Gestational Diabetes Mellitus, Self-Care

Caring for yourself after a diagnosis of gestational diabetes mellitus means keeping your blood sugar under control. This can be done through nutrition, exercise, lifestyle changes, insulin and other medicines, and support from your health care team. Your health care provider will set individualized treatment goals for you.

What are the risks?

If left untreated, gestational diabetes can cause problems for mother and baby.

For the mother

• Have labor induced and deliver early.
• Have problems during labor and delivery, if the baby is larger than normal. This includes difficult labor and damage to the birth canal.
• Have a cesarean delivery.
• Have problems with blood pressure, including high blood pressure and preeclampsia.
• Get it again if they become pregnant.
• Develop type 2 diabetes in the future.

For the baby

• Low blood glucose (hypoglycemia).
• Larger-than-normal body size (macrosomia).
• Breathing problems.

How to monitor blood glucose

1. Wash your hands with soap and water for at least 20 seconds.
2. Prick the side of your finger (not the tip) with the lancet. Use a different finger each time.
3. Gently rub the finger until a small drop of blood appears.
4. Follow instructions that come with your meter for inserting the test strip, applying blood to the strip, and getting the result.
5. Write down your result and any notes.

• 95 mg/dL (5.3 mmol/L) when fasting.
• 140 mg/dL (7.8 mmol/L) 1 hour after a meal.
• 120 mg/dL (6.7 mmol/L) 2 hours after a meal.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If your health care provider prescribed insulin or other diabetes medicines:
  • Take them every day.
  • Do not run out of insulin or other medicines. Plan ahead so you always have them available.

Eating and drinking

• Follow instructions from your health care provider about eating or drinking restrictions.
• See a diet and nutrition expert (registered dietician) to help you create an eating plan that helps control your diabetes. The foods in this plan will include:
  • Lean proteins.
  • Complex carbohydrates. These are carbohydrates that contain fiber, have a lot of nutrients, and are digested slowly. They include dried beans, nuts, and whole grain breads, cereals, or pasta.
  • Fresh fruits and vegetables.
  • Low-fat dairy products.
  • Healthy fats.
• Eat healthy snacks between nutritious meals.
• Drink enough fluid to keep your urine pale yellow.
• Keep a record of the carbohydrates that you eat. To do this:
  • Read food labels.
  • Learn the standard serving sizes of foods.
• Make a sick day plan with your health care provider before you get sick. Follow this plan whenever you cannot eat or drink as usual.

Activity

• Do exercises as told by your health care provider.
• Do 30 or more minutes of physical activity a day, or as much physical activity as your health care provider recommends. It may help to control blood glucose levels after a meal if you:
  • Do 10 minutes of exercise after each meal.
  • Start this exercise 30 minutes after the meal.
• If you start a new exercise or activity, work with your health care provider to adjust your insulin, other medicines, or food as needed.

Lifestyle

• Do not drink alcohol.
• Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
• Learn to manage stress. If you need help with this, ask your health care provider.

Body care

• Keep your vaccines up to date.
• Practice good oral hygiene. To do this:
  • Clean your teeth and gums two times a day.
  • Floss one or more times a day.
  • Visit your dentist one or more times every 6 months.
• Stay at a healthy weight while you are pregnant. Your expected weight gain depends on your BMI (body mass index) before pregnancy.

General instructions

• Talk with your health care provider about the risk for high blood pressure during pregnancy (preeclampsia and eclampsia).
• Share your diabetes management plan with people in your workplace, school, and household.
• Check your urine for ketones when sick and as told by your health care provider. Ketones are made by the liver when a lack of glucose forces the body to use fat for energy.
• Carry a medical alert card or wear medical alert jewelry that says you have gestational diabetes.
• Keep all follow-up visits. This is important.

Get care after delivery

• Have your blood glucose level checked with an oral glucose tolerance test (OGTT) 4–12 weeks after delivery.
• Get screened for diabetes at least every 3 years, or as often as told by your health care provider.

Where to find more information

• American Diabetes Association (ADA): diabetes.org
• Association of Diabetes Care & Education Specialists (ADCES): diabeteseducator.org
• Centers for Disease Control and Prevention (CDC): cdc.gov
• American Pregnancy Association: americanpregnancy.org
• U.S. Department of Agriculture MyPlate: myplate.gov

Contact a health care provider if:

• Your blood glucose is above your target for two tests in a row.
• You have a fever.
• You have been sick for 2 days or more and are not getting better.
• You have either of these problems for more than 6 hours:
  • Vomiting every time you eat or drink.
  • Diarrhea.

Get help right away if you:

• Become confused or cannot think clearly.
• Have trouble breathing.
• Have moderate or high ketones in your urine.
• Feel your baby is not moving as usual.
• Develop unusual discharge or bleeding from your vagina.
• Start having early (premature) contractions. Contractions may feel like a tightening in your lower abdomen
• Have a severe headache.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Check your blood glucose every day during your pregnancy. Do this as often as told by your health care provider.
• Take insulin or other diabetes medicines every day, if your health care provider prescribed them.
• Have your blood glucose level checked 4–12 weeks after delivery.
• Keep all follow-up visits. This is important.