Gestational Diabetes: High Blood Sugar in Pregnancy

What is it?

Gestational diabetes is a form of diabetes you get in pregnancy, which usually goes away after you stop being pregnant.

You have a hormone called insulin that your body uses to tell your body to use sugar and turn it into energy. When pregnant, our bodies become less sensitive to insulin and some people cannot make enough insulin for their body. This may cause you to have high levels of sugar that cannot be used to make energy.

To help, you can lower the sugar in the diet and increase daily exercise. You may be asked to take medications to allow your body to lower the sugar in your body.

Signs of low blood sugar:

• Shakiness
• Tiredness
• Confusion
• Fast heart rate
• Hunger
• Weakness
• Sweating

What to do if your blood sugar is low

If you have the symptoms above, check your blood sugar. If your blood sugar is under 70, drink some juice, half a soda, or a packet of sugar/honey. If it is still low after 15 minutes, drink more juice or eat a fruit and come to the clinic or hospital. If you feel unsafe, call the ambulance.

Signs of high blood sugar:

• Thirst
• Peeing more than normal
• Nausea and vomiting
• Blurry vision
• Belly pain
• Breathing quickly
• Sweet smelling breath

What to do if your blood sugar is high

If you have any of the symptoms above, check your blood sugar. If your blood sugar is 250 or higher and you have symptoms that don’t get better go see a doctor.

Day in the Life

Monitoring blood sugar

You will need to check your blood sugar 4 times a day. Once before eating or drinking anything in the morning, and two hours after every meal.

Diet

You will meet a nutritionist during your pregnancy. While you wait for the appointment, focus on eating protein and vegetables. Protein can include beans, nuts, yogurt, and meat. Carbohydrates are sugars. Things with a lot of sugar can include drinks, juice, soda, pasta, bread, rice, and more. It’s okay to eat these things but you want to lower the amount and how often you eat them.

Should I exercise?

You should definitely exercise! It is safe to exercise your entire pregnancy and is a great way to lower blood sugar without medication. If you do not exercise normally, start small with a short walk after eating and slowly increase from there.

Medicine

If your blood sugar is still high even after changing your diet and exercising, you may need medication to lower your blood sugar and decrease risk to the pregnancy. The two medications used most are insulin and metformin.

• Insulin is an injection you take 1 to 4 times a day.
• Metformin is a pill that you take 1 or 2 times a day, which makes your body more sensitive to insulin.

Do I need extra testing?

Heart rate monitoring

Once or twice a week starting at 32 weeks of pregnancy, you will be asked to go to the hospital for monitoring. We will monitor the baby’s heart beat for 20-40 minutes. We look for certain things during that time that show us the baby is doing well and is not stressed.

Ultrasounds

Once a week, starting at 32 weeks, you will get an ultrasound to make sure the baby is healthy.

We may also measure the growth of your baby via ultrasound, generally once a month. Moms know their babies’ sizes best though – studies show that pregnant parents are as good as ultrasounds at knowing how big their baby is.

During delivery

We will check your blood sugar during the delivery to make sure it isn’t too low or too high. Depending on your blood sugar, we may check your sugar every 1 hour or every 4 hours.

After delivery

We will check your blood sugar before you eat the next morning. Your baby will have their blood sugar checked every few hours. At your next appointment after the birth, your clinician will order a 2 hour glucose test (with a drink like the one you drank during pregnancy) to see if you still have diabetes or not. You usually do not need to take medications after you give birth.