Managing gestational diabetes

When you are diagnosed with gestational diabetes there are health professionals who can help you. This includes specialist doctors, diabetes educators and dietitians. They can work with you to help keep your blood glucose levels within the target range. This will provide the best outcome for both you and your baby.

You can manage gestational diabetes by following a healthy eating plan, doing regular physical activity, and monitoring blood glucose levels. This will help keep blood glucose levels within the target range for a healthy pregnancy. It will also help you to manage your pregnancy weight gain. Some women will also need medication called metformin or insulin injections to help manage gestational diabetes.

* Every woman’s experience with gestational diabetes and how it is managed will be different.*

Read more about managing gestational diabetes in the National Diabetes Services Scheme booklet Gestational diabetes: caring for yourself and your baby.

Why is it important to manage gestational diabetes?

If blood glucose levels are high during pregnancy, extra glucose passes across the placenta to the baby, who then makes extra insulin. This can sometimes make the baby grow too big, which can cause problems during labour, and increase the risk of early delivery or the need for a caesarean section.

After the birth, the baby may have a greater risk of low blood glucose levels (hypoglycaemia or hypo). This is because the baby is no longer receiving extra glucose from their mother, but they continue to make extra insulin, causing their blood glucose levels to drop.

Women with gestational diabetes also have an increased risk of developing high blood pressure during pregnancy.

Blood glucose monitoring is an essential part of managing gestational diabetes. A diabetes educator can show you how to check your blood glucose levels using a blood glucose meter and advise you on target levels for pregnancy.

The most common times to check blood glucose levels are when you wake up in the morning (fasting) and one or two hours after each main meal. You may also be advised to check your blood glucose levels at other times.

Regular blood glucose monitoring can be helpful for understanding the effects of food and physical activity on blood glucose levels. Keep a record of your blood glucose readings so that your diabetes health professionals can help you look for any patterns in your blood glucose levels. They can also advise you on what to do if your blood glucose levels are outside the target range.

Healthy eating

Healthy eating is important to help you keep blood glucose levels within the target range, and to provide all your nutritional needs for pregnancy and a healthy pregnancy weight gain.

Eating well for gestational diabetes includes choosing the right type and amount of carbohydrate foods, limiting foods high in saturated fat, and eating a variety of nutritious foods.

Choose the right type and amount of carbohydrate foods

Women with gestational diabetes are encouraged to: Carbohydrate foods are an important source of energy for your body, especially during pregnancy. These foods include breads and cereals, grains, starchy vegetables (such as potato, corn and sweet potato), fruit, legumes, yoghurt and milk. To manage your blood glucose levels, you need to eat the right type and amount of carbohydrate foods.

Eat some carbohydrate food at each meal and snack. The best choices are those that are high in fibre and have a lower glycaemic index (GI). Low-GI carbohydrates include dense grainy/seeded breads, rolled oats, natural muesli, pasta, low-GI white or brown rice, milk, yoghurt, legumes and most fruit.

Spread carbohydrate foods over three small meals and two or three snacks. This can help keep blood glucose levels in the target range and maintain your energy levels. Large amounts of carbohydrate foods at any one meal or snack can cause blood glucose levels to rise too high.

Your dietitian can advise you on the amounts of carbohydrates that are right for you.

Avoid food and drinks that are high in added sugars and have little nutritional value. These include, soft drinks, cordial, cakes, biscuits, chocolates and lollies.

Limit foods high in saturated fat

Eat less saturated fat by choosing lean meats, skinless chicken and low-fat dairy foods, and by avoiding takeaway and processed foods.

Have small amounts of healthy fats, such as olive oil or canola oil, unsalted nuts, seeds and avocado.

Eat a variety of nutritious foods

During pregnancy, your body needs extra nutrients, including iron and folate, to help your baby develop. Eating a wide variety of nutritious foods—including vegetables, fruits, lean meats, low-fat dairy foods and wholegrain breads and cereals—can help you to meet these extra nutritional needs.

Food safety is also important during pregnancy, so avoid high-risk foods such as processed meats, uncooked meat, cold seafood, raw eggs, soft cheeses and pre-prepared vegetables and salads.

A dietitian can advise you on how to meet your nutritional needs during pregnancy, and on food safety and healthy eating for gestational diabetes.

Physical activity

Physical activity can help you manage your blood glucose levels and pregnancy weight gain, as well as keep you fit to prepare for the birth of your baby.

It also has other benefits, such as managing pregnancy symptoms like heartburn, constipation and lower back pain.

Talk to your doctor before starting or continuing any form of physical activity while you are pregnant.

When you have gestational diabetes, it’s important to try and be active every day. Activities could include swimming, brisk walking, pregnancy yoga or pilates, and aqua fitness classes.

Talk to your diabetes educator about the effects of exercise on your blood glucose levels, especially if you are taking insulin.

Medication

If your blood glucose levels are above the target range, you may need medication to help manage gestational diabetes.

Some women will need insulin injections to help keep blood glucose levels in the target range. This will not harm your baby. If you need insulin, your diabetes educator will teach you how to give an injection. Your insulin doses will also need to be reviewed regularly.

Most diabetes tablets are not suitable for use during pregnancy, but a medication called metformin is sometimes used. If you need medication, your health professional will advise on the most suitable medication to meet your individual needs.

Pregnancy weight gain

As your baby grows, it’s normal to gain weight during your pregnancy. How much weight you should gain depends on your weight before you were pregnant. Discuss your individual pregnancy weight gain targets with your health professional.

Who can help with your gestational diabetes?

Managing gestational diabetes is a team effort, involving you, your family, and health professionals. There are many different health professionals who can help you, including:

  • your general practitioner
  • an endocrinologist (diabetes specialist)
  • an obstetrician
  • a credentialled diabetes educator or diabetes nurse practitioner
  • an accredited practising dietitian
  • an accredited exercise physiologist or physiotherapist
  • a midwife.

After your baby is born

Breastfeeding is recommended for all women, including women with gestational diabetes. Breastfeeding provides the best start for your baby and can help you to return to your pre-pregnancy weight.

You will be advised to have an oral glucose tolerance test (OGTT) 6–12 weeks after your baby is born (or as soon as possible after this time). This is to check that your blood glucose levels have returned to the normal range.

Depending on your risk factors, you will also need to be screened for type 2 diabetes again every one to three years. Ask your doctor for more information.

Future health

Gestational diabetes can occur again in future pregnancies, and you have an increased risk of developing type 2 diabetes. You can reduce your risk by:

  • being in the healthy weight range
  • making healthy food choices
  • being physically active every day.

If you develop type 2 diabetes, early diagnosis and management is important for good health, especially if you are planning for a future pregnancy.

Babies born to women who have had gestational diabetes also have an increased risk of childhood obesity and type 2 diabetes later in life. It’s important for the whole family to eat well and stay active to reduce this risk.

National Gestational Diabetes Register

The National Gestational Diabetes Register was established within the NDSS to help women who have had gestational diabetes manage their health during pregnancy and into the future. When you first register with the NDSS with gestational diabetes you are automatically included on the Register. As part of the Register, both and your doctor will be sent reminders about having regular type 2 diabetes checks after your baby is born.

You will receive:

  • regular reminders for follow-up diabetes screening
  • valuable information on how to maintain a healthy lifestyle and minimise your risk of type 2 diabetes
  • access NDSS support services and programs and subsidised NDSS products for 12 months from registration

Find out more about the National Gestational Diabetes Register or call the NDSS Helpline on 1800 637 700.

Resources

If you are diagnosed with gestational diabetes and you register with the National Diabetes Services Scheme (NDSS), you will receive a booklet called Caring for yourself and your baby.

You can also access the NDSS Understanding gestational diabetes videos. These videos are about gestational diabetes, how it is managed and where to get the information and support you need.

After your baby is born, the NDSS will send you another booklet, Life after gestational diabetes, as well as regular reminders for follow-up diabetes testing and healthy lifestyle information. For more information on how to register, visit https://ndss.com.au or speak to your health professional.

Australasian Diabetes in Pregnancy Society

The Australasian Diabetes in Pregnancy Society is a professional body established to advance clinical and scientific knowledge of diabetes in pregnancy

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