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Gestational Diabetes, Ambulatory Care

Gestational diabetes (GDM)

is a type of diabetes that develops during pregnancy, usually in the second or third trimester. GDM causes your blood sugar level to rise too high. This can harm you and your unborn baby. Blood sugar levels usually go back to normal after you give birth.

Common symptoms include the following:

  • More hunger or thirst than usual
  • Frequent urination
  • Blurred vision
  • More fatigue (tired) than usual
  • Frequent bladder, vaginal, or skin infections
  • More weight gain than your healthcare provider suggests during your pregnancy
  • Nausea or vomiting

Seek immediate care for the following symptoms:

  • Fast and weak heartbeat, or fast and shallow breathing
  • Feeling more sleepy than usual or becoming confused
  • Blurred or double vision
  • Fruity, sweet smelling breath
  • Shakiness or sweatiness

Check your blood sugar level as directed:

  • You will be taught how to check a small drop of blood in a glucose monitor. Ask your healthcare provider when and how often to check your blood sugar level during the day. You may need to check your blood sugar level at least 3 times each day.

  • Ask your healthcare provider what your blood sugar levels should be before and after you eat. He may suggest that your blood sugar level should be at or below 95 mg/dL before you eat. The level may need to be at or below 140 mg/dL 1 hour after you eat or at or below 120 mg/dL 2 hours after you eat. Write down your results, and show them to your healthcare provider. He may use the results to make changes to your medicine, food, and exercise schedules.

Control gestational diabetes:

Gestational diabetes can usually be controlled with meal planning and exercise. The goal is to keep your blood sugar level as close to normal, as safely as possible. Your healthcare provider and dietitian will help set up a meal and exercise plan for you.

  • Follow your meal plan as directed. Talk to a dietitian about the best meal plan for you. Eat 3 small meals and 3 snacks every day. Wait at least 2 hours between all meals and snacks. Limit carbohydrates (such as bread, cereal, and fruit). Too much carbohydrate in 1 meal or snack can cause your blood sugar to rise to a high level. Eat foods that are a good source of fiber, such as vegetables and legumes (beans and lentils).
  • Exercise regularly. Exercise helps keep your blood sugar level steady. Exercise for at least 30 minutes, 5 days a week. Work with your healthcare provider to create an exercise plan. Low impact exercises such as swimming and bicycling may be safer and more comfortable for you. If you walk, wear flat shoes with cushioned soles.
  • Insulin may be needed if your diabetes is not controlled by nutrition and exercise. Insulin is safe to use during pregnancy. Talk to your healthcare provider about all of the medicines you are currently taking. Some diabetes medicines are not safe during pregnancy.

Manage gestational diabetes:

  • Check your blood pressure often. High blood pressure can cause problems with your health and your pregnancy. Blood pressure readings are usually written as 2 numbers. Your systolic blood pressure (the first number) should be between 110 and 129. Your diastolic blood pressure (the second number) should be between 65 and 79.
  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. A healthy weight can help you control your GDM. Ask him to help you create a weight loss plan if you are overweight. The recommended weight gain for women who are overweight is 15 to 25 pounds. The recommended weight gain for women who are obese is 10 to 20 pounds. Your risk of problems such as high blood pressure and premature labor are higher if you are overweight.
  • Do not smoke. Nicotine is dangerous for you and your baby and can make it harder to manage your GDM. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.

Follow up with your healthcare provider as directed:

You may need to have screening tests for diabetes after you have your baby. Write down your questions so you remember to ask them during your visits.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.