Type diabetes gestational diabetes -
Visit your doctor to have your blood sugar tested 6 to 12 weeks after your baby is born and then every 1 to 3 years to make sure your levels are on target.
Talk to your doctor about how much weight you should gain for a healthy pregnancy. You can do a lot to manage your gestational diabetes.
Go to all your prenatal appointments and follow your treatment plan, including:. Skip directly to site content Skip directly to search. Español Other Languages. Gestational Diabetes. Español Spanish Print.
Minus Related Pages. Follow a healthy eating plan to nourish you and your baby. Preventing Type 2 Diabetes. Diabetes During Pregnancy Diabetes and Women Insulin Resistance Diabetes Articles Infographics.
Last Reviewed: December 30, Source: Centers for Disease Control and Prevention. Facebook Twitter LinkedIn Syndicate.
home Diabetes Home. To receive updates about diabetes topics, enter your email address: Email Address. What's this. Blood sugar monitoring — You will learn how to check your blood sugar level and record the results figure 1. Instructions for choosing a blood sugar meter, checking blood sugar levels at home, and ways to record the results are discussed separately.
See "Patient education: Glucose monitoring in diabetes Beyond the Basics ". This information can help to determine whether your blood sugar levels are on target. If your levels stay higher than they should be, your doctor will probably recommend that you start using insulin.
See 'Insulin' below. Exercise — Although exercise is not a necessary part of gestational diabetes treatment, it might help to control blood sugar levels. If you were exercising before, you should continue after being diagnosed with gestational diabetes.
If you did not previously exercise, ask your doctor or nurse if exercise is recommended. Most individuals who do not have medical or pregnancy-related complications are able to exercise, at least moderately, throughout their pregnancy. Walking is a great form of exercise for those starting an exercise regimen.
Insulin — Approximately 15 percent of patients with gestational diabetes will require insulin. Insulin is a medicine that helps to reduce blood sugar levels and can reduce the risk of gestational diabetes-related complications.
Insulin is the most common medicine for treating gestational diabetes. You must give insulin by injection because it does not work when it is taken by mouth. Most pregnant people start by giving one to two shots of insulin per day.
If your blood sugar levels are high after eating, you may need to give yourself a shot three or four times per day. Instructions for drawing up and giving insulin shots are available separately. See "Patient education: Type 2 diabetes: Insulin treatment Beyond the Basics ". If you take insulin, you should check your blood sugar level at least four times per day.
You also need to write down your results or store them in the meter and how much insulin you took and review these records at each prenatal visit or more frequently based on your doctor's recommendation figure 1. Keeping accurate records helps to adjust insulin doses and can decrease the risk of complications.
The bedtime snack is especially important to help keep your fasting first blood sugar of the day before eating in range. Oral diabetes medicines, such as those taken by people with type 2 diabetes, are sometimes used during pregnancy in the United States. We prefer insulin therapy for pregnant patients with diabetes who cannot control blood glucose levels adequately by their diet nutritional therapy.
Insulin is effective and safe and does not cross the placenta to the fetus. Most oral diabetes medicines pass from the pregnant individual to their baby through the placenta; while they have not been shown to harm the fetus or newborn, it is not known if there are longer term effects on children.
There are studies underway to help answer this question. However, oral anti-hyperglycemic agents are a reasonable alternative for individuals who will not take, or are unable to comply with, insulin therapy, as long as they understand the lack of information on long-term risks or benefits.
Prenatal visits — Most pregnant individuals who develop gestational diabetes have more frequent prenatal visits eg, once every week or two , especially if insulin is used. The purpose of these visits is to monitor your and your baby's health, discuss your diet, review your blood sugars, and adjust your dose of insulin if you are taking it to keep your blood sugar levels near normal.
It is common to change the dose of insulin as the pregnancy progresses. You may also be asked to have one or two ultrasound examinations to check on the growth and size of the baby.
See "Gestational diabetes mellitus: Obstetric issues and management". Nonstress testing — You may need tests to monitor the health of the baby during the later stages of pregnancy, especially if your blood sugars have been high, you are using insulin, or if you have any pregnancy-related complications eg, high blood pressure.
The most commonly used test is the nonstress test. This test is discussed in a separate topic review. See "Patient education: Postterm pregnancy Beyond the Basics ". If your blood sugar levels are close to normal during pregnancy and you have no other complications, the ideal time to give birth is between 39 and 40 weeks of pregnancy, no later than your due date.
If you do not give birth by your due date, you may be offered induction of labor or additional testing to monitor your and your baby's health.
In most individuals with gestational diabetes and a normal-size baby, there are no advantages to a cesarean over a vaginal birth, although cesarean may be needed in any pregnancy, especially with a first baby.
Those with a very large baby may be offered cesarean birth before labor starts. The risks and benefits of cesarean birth are discussed separately. See "Patient education: C-section cesarean delivery Beyond the Basics ".
Your blood sugar levels will be monitored during labor. Most individuals have normal blood sugar levels during labor and do not need any insulin. Insulin is given if your blood sugar level becomes high. High blood sugar levels during labor can cause problems in the baby, both before and after delivery.
See "Pregestational preexisting and gestational diabetes: Intrapartum and postpartum glucose management". After giving birth, most individuals with gestational diabetes have normal blood sugar levels and do not require further treatment with insulin.
You can return to your prepregnancy diet, and you are encouraged to breastfeed. See "Patient education: Deciding to breastfeed Beyond the Basics ". However, your doctor may check your blood sugar level the day after delivery to be sure that it is normal or near normal.
Pregnancy itself does not increase the risk of developing type 2 diabetes. However, having gestational diabetes does increase your risk of developing type 2 diabetes later in life.
After you deliver, you should have testing for type 2 diabetes. Typically, this is done between 4 and 12 weeks postpartum, ideally prior to your postpartum check-up. But it may be done in the hospital before you are discharged. Testing usually includes a two-hour glucose tolerance test GTT so that you are tested for both pre-diabetes and diabetes.
Risk of recurrent gestational diabetes — One-third to two-thirds of individuals who have gestational diabetes in one pregnancy will have it again in a later pregnancy. If you are overweight or obese, weight reduction through diet and exercise can reduce this risk.
Risk of developing type 2 diabetes — Individuals with gestational diabetes have an increased risk of developing type 2 diabetes later in life, especially if they have other risk factors eg, family history of type 2 diabetes.
The risk of developing type 2 diabetes is greatly affected by body weight. Individuals with obesity have a 50 to 75 percent risk of developing type 2 diabetes, while this risk is less-than percent in those who are a normal weight. If you are overweight or obese, you can reduce your risk of type 2 diabetes by losing weight and exercising regularly.
The American Diabetes Association ADA recommends that all persons with a history of gestational diabetes have testing for type 2 diabetes every one to three years after their initial post-pregnancy test for diabetes. If you have elevations in your blood sugars in the pre-diabetes range at the time of your postpartum screening, the ADA recommends testing yearly testing.
It is also recommended that you work with your primary care provider to eat a healthy diet, lose any excess weight, and exercise regularly to help decrease your risk of developing type 2 diabetes. Cardiovascular disease — Individuals who have had gestational diabetes in the past are at increased risk of developing cardiovascular disease, including heart attack and stroke.
While this is mostly tied to the risk of type 2 diabetes see above , even those who do not develop type 2 diabetes appear to have a small increase in their risk of heart disease later in life. Continuing to make healthy lifestyle choices such as eating a balanced diet, exercising regularly, and avoiding smoking can help minimize this risk.
See "Patient education: Diet and health The Basics ". Birth control — Individuals with a history of gestational diabetes can use any type of birth control after pregnancy.
A review of all of the birth control options is available separately. See "Patient education: Birth control; which method is right for me? Beyond the Basics ". Your health care provider is the best source of information for questions and concerns related to your medical problem.
This article will be updated as needed on our web site www. Related topics for patients, as well as selected articles written for health care professionals, are also available.
Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.
These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: Gestational diabetes The Basics.
Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon. Patient education: Preeclampsia Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics Patient education: Type 2 diabetes: Insulin treatment Beyond the Basics Patient education: Postterm pregnancy Beyond the Basics Patient education: C-section cesarean delivery Beyond the Basics Patient education: Deciding to breastfeed Beyond the Basics Patient education: Birth control; which method is right for me?
Beyond the Basics. Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based.
Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.
Clinical presentation, diagnosis, and initial evaluation of diabetes mellitus in adults Effects of advanced maternal age on pregnancy Infants of mothers with diabetes IMD Pregestational preexisting diabetes mellitus: Obstetric issues and management Gestational diabetes mellitus: Screening, diagnosis, and prevention Gestational diabetes mellitus: Glucose management and maternal prognosis Gestational diabetes mellitus: Obstetric issues and management Pregestational preexisting and gestational diabetes: Intrapartum and postpartum glucose management.
htm , available in Spanish. The editorial staff at UpToDate would like to acknowledge Donald R Coustan, MD, and Michael F Greene, MD, who contributed to earlier versions of this topic review. Contributor disclosures are reviewed for conflicts of interest by the editorial group.
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