Many women with gestational diabetes have healthy pregnancies and healthy babies because they follow the treatment plan that their health care providers set up for them. However, because gestational diabetes can hurt you and your baby, you need to start treatment quickly. Treatment for gestational diabetes aims to keep blood glucose levels equal to those of pregnant women who don't have gestational diabetes. Treatment for gestational diabetes always includes special meal plans and scheduled physical activity. It may also include daily blood glucose testing and insulin injections. You will need help from your doctor, nurse educator, and other members of your health care team so that your treatment for gestational diabetes can be changed as needed. For you as the mother-to-be, treatment for gestational diabetes helps lower the risk of a cesarean section birth that very large babies may require. Sticking with your treatment for gestational diabetes will give you a healthy pregnancy and birth, and may help your baby avoid future poor health.

A general treatment plan may include the following:

• Checking Your Blood Glucose
• Eating a healthy diet & maintaining a healthy weight gain
• Getting regular, moderate physical activity
• Taking insulin and/or other medications as prescribed

Checking Your Blood Glucose

Blood checks will help you keep your blood glucose on target.

Check your blood glucose levels at the times your diabetes team advises; this may be up to eight tests daily and will probably include after-meal checks.

•  Write down your results

•  Keep notes on your meal plan and exercise

•  Make changes in your meal plan and insulin only with the advice of your diabetes team

Measuring your blood sugar will give you information about: the amount of food you can eat, foods that affect your glucose level, times when your glucose level is high or low and times that physical activity is more likely to keep your glucose level in the target range.

A healthy target range for glucose levels*

Fasting – No higher than 95 mmol

One hour after eating – No higher than 140 mmol

Two hours after eating – No higher than 120 mmol

*Always check with your health care provider about your target glucose range should be and what to do if your glucose level is outside the healthy target listed here.

Eating a healthy diet & maintaining healthy weight gain

During pregnancy you and your dietitian or doctor may need to change your meal plan to avoid problems with low and high blood glucose levels. This is the most important reason for keeping track of your blood glucose results.

Women with gestational diabetes have special dietary needs. Because eating a healthy diet is such an important part of a treatment plan for gestational diabetes, women should NOT try to create their own diets. To promote health throughout your pregnancy, it is essential that you work with your health care provider to create a plan for your healthy diet and that you follow the plan as outlined. Sticking to your meal plan is one of the most effective ways to control gestational diabetes.

If you start pregnancy weighing too much, you should not try to lose weight. Instead work with your dietitian or doctor to curb how much weight you gain during pregnancy.

Your dietitian will keep track of your weight gain. If you start pregnancy at a normal weight, expect to add between 25 to 35 pounds. Women who start pregnancy too thin need to gain more. If you are obese at the start of your pregnancy, work with your dietitian to limit your weight gain to about 15-25 pounds.

Getting regular, moderate physical activity

Exercise can help you stay healthy during pregnancy and aid in controlling glucose levels. In general, it's not a good idea to start a new strenuous exercise program during pregnancy. Good exercise choices for pregnant women include walking, low-impact or prenatal aerobics, swimming or water aerobics.

Your health care provider may tell you not to do any moderate physical activity because of other health conditions you have or because of complications with your pregnancy. Do not begin any physical activity without talking to your health care provider first.

Taking insulin and/or other medications as prescribed

Even if you do everything your health care provider tells you to manage your gestational diabetes, you still might need to take insulin during your pregnancy to keep it under control. You may have to include small amounts of insulin in your treatment plan if:

•  Your blood sugar level is too high or high too many times

•  Your blood sugar level remains high, but you aren't gaining much weight or are not eating poorly.

•  You cannot safely add physical activity to your treatment plan.

In these cases, the best action for maintaining a healthy pregnancy is to add insulin. Insulin does not hurt the fetus. This is why it is critical to maintain a daily record of your glucose levels. It will help your health care provider decide when and if it's time to begin insulin.

If you do begin insulin therapy, read about risks of hypoglycemia (low glucose levels).