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I have gestational diabetes. Will I see my doctor more often?
Once you know you have gestational diabetes, you'll probably see your healthcare provider at least every two weeks. If you take insulin or another medication, you may need to see your provider once a week.
In your third trimester, you may have one or more ultrasound exams to check how your baby is growing. If you take medications to control your diabetes, you may also have a fetal nonstress test once or twice a week. This is a safe test which measures your baby's movements and heartbeat.
It's important to go to all your prenatal appointments, even if you're feeling well. Your provider will need to monitor you and your baby regularly and may adjust your treatment plan based on the results of your tests.
What will I need to do if I have gestational diabetes?
The key to managing your condition is tracking your blood sugar levels. This helps you take control of your condition and be sure that your treatment plan is working.
Your healthcare provider will show you how to test your own blood sugar using a special device. This involves pricking your finger with a small surgical blade called a lancet. Although some women find it unpleasant at first, it isn't usually painful.
Your provider will tell you how often to test your blood sugar. Usually, you need to test yourself first thing in the morning before you eat or drink anything, and then one or two hours after each meal.
If you have trouble controlling your blood sugar, you may need to test more often. If your blood sugar is normal most of the time, you may be able to test less often.
Your provider will also recommend lifestyle changes to help you to manage your gestational diabetes. Your blood sugar levels will show if these changes are working.
What lifestyle changes do I need to make?
To control your blood sugar, be sure to:
- Eat well. A healthy diet is key to managing your gestational diabetes. Plan to eat three medium-size meals every day, with two to three small snacks in between. Opt for whole grains, lean proteins, and vegetables over sugary, processed foods. Your provider may refer you to a registered dietitian who can help you create a healthy meal plan that's easy to stick to.
- Exercise regularly. Some providers advise moderate exercise to help balance blood sugar. Try to exercise for about 30 minutes, at least five times a week. You could head outside for a brisk walk, enjoy a swim, or try a pregnancy yoga class. Always check with your provider before starting a new exercise program.
What should I do if my blood sugar is high?
Several factors contribute to high blood sugar (hyperglycemia), including what and how much you eat. If you're taking medication, the timing of when you take that medication can have an effect too. Most often high blood sugar doesn't cause any symptoms, but some people notice an increase in thirst or urination.
A vital part of managing high blood sugar is to know when and why it happens. Then you can work with your provider to plan what to eat and when to take your medication to suit your individual needs. Here are some simple steps for managing your condition:
- Track your blood sugar levels.
- Keep a diary to record information about what you eat, when you take your medication, and what type of exercise you get how often. Writing all this down in addition to the results of your blood tests lets you and your provider see if there's a pattern to spikes. You may notice certain foods or combinations of foods are more likely to lead to high blood sugar.
- Discuss your diary with your provider or a dietitian so you can work out lifestyle changes to help you continue to manage your blood sugar levels.
What should I do if my blood sugar is low?
Low blood sugar is called hypoglycemia. People taking insulin or other medications that lower blood sugar are at risk for hypoglycemia. It's important to treat low blood sugar quickly.
The symptoms of low blood sugar include:
- rapid heartbeat
Your provider may recommend that you carry glucose tablets or candy with you in case your blood sugar drops too low. Talk to your provider if you have two or more episodes of low blood sugar during one week.
Do I need to take medication?
Maybe. But most women – about 85 percent – find that they can manage gestational diabetes with diet and exercise.
If blood sugar is high despite making lifestyle changes, your provider will prescribe insulin or an oral medication. Insulin can't be taken in tablet form, so your provider will show you how to give yourself injections. You'll need to give yourself up to three injections each day.
Insulin treatment aims to bring down your blood sugar so it's at the same level as a woman who doesn't have gestational diabetes. Insulin is safe to take in pregnancy.
If you take insulin or any other medication, follow your provider's instructions for how and when to take it. Go to all your prenatal appointments because your medication may need to be adjusted.
Taking medication doesn't mean you can eat what you like. You still need to eat a balanced, healthy diet and exercise regularly. You also need to test your own blood sugar as recommended by your doctor.
How can I make sure I stick to the plan?
Being diagnosed with gestational diabetes can be stressful. It's natural to feel apprehensive about trying to manage your condition, especially if you already feel tired or overwhelmed.
At first, your new meal plan may seem boring or restrictive, and you may find yourself feeling resentful about having to make these changes. You may also find it hard to get motivated to exercise.
But remember that by sticking to your treatment plan, you're doing your best to ensure a successful pregnancy and a healthy outcome for you and your baby. Remind yourself that this situation won't last forever. Gestational diabetes is likely to go away as soon as your baby's born.
However, the risk of developing type 2 diabetes in later life is much higher. So the lifestyle changes you make when you're pregnant can help you stay healthy in the long term.
Here are some other ideas to help you follow your plan:
Get your partner or other family members involved. It may be easier to change what you eat if you aren't alone. Ask your partner or another family member to join you in cutting out added sugar and eating healthy, balanced meals.
Choose an exercise you enjoy. Find a form of exercise that that you've always wanted to try, or at least one that doesn't feel like a chore. You could sign up for a pregnancy yoga or Pilates class, or get some friends together for a walk. You may end up enjoying being active and appreciating the extra energy that exercise gives you.
Find other ways to treat yourself. If you're missing candy, cakes, or soda, find an alternative treat to look forward to. A pregnancy massage or a day out with friends can boost your motivation and keep you from feeling deprived.
Ask for help. Let your provider know if you're having trouble sticking to your treatment plan. She can offer extra support and advice, or recommend a dietitian who can help if your food choices seem uninspiring.
It's worth remembering that the changes you're being asked to make will be good for your general health in the long term as well as helping you manage your condition now.
Visit the Society for Maternal-Fetal Medicine's website for more information and to find an MFM specialist near you.