Treatment for gestational diabetes

Gestational diabetes can often be managed by making changes to your diet, and working out, to manage blood sugar levels. If this doesn’t work, you may need medication.

If you have gestational diabetes, you can reduce the risk of problems during your pregnancy by keeping your blood sugar (glucose) levels in the ideal range. Ways to do this include:

• eating a healthy diet
• exercising often 
• managing your weight gain during pregnancy
• taking medication, if it’s needed.

You'll be monitored during pregnancy and labour to check your blood sugar levels and manage any problems, should they arise.

Monitoring your blood sugar levels

If you have gestational diabetes, you will need to check your blood sugar levels throughout each day for the rest of your pregnancy. This is vital as it will show if you’re reaching your ideal blood sugar levels.

You’ll be given a kit that lets you check your own blood sugar levels by pricking your finger and putting a drop of blood on a testing strip.  
Your healthcare team will tell you:

• how to check your blood sugar level
• when and how often to check (usually when you wake up, and then 1 hour after each meal)
• what levels to aim for (usually below 5.3 mmol/l before breakfast, and below 7.8 mmol/l 1 hour after each meal).

You’ll be asked to keep a record of your blood sugar levels. Your healthcare team will see you often to check your results and make sure that treatment (diet, exercise and any medications) is keeping your blood sugar levels controlled.

Checks and changes to your diet and workout routine can take some getting used to. Some people find it all a bit much at first. But most people do adjust to their new healthy pregnancy routines over time.

Read more about checking your blood sugar levels.

How is gestational diabetes treated?

This will depend on how well your blood sugar levels are being controlled.

Support with diet and exercise

Gestational diabetes can often be managed by changing your diet and doing exercise. This can help to lower your blood sugar.

Try to eat a healthy, balanced diet that is low in fat, sugar and salt, and high in fruits and vegetables. Where you can, choose foods with a low glycaemic index. This will all help to manage your blood sugar levels.

Gentle exercise can help anyone to have a more healthy pregnancy, and to cope better with labour and birth. If you have gestational diabetes, it can also help to reduce your blood sugar. Taking short walks, trying pregnancy yoga, and going swimming are all great options.

Your healthcare team will give you information and support to help you make healthy changes.

Read more about a healthy pregnancy diet and doing exercise if you have gestational diabetes.

Tablets

You may need metformin tablets if diet and exercise alone aren’t enough to manage your blood sugar levels. Metformin helps your body respond better to the hormone insulin, which helps to lower your blood sugar.

Read more about taking metformin for gestational diabetes.

Insulin

You may be offered insulin injections if your blood sugar levels still aren’t low enough with metformin tablets, or if you can’t take metformin.

Some people are offered insulin injections as soon as they are diagnosed with gestational diabetes. This could happen if your blood sugar level is very high, or if your baby is large.

Read more about using insulin for gestational diabetes.

What care should I expect?

It is natural to want your pregnancy to go smoothly and to be anxious if something unexpected happens. But once gestational diabetes is diagnosed, you will have extra appointments with specialists, who will help you reduce the risk of any complications. 

This does mean that your experience of pregnancy may be different to what you had expected. But your midwife and diabetes team will be there to support you.  

"Gestational diabetes sounded like something small to me, but it was big. It changes your whole pregnancy – I couldn’t have the birth I wanted. It preyed on my mind and I started creating problems in my head, but looking at my son, you’d never know that anything had happened at all." 

Kate

Your healthcare team

Your specialist diabetes clinic team may include:

• specialist midwife – you may see a diabetes midwife or clinic lead midwife. They will give you specialist support while you are pregnant, and during and after the birth
• endocrinologist or diabetologist – a consultant doctor who specialises in diabetes
• obstetrician – a consultant doctor who specialises in pregnancy and birth
• diabetes nurse specialist – a nurse who specialises in caring for people with diabetes
• diabetes dietitian – a healthcare professional who can give advice on your diet.

These professionals will work alongside the other members of your healthcare team, such as your GP and your community midwife.

Who to contact

Your main contact person will tend to be your diabetes midwife or the diabetes nurse specialist. Make sure you know who to contact and how to get hold of them. Ideally, you should have a direct telephone number or email address. You should also find out which days they work. 

"My advice to others would be, don’t be afraid to ask questions of the midwives, the consultants, and all the other people carrying out the tests. Ask them how things can affect you, and try to stay healthy."

Gemma

Extra scans

All pregnant people are offered routine ultrasound scans. If you have gestational diabetes, you should be offered extra scans at points during your pregnancy. This is to check how your baby is growing and how much amniotic fluid is sitting around the baby. The timing of these scans may depend on your own situation.

These scans matter because gestational diabetes can cause your baby to grow larger than usual (known as macrosomia). This can cause complications in labour and giving birth. The team will need to check your baby’s size quite often and will talk to you about the best options for birth. Towards the end of your pregnancy, you will be checked even more, to make sure that all is well. 

"I was reassured that they were keeping an eye on me. At least I could see the baby was OK."

 Gemma

Your team will give you lots of information and advice about your care leading up to and after the birth.

Extra appointments during your pregnancy

As soon as you are diagnosed with gestational diabetes you will be offered an appointment with a specialist team within a week. It will most likely be at your local pregnancy diabetes clinic and you should start getting extra care straight away.

You should also have an HbA1c test. This is a simple blood test that measures your average blood sugar levels over the last 3 months. It can show if you may have had type 2 diabetes before you became pregnant. 

You will have contact with the diabetes and antenatal team every 1 to 2 weeks during your pregnancy. This may be in clinic, or by phone or email to check that all is fine. 

"At first it was quite overwhelming. I was a borderline case but all of a sudden you’ve got a dietitian and an obstetrician. Before, it had been just the midwife."

Michelle

Working with gestational diabetes

You do not have to tell your employer about your pregnancy until 15 weeks before your baby is due, if you don’t want to. But you will only get paid time off for antenatal appointments and scans if you tell them. Also, the sooner they know about your gestational diabetes, the better they can support you. 

Don’t feel bad about needing to go to extra appointments and scans. These are to keep you and your baby safe throughout your pregnancy. 

If you are worried that your employer might not understand, ask them to read our webpages on gestational diabetes. They might also be interested in our training and resources for employers. Diabetes UK also has a resource on how to support someone with diabetes at work.

Read more about pregnancy and work.

Giving birth

Because of the risks that can come with having gestational diabetes, your healthcare professionals should explain your options for giving birth before you make your birth plan.

If your pregnancy carries on for too long, this may increase the risk of problems for you and your baby. If you have not given birth by 40 weeks and six days, you should be offered an induction (starting labour artificially) or a caesarean section. 

If your ultrasound scans have shown that your baby is large, or if you have other complications, you may be advised to give birth before 40 weeks and six days.

Your blood sugar levels will be monitored carefully during labour and birth. 

Read more about giving birth with gestational diabetes.