Why Monitoring Your Blood Sugar with Gestational Diabetes Is Important

By Hannah Murphy
Reviewed by Alyssa Quimby, M.D.
September 01, 2023

Getting a gestational diabetes (GD) diagnosis during pregnancy can be overwhelming. But with monitoring and a care plan from your doctor, you can manage the condition and have a healthy pregnancy and deliver a healthy baby.

GD is a type of diabetes that is diagnosed for the first time during pregnancy and usually goes away after delivery. With GD, a person’s body becomes resistant to insulin (a hormone that regulates metabolism of carbohydrates), and the result is high blood sugar (glucose).

How Gestational Diabetes Is Diagnosed

Most pregnant people find out whether they have GD after the routine oral glucose tolerance test commonly given between 24 and 28 weeks of gestation. During the test, you’re given a sugary beverage and then have your blood sugar tested one hour later.

If the results show risk, most people are then referred to a three-hour test to confirm the results. If the second test also shows elevated blood sugar levels, then you may be diagnosed with GD.

What Happens After Diagnosis?

If you’re diagnosed with GD, the first step will likely be a long conversation with your healthcare provider. The condition will be monitored, and you’ll learn to manage it with diet, exercise, and possibly medications, including insulin injections.

Consulting with a registered dietitian is also a good idea; they can help you develop a healthy meal plan to promote optimal blood glucose levels. “Dietary recommendations are geared towards [choosing] complex carbohydrates over simple carbohydrates (whole wheat products, brown rice, beans, vegetables) and [eating] a healthy balance of proteins and fats as equal energy sources,” says Andres Rodriguez, M.D., a board certified ob-gyn with Maury Regional Health in Columbia, Tennessee.

It is a manageable condition, Rodriguez stresses. “Do not panic,” he says.

One of the most important things to do after diagnosis is learn to monitor your glucose levels each day during the remainder of your pregnancy, explains Rodriguez. “Based on your daily results, your physician will review how your blood sugar levels are looking and discuss if any medications or alternative therapies are recommended.” Since much of your treatment plan will revolve around this testing, it’s important to get it right.

The Importance of Monitoring Glucose Levels with GD

With GD, you’re typically instructed to test your blood sugar levels around four times per day—first, in the morning after waking up for a “fasting” level, and then one hour after each meal, says Rodriguez.

This is important in helping you understand how your glucose levels are affected by what you eat and do so you can make adjustments to your diet and routine accordingly. Although sometimes diet and exercise changes are enough to control blood sugar, some people need to start treatment if their numbers remain too high, says Alisa Bowersock, D.O., a board-certified ob-gyn at Southern Women’s Care in Hermitage, Tennessee.

Treatments for gestational diabetes include self-administering insulin injections before meals, or taking oral medications like metformin and glyburide. Deciding which medical intervention is best will depend on each person’s unique situation. Have a discussion with your provider to thoroughly discuss all the options.

Left untreated, the risks to your baby can be severe. These risks include high birth weight and polyhydramnios (excessive amniotic fluid), which can increase the risk of preterm birth, stillbirth, delivery trauma, or admission to the neonatal intensive care unit (NICU).

Luckily, testing and monitoring your blood glucose can be done from home and learned quickly.

How to Test Your Blood Glucose

Blood glucose testing is a relatively simple process, Rodriguez says. To do it, you’ll need a glucometer (a pocket-size device that instantly analyzes the blood sample for glucose levels, measured in milligrams per deciliter, or mg/dl), a lancet (a small device to prick your finger), and testing strips. Here are the steps:

  1. Poke your finger with the lancet and then squeeze to draw a couple drops of blood.
  2. Place the drops on a testing strip and put the end of the testing strip into the glucometer.
  3. Read the glucometer and assess. Levels should ideally be under 95 mg/dl for fasting sugars, and under 140–120 mg/dl an hour or two after meals.
  4. Report anything that’s too high to your provider. They can help advise you on adjustments to make in order to lower your glucose levels.

Amy N., a mother of two from Murfreesboro, Tennessee, says testing her blood sugar and writing down all the foods she ate was a lot to handle, but the outcome was well worth it—she delivered a healthy baby boy and experienced a healthy postpartum period. “It was exhausting, but I just tried to look at the good in it.”

If you don’t like pricking your finger, or you’re interested in another monitoring option, you may want to ask your doctor if a continuous glucose monitor for gestational diabetes might be a good choice for you.

This is a wearable device that stays in place all day and night to measure glucose levels constantly.

“We try to make it as easy as possible with traditional glucometers and finger sticking, but in a few instances these last couple of years, my patients have requested to use disposable monitors [that send results to] their smartphones and have had good results and tight control,” Bowersock says.

Though not approved for use in pregnant people, there have been successful trials with continuous glucose monitors, and Bowersock has seen people with GD use it under her supervision and be happy with it.

Each time you test, write down your blood sugar level so you have a detailed log to share with your provider, Rodriguez says. As a basic rule of thumb, if blood glucose levels are elevated 50% of the time or more, additional interventions are necessary, he notes.

What Happens After Delivery

The good news is that gestational diabetes usually goes away after the baby is born.

“After delivery, most patients usually do not require any further medications as their bodies recover from pregnancy through the postpartum period,” Rodriguez says. You’ll need to have your blood sugar assessed after delivery to make sure this happens as expected.

This assessment is very similar to the original glucose tolerance test and typically occurs during the six-week postpartum visit, according to Rodriguez. The majority of people will be cleared and won’t require further testing.

Even if your gestational diabetes resolves itself after you give birth, it’s important to continue to make healthy diet and lifestyle choices, Rodriguez says. “Pregnant people with a diabetes diagnosis are at an increased risk of developing diabetes later in their lifetime.”

Although a gestational diabetes diagnosis can feel overwhelming at first, Rodriguez urges people to remain calm, to stay in communication with their healthcare provider, and to master the steps to monitoring and controlling blood glucose levels: “80% of patients with gestational diabetes can maintain safe and normal blood sugar levels in pregnancy through lifestyle and diet modification.”

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