doctor before you start exercising. Low-impact activities, such as walking or swimming, are especially good for pregnant women. You may also want to try special exercise classes for pregnant women.
• Checking blood sugar levels. An important part of treating gestational diabetes is checking your blood sugar level at home. Every day, you will do a home blood sugar test up to 4 times a day (first thing in the morning before breakfast and 1 hour after each meal). If you take insulin, you will need to test your blood sugar up to 6 times a day (before each meal and 1 hour after each meal). Even though it can be overwhelming to test your blood sugar so often, knowing that your level is within a safe range can help put your mind at ease.
• Monitoring fetal growth and well-being. Your doctor may want you to monitor fetal movements called kick counts and let him or her know if you think your baby is moving less than usual. You may also have fetal ultrasounds to see how well your baby is growing. If your baby is growing larger than normal, you may need insulin shots. If you take insulin, you may have a nonstress test to check how well your baby's heart responds to movement. Even if you do not take insulin, you may have a nonstress test and ultrasound as you get closer to your due date.
• Getting regular medical checkups. Having gestational diabetes means regular visits to your doctor. At these visits, your doctor will check your blood pressure and test a sample of your urine. You will also discuss your blood sugar levels, what you have been eating, how much you have been exercising, and how much weight you have gained.
• Taking insulin shots. The first way to treat gestational diabetes is by changing the way you eat and exercising regularly. If your blood sugar levels are still too high after changing the way you eat and exercising regularly, you may need insulin shots. Man-made insulin can help lower your blood sugar level without harming your baby.

Generally, it is not a good idea to diet while you are pregnant. Most doctors recommend that women gain 25 lb (11.3 kg) to 35 lb (15.9 kg) during pregnancy. But if you are overweight or obese, your doctor may recommend that you eat less and gain less weight than other pregnant women. Overweight or obese women have a higher risk for developing high blood pressure and a blood circulation problem called preeclampsia.

Most doctors will recommend that you breast-feed your baby, if possible. Breast-feeding can help prevent your child from becoming overweight, which may reduce his or her chances of developing diabetes. If you are breast-feeding, be sure to continue checking your blood sugar levels.

During labor and delivery

Most women with gestational diabetes are able to have their babies naturally. Just because you have gestational diabetes does not mean that you will need to have a cesarean section (C-section).

Because a baby that has grown too large can be difficult to deliver safely, your doctor will do frequent fetal ultrasounds to check the size of your baby. If your doctor thinks that your baby is in danger of being too large, he or she may decide to induce labor or do a C-section in your 38th week of pregnancy.

During labor and delivery, you and your baby are monitored closely. This includes:

• Checking your blood sugar level at least every 1 to 2 hours. If your level gets too high, you may be given small amounts of insulin through a vein (intravenously, or IV). If your level drops too low, you may be given IV fluid that contains glucose.
• Checking your baby's heart rate and how well your baby's heart responds to movement. Fetal heart monitoring helps your doctor know how your baby is doing during labor. If the baby is large or does not seem to be doing well, you may need to have a C-section to deliver your baby. But most women who have gestational diabetes deliver their babies naturally.

After delivery

After delivery, you and your baby still need to be monitored closely.

• For the first few hours, your blood sugar level may be tested every hour. Usually blood sugar levels quickly return to normal.
• Your baby's blood sugar level will also be monitored. If your blood sugar levels were high during pregnancy, your baby's body will make extra insulin for several hours after birth. This extra insulin may cause your baby's blood sugar to drop too low (hypoglycemia). If your baby's blood sugar level drops too low, he or she may need extra sugar, such as a sugar water drink or glucose given intravenously.
• Your baby's blood may also be checked for low calcium, high bilirubin, and extra red blood cells.

What to Think About

Most of the time, the blood sugar levels of women who have gestational diabetes return to normal within a few hours after delivery.

If you have had gestational diabetes, you are at risk for developing it again in a future pregnancy. You are also at risk of developing type 2 diabetes, a permanent type of diabetes. The healthy choices and changes you made during your pregnancy, if continued, will help you prevent diabetes in the future. If you are worried about type 2 diabetes in yourself or in your child, talk to your doctor about your concerns. If you want to learn more about type 2 diabetes, see the topic Type 2 Diabetes.

Prevention

In some women, gestational diabetes cannot be prevented. But you may be able to lower your chance of getting gestational diabetes by staying at a healthy weight and not gaining too much weight during pregnancy. Regular exercise can also help keep your blood sugar level within a safe range and prevent gestational diabetes.

If you have had gestational diabetes, you are at risk of developing it again in a future pregnancy. You are also at risk of developing type 2 diabetes, a permanent type of diabetes. One of the best ways to prevent developing gestational diabetes again is to stay at a healthy weight.

If you have had gestational diabetes, avoid medicines that increase insulin resistance, such as nicotinic acid and glucocorticoid medicines (for example, prednisone and dexamethasone). It is also a good idea to avoid progestin-only birth control pills because they may raise your risk for developing type 2 diabetes. Low-dose combination birth control pills that contain estrogen and progestin are not linked with an increased risk of type 2 diabetes. Talk to your doctor about the best kind of contraception for you.⁴

A baby who is born to a woman with gestational diabetes is at risk for being overweight and for developing type 2 diabetes. If you are able to breast-feed your baby, doing so may lower the chance that he or she will become overweight. As your child gets older, encourage him or her to eat healthy foods and to exercise regularly to help prevent type 2 diabetes.

Home Treatment

You are the most important person in determining whether you will have a healthy pregnancy. Gestational diabetes, like any form of diabetes, cannot be successfully treated with medicines alone.

Your doctor, diabetes nurse educator, registered dietitian, and other health professionals can help you learn how to care for yourself and protect your baby from problems. If you learn as much as you can about gestational diabetes, you will have the knowledge you need to have a healthy pregnancy. As you understand how food and exercise affect your blood sugar, you can better control your blood sugar level and help prevent problems from gestational diabetes.

Home treatment for gestational diabetes includes changing the way you eat, exercising regularly, and checking your blood sugar.

Eating healthy foods

Changing what, when, and how much you eat can help keep your blood sugar level within a safe range. After you are diagnosed with gestational diabetes, you will meet with a registered dietitian to decide on an individualized healthy eating plan. Your dietitian may ask you to write down everything you eat and to keep track of your weight. He or she will also teach you how to count carbohydrate in order to spread carbohydrate throughout the day. For more information, see:

Gestational diabetes: Counting carbs.

Getting regular exercise

Regular, moderate exercise during pregnancy helps your body use insulin better, which helps control your blood sugar level. Often, exercising and eating well can treat gestational diabetes. Try to do at least 2½ hours a week of moderate exercise.^{5, 6} One way to do this is to be active 30 minutes a day, at least 5 days a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.

If you have never exercised regularly or were not exercising before you became pregnant, talk with your doctor before you start exercising. Exercise that does not place too much stress on your lower body-such as using an arm ergometer, a machine that just works your arm muscles; or riding a recumbent bicycle, a type of bike with a seat that looks like a chair-are especially good for pregnant women. You may also want to try special exercise classes for pregnant women or other low-impact activities such as swimming or walking.

If exercise and changing the way you eat keep your blood sugar within a safe range, you will not need to take insulin. If you do need to take insulin, make sure you have a quick-sugar food with you when you exercise in case you have symptoms of low blood sugar. If you think that your blood sugar is low, stop exercising, check your blood sugar level, and eat the snack.

Checking your blood sugar

An important part of treating gestational diabetes is checking your blood sugar level at home. Every day, you will do a home blood sugar test up to 4 times a day (first thing in the morning before breakfast and 1 hour after each meal). If you take insulin, you will need to test your blood sugar up to 6 times a day (before each meal and 1 hour after each meal). Even though it can be overwhelming to test your blood sugar so often, knowing that your levels are normal can help put your mind at ease. For more information, see:

Gestational diabetes: Checking your blood sugar.

Other aspects of your care

• If changing the way you eat and exercising do not control your blood sugar level, you may need to take daily insulin shots.
• If you were overweight before you became pregnant, do not try to lose weight while you are pregnant. Ask your doctor how much weight you should gain during your pregnancy.
• Your doctor may have you check kick counts and let him or her know if you think your baby has been moving less than usual. Most pregnant women can feel their baby move after the 18th week of pregnancy. Normally, a baby moves several times during the day. If you don't feel movement for what seems like a long time, lie on your left side for 30 minutes or longer. If you don't feel movement within 2 hours, call your doctor.
• If you take insulin, it can cause your blood sugar to drop below the safe range. Even though very low blood sugar is rare in women who have gestational diabetes, it is important to know the symptoms of low blood sugar and have quick-sugar foods with you at all times. For more information, see:

Gestational diabetes: Dealing with low blood sugar.

Medications

Most women can treat gestational diabetes by changing the way they eat and exercising more often. If these changes do not keep your blood sugar level within a safe range, you may need to take insulin. You may also need to take insulin if your doctor thinks that your baby is getting too large.

If you need to take insulin, your doctor will teach you how to give yourself an insulin shot. For more information, see:

Gestational diabetes: Giving yourself insulin shots.

Medication Choices

Insulin

What to Think About

Insulin is the only medicine approved by the U.S. Food and Drug Administration (FDA) to treat gestational diabetes. Insulin is only used if you cannot control your blood sugar level by eating well and exercising regularly.

How much insulin you need depends on how much you weigh and on how close you are to your due date. Some women need more insulin as they get closer to their delivery date because the placenta makes more and more hormones that make it harder and harder for insulin to do its job. In rare cases, a woman with gestational diabetes has to stay in the hospital for a short time to get her blood sugar level within a safe range.

There is a pill called glyburide for type 2 diabetes that some doctors are using to treat women with gestational diabetes. But until more information is available to prove that glyburide is safe and effective, the American Diabetes Association continues to recommend only insulin for women with gestational diabetes.

Other Treatment

All pregnant women need to take prenatal vitamins. If you want to take other types of vitamins, talk with your doctor. Do not take more of any vitamin than would be found in the approved prenatal vitamins.

Other Places To Get Help

Organizations

Related Information

• Pregnancy
• Type 1 Diabetes
• Type 2 Diabetes

References

Citations

1. Aronovitz MD, Metzger BE (2006). Gestational diabetes mellitus. In DC Dale, DD Federman, eds., ACP Medicine, section 9, chap. 4. New York: WebMD.

2. Gabbe SC, Graves CR (2003). Management of diabetes mellitus complicating pregnancy. Obstetrics and Gynecology, 102(4): 857-868.

3. U.S. Preventive Services Task Force (2008). Screening for gestational diabetes mellitus. Available online: http://www.ahrq.gov/clinic/uspstf/uspsgdm.htm.

4. Brown FM (2005). Diabetes and pregnancy. In CR Kahn et al., eds., Joslin's Diabetes Mellitus, 14th ed., pp. 1035-1047. Philadelphia: Lippincott Williams and Wilkins.

5. U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/pdf/paguide.pdf.

6. American College of Obstetricians and Gynecologists (2002, reaffirmed 2007). Exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 267. Obstetrics and Gynecology, 99(1): 171-173.

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