I have been diagnosed with Gestational Diabetes. Now what?


Note: This article is part of a series on Gestational Diabetes.

Is Gestational diabetes mellitus (GDM) manageable?

Absolutely! In fact, managing blood glucose is the way to prevent many of the pregnancy complications associated with diabetes. Even small changes in lifestyle can help to reduce blood glucose levels and lead to a healthy pregnancy and birth for you and your baby.

-Adopt a carbohydrate consistent diet, including smaller more frequent meals.

-Eliminate liquid and concentrated carbohydrates (soda, juice, concentrated sweets).

-Limit complex carbohydrates and combine with protein and healthy fats.

-Unless you’re told it is dangerous for you—exercise, especially after meals.

-Get plenty of sleep and work on reducing stress in your life.

Do I need to check my blood glucose with GDM?

Most women are asked to check blood glucose four times a day (before breakfast and after meals). This can be done with a small home blood glucose meter. It can be helpful to keep a log with notes about food and exercise for you to determine what effects your lifestyle choices have on your blood glucose.

What are my blood glucose targets?

Your health care provider will give you specific targets. The American College of Obstetricians and Gynecologists recommends:

Fasting < 95

One hour after meals < 140

Two hours after meals <120

A1c < Six

Will I need to take medication?

The majority of women with gestational diabetes are able to keep blood glucose in a target range by making changes in lifestyle and without the addition of medications. As pregnancy progresses, insulin requirements increase for all women. Sometimes, this will result in rising blood glucose. If medication becomes necessary, your health care provider will discuss options with you. 

How much weight should I gain with GDM?

Recommended weight gain with GDM is no different from weight gain recommendations in pregnancy without GDM. Recommendations are based on body mass index (BMI).

BMI  ≤ 18.5, gain 28-40lb

BMI    18.5-24.9, gain 25-35lb

BMI    25-29.9, gain 15-25lb

BMI    ≥ 30, gain 11-20lb

When should I call my health care provider?

You should contact your health care provider right away if your blood glucose is significantly out of range (typically < 60 or > 200 but ask for specific guidance here).

As with any pregnancy, contact your health care provider for preterm contractions, bleeding, headache, visual changes, nausea, or vomiting.

What else can I do to have a healthy pregnancy?

Find support. Ask family, join a support group or connect with someone who had diabetes in pregnancy.

Stay positive! Gestational diabetes is an opportunity to improve health during pregnancy.

Many women with GDM say that after adopting a healthier lifestyle, they feel better than ever! 

Read A (Gestational Diabetes) Wake Up Call by Casey Tunguz.

WRITTEN BY Jessica Lynn, MSN, CNM, CDE, POSTED 11/29/18, UPDATED 11/02/22

Jessica Lynn, MSN, CNM, CDE is a nurse midwife and perinatal diabetes educator in New York City. Her passion is helping women with diabetes have healthy pregnancies and births on their own terms. You can find her at diabetesmidwife.com.