Gestational Diabetes Mellitus, Self-Care

• Eat healthy foods.
• Exercise often.
• Change your lifestyle.
• Use insulin and other medicines.
• Get support from your health care team.

Your health care provider will set treatment goals for you.

What are the risks?

If you do not get treated for this condition, it may cause problems for you and your unborn baby.

For the mother

• Give birth early.
• Have a difficult labor and birth if the baby is larger than normal.
• Have surgery to deliver the baby.
• Have high blood pressure and preeclampsia.
• Get it again if they become pregnant.
• Develop type 2 diabetes in the future.

For the baby

• Low blood sugar.
• Bigger body size than normal.
• Breathing problems.

Checking your blood sugar

Check your blood sugar every day while you're pregnant, or as often as told.

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

Follow these instructions at home:

Medicines

• Take your medicines only as told by your provider.
• If you were given insulin or other diabetes medicines:
  • Take them every day.
  • Do not run out of these medicines. Plan ahead so you always have them.

Eating and drinking

• What you eat or drink affects your blood sugar. A healthy meal plan includes:
  • Lean proteins, such as chicken, fish, egg whites, and beans.
  • Carbohydrates that contain fiber, have a lot of nutrients, and are digested slowly. They include beans, oats, whole grain breads, pasta, and brown rice.
  • Fresh fruits and vegetables.
  • Low-fat dairy products.
  • Healthy fats, such as nuts, seeds, and fish.
• See a food expert called a dietitian to help you create an eating plan that's right for you. Make sure that you:
  • Follow your eating plan instructions.
  • Eat healthy snacks between meals.
  • Drink enough fluid to keep your pee (urine) pale yellow.
• Keep a record of the carbohydrates that you eat. To do this:
  • Read food labels.
  • Learn the serving sizes of foods.
• Make a sick day plan with your provider before you get sick. Follow this plan when you cannot eat or drink as usual.

Activity

• Do 30 minutes or more of physical activity a day, or as told by your provider. It may help to control blood sugar levels after a meal.
• Talk with your provider before you start a new exercise. Your provider may tell you to change your insulin, other medicines, or food as you exercise.

General instructions

• Stay at a healthy weight while you're pregnant. Your weight gain during pregnancy depends on your weight before pregnancy.
• Share your diabetes care plan with:
  • People at your workplace or school.
  • People you live with.
• Check your pee for ketones when you're sick and as told.
  • Ketones in your pee is a sign that your body is using fat for energy because it's not making enough insulin.
• Carry a card or wear a bracelet that says you have diabetes.
• Keep all follow-up visits. Your provider needs to check your health and your baby's growth.

Get care after delivery

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

Where to find more information

• American Diabetes Association (ADA): diabetes.org
• Centers for Disease Control and Prevention (CDC): cdc.gov
• American Pregnancy Association: americanpregnancy.org
• U.S. D. A. MyPlate: myplate.gov

Contact a health care provider if:

• Your blood sugar is above your target for two tests in a row.
• You have a high blood sugar level and you also have ketones in your pee.
• You've been sick or have had a fever for 2 days or more and aren't getting better.
• You have any of these problems for more than 6 hours:
  • You can't eat or drink.
  • You vomit or feel like you may vomit.
  • You have watery poop (diarrhea).

Get help right away if:

• You become confused or cannot think clearly.
• You have trouble breathing.
• You have chest pain.
• Your baby is moving less than usual.
• You have abnormal discharge or bleeding from your vagina.
• You have cramping in your belly or have pain in your hips or lower back.
• You have symptoms of high blood pressure or preeclampsia. These include:
  • A severe, throbbing headache that doesn't go away.
  • Sudden or extreme swelling of your face, hands, legs, or feet.
  • Vision problems, such as:
    • Seeing spots.
    • Blurry vision.
    • Sensitivity to light.

• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.