Gestational Diabetes Medication And Treatment

Gestational diabetes is a form of high blood sugar affecting pregnant women who don't have a previous diabetes diagnosis. This condition occurs when your blood glucose levels get too high during pregnancy.

It can develop at any stage but is more common in the second or third trimester. Doctors usually test for gestational diabetes between the 24th and 28th weeks of pregnancy. If the insulin produced by the pancreas is not enough or does not work properly, this results in unhealthy sugar levels in the blood.

In addition, hormones released in the body during pregnancy can interfere with how insulin works. As a result, you may develop gestational diabetes because the blood contains high amounts of sugar due to insulin resistance.

Fortunately, gestational diabetes can be treated through medication and other practices, such as healthy eating and positive lifestyle changes.

Why is it important to treat gestational diabetes? 

Early detection of gestational diabetes allows for proper management of the condition. This includes avoiding health risks to you and your baby during pregnancy and after birth.

For example, one of the main complications of gestational diabetes is an overly large baby. A natural birth will increase a large baby's risk of injuries such as nerve damage and broken bones. A large baby may also cause severe vaginal lacerations to the mother, and the doctor may have no other option but to recommend Cesarean birth.

Gestational diabetes can also increase the risk of premature birth, obesity, and breathing problems in your baby. It also elevates the mother's risk of high blood pressure during pregnancy (preeclampsia). Other potential risks to the baby and the mother include future type 2 diabetes and low blood sugar (hypoglycemia) after birth.

Therefore, it's important to treat gestational diabetes as early as possible to protect your baby's health and yours.

How is gestational diabetes treated?

Managing gestational diabetes involves keeping your blood sugar levels equal to those of pregnant women who don't have this condition. Your doctor may prescribe gestational diabetes medication or guide you to incorporate three basic components of effective gestational diabetes management.

These include monitoring blood glucose, adopting a healthy eating plan, and scheduling physical activity. Starting your gestational diabetes treatment plan early ensures you and your baby are safe.

Medications for gestational diabetes

During pregnancy 

1. Insulin injections

Insulin therapy helps lower your blood sugar levels, thus reducing the risk of complications related to gestational diabetes. It is the most common medication for treating this condition. Insulin cannot be taken orally because it's digestible, so this treatment is received as an injection.

Most patients start by receiving 1-2 shots of insulin daily. But if your blood sugar levels get too high after eating, you might need 3-4 shots daily. If you take insulin injections, you should monitor your blood sugar levels at least four times or more per day and record all results.

You should then review the records with your doctor at each prenatal visit or more frequently as required, depending on their recommendation. These records help you adjust your insulin doses and reduce the risk of complications.

2. Oral medications

The doctor may also prescribe oral medications to treat gestational diabetes. They are reasonable alternatives if you can't take insulin injections. Metformin is the most commonly prescribed oral medication to treat gestational diabetes.

However, Metformin may cause side effects such as feeling sick, diarrhea, stomach cramps, and loss of appetite. Therefore, it's advisable to begin with a low dose of a single tablet and increase the dosage slowly to reduce the side effects. Taking Metformin tablets with or after food can also help control side effects.

Glyburide is another type of oral medication used to treat gestational diabetes. It’s a once-daily tablet. Glyburide is more likely to lead to excessively low blood sugar, which can present as dizziness, fatigue, or weakness.

Any oral medication should be taken as prescribed by your doctor.

After birth

Gestational diabetes occurs during pregnancy and usually disappears after you give birth. Health care providers will check your blood sugar levels multiple times to confirm the condition has gone before the hospital discharges you after delivery. These tests will also help your doctor determine whether you should continue with medication or not.

Ensure that you continue with all your follow-up medical care and keep all your appointments, including doctor visits and blood tests. Your doctor will need to perform an Oral Glucose Tolerance Test six weeks after delivery to confirm whether your blood glucose levels have returned to normal.

Aside from the special test performed six weeks after delivery, it is important to test for diabetes every 2-to 3 years if you have experienced gestational diabetes. This is because women with gestational diabetes are at a higher risk of developing type 2 diabetes later in life.

What can I do besides taking medication?

1. Follow a healthy diet

Following a healthy diet can help manage your sugar levels and weight, thus reducing the risk of pregnancy complications such as gestational diabetes.

• Avoid sugary drinks

Avoid sugary drinks. Note that even smoothies, fruit juices, and drinks with 'no added sugar' can contain too much sugar for your condition. Water is a perfect drink during pregnancy since it does not contain calories or carbohydrates. You can take a large glass of water with every meal and another between meals.

• Switch to low or medium Glycaemic Index (GI) foods

Glycaemic Index (GI) is a rating system that indicates how fast carbohydrate foods affect your glucose levels. If you have gestational diabetes, avoid high GI carbohydrates since they quickly increase sugar levels in your body. Such foods include white bread, white rice, potatoes, and sugary confections. You should switch to low or medium GI foods such as wholegrain foods, fruits, and vegetables. These foods increase your sugar levels much more slowly and can help make you feel full for longer.

• Eat regularly but watch your portion sizes

Aim to have regular meals –usually three per day. However, you don't have to consume a large portion for each meal. The amount of carbohydrates you consume influences your glucose levels more than even your GI rating. It might be difficult to manage gestational diabetes if you are eating too much.

Also, ensure you have a healthy snack such as pieces of pear or apples. Grab these when you get hungry to avoid convenience foods such as sugary drinks and other sweets.

• Consider natural fat options

You may choose low-fat foods, but these can sometimes contain more glucose than full-fat options. Therefore, you should check the ingredients closely. Foods with fats can hold up the release of sugar from carbohydrates, thus helping stop an increase in glucose levels. Natural fat options include avocado, seeds, natural or Greek yogurt, eggs, milk, and olive oil.

2. Improve lifestyle

Another effective way to manage gestational diabetes is by improving your lifestyle. If you have been inactive, consider safe exercises during pregnancy. Some pregnant women worry that the baby will be shaken or hurt during exercise, but an unborn baby is protected and secure in the womb.

It can be quite hard to start physical activity, especially if you have not been very active, so start gradually with moderate exercises and take rest periods. The perfect exercise pace is when you can still hold a conversation as you exercise, but you cannot sing. If you become breathless, that's a sign that you are pushing yourself too hard.

Some great exercises include swimming, walking, aquatic exercises, stationary cycling, and low-impact aerobics. Strength training, including using light weights, can also help. Some great flexibility exercises for gestational diabetes include Yoga and Pilates.

A session should take 30-60 minutes but if you cannot do that all at once, break it into 10 minutes at a time. You can also build up gradually from 10 minutes if you have not been active for a while. Generally, aim to do this every day of the week or at least 150 minutes per week.

However, your healthcare team can guide you on proper exercise, frequency, and duration.

3. Monitoring your blood sugar

Monitoring your blood sugar is another way to manage gestational diabetes effectively. Your doctor will guide you in choosing a blood sugar meter, checking your blood glucose levels at home, and recording the results.

At first, you should check your blood sugar levels four times daily—before breakfast and one or two hours after breakfast, lunch, and dinner. The information can help show whether your blood glucose levels are on target. If the levels remain higher than they should be, your health care provider will know whether and how to adjust any medication.

The lowdown

Gestational diabetes develops during pregnancy when there are high glucose levels in the blood. Early diagnosis and proper treatment of this condition can help avoid health complications for the mother and the baby.

To treat the condition, your doctor may prescribe insulin therapy or oral medication such as Metformin. Other non-pharmacological ways to manage the condition include checking your sugar levels regularly, following a healthy diet, and improving your lifestyle. Maintaining a healthy weight is also important. Sticking with the treatment plan ensures you have a healthy pregnancy and birth.