During pregnancy, high blood glucose levels mark gestational diabetes. Gestational diabetes blood sugar goals are typically the same as those in people without the condition.

After their initial blood glucose tests, a person with gestational diabetes can use at-home blood sugar monitors to check and record their sugar levels. Then, a doctor can advise them on any additional measures to meet or maintain their blood sugar goals.

There are several ways a person can manage their gestational diabetes — including diet changes, physical activity, and sometimes insulin — but the goal remains the same: meeting and maintaining blood sugar goals.

This article discusses blood sugar goals, how to meet them, blood sugar testing, and more.

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Sugar, or glucose, is not inherently bad. Glucose is the body’s primary source of energy, and blood carries sugar to cells to use as energy.

Diabetes occurs when a person’s blood sugar levels are too high.

Sometimes, this happens during pregnancy. This is known as gestational diabetes, and it usually resolves after a person gives birth.

Most pregnant individuals’ blood sugar levels come down after they give birth, as their hormone levels return to normal. However, some people with gestational diabetes develop type 2 diabetes later in life.

Gestational diabetes treatments aim to lower the blood glucose levels to equal those levels of pregnant people who do not have diabetes. The American Diabetes Association (ADA) recommends the following blood sugar goals:

  • Preprandial (before eating): 95 milligrams per deciliter (mg/dl) or less
  • Postprandial (1 hour after eating): 140 mg/dl or less
  • Postprandial (2 hours after eating): 120 mg/dl or less

Note that the gestational diabetes blood sugar goals may not always reflect the ADA-recommended levels. Ultimately, a doctor will determine a person’s ideal glycemic targets.

A person can check their blood sugar levels at any time with blood glucose testing.

People with gestational diabetes can test their blood sugar levels similarly to people with type 1 or type 2 diabetes — at home with a blood glucose monitor. Using a drop of blood, a blood glucose monitor measures and displays the level of sugar in a person’s blood.

Generally, a person learns they have gestational diabetes after their glucose screening and tolerance tests at a doctor’s appointment. Going forward, they can test their blood sugar levels at home using a blood glucose monitor.

There are various types of glucose monitors available, but most are relatively easy to use. Typically, they use a lancing device to prick the skin and test strips to collect the blood, both of which may come with a kit or may be sold separately.

After a person washes their hands or uses alcohol to clean the area they plan to prick, they will:

  • Step 1: Place a test strip into the monitor.
  • Step 2: Use the lance to prick the skin for a drop of blood. Depending on the meter, the person might prick their finger, forearm, thigh, or the fleshy part of their hand.
  • Step 3: Hold the edge of the test strip to the blood until the monitor’s display shows the result.

People can record their results to share with a doctor. Additionally, they may want to take notes on what might have affected their blood sugar levels, such as food and drinks or physical activities, and look for trends.

The ADA provides a free printable log sheet, and there are several smartphone apps to track blood glucose.

Left unmanaged, gestational diabetes can cause pregnancy and delivery problems, such as preeclampsia, labor induction or a cesarean section, and perineal trauma. Gestational diabetes can also lead to infants born with low blood sugar, breathing problems, and an increased risk of obesity.

Typically, doctors prescribe lifestyle changes for managing gestational diabetes. These include following a balanced, nutritious diet and exercising regularly. In some cases, they may prescribe insulin or other medications.

Diet and exercise

Generally, a combination of diet and exercise is the first line of treatment for people with gestational diabetes.

If a pregnant person develops gestational diabetes, a doctor will advise them on making adjustments to their diet. They may provide suggestions on which foods to eat and which to limit or avoid, or even refer them to a dietitian.

For instance, the Diabetes Plate Method aims to help people put together properly portioned, nutritious meals without measuring or weighing food or counting calories.

It recommends a person use a 9-inch plate and fill their plate half with nonstarchy vegetables, one-quarter with lean protein, and the remaining quarter with carbohydrates. However, this is a generalized approach, and it is a good idea to discuss nutrition with a doctor.

Exercise is critical and doctors often prescribe physical activity in combination with healthy diets and exercise

While the authors of a 2018 overview state that more research is necessary, they note that physical activity is among several lifestyle changes that appear to positively affect both the mother’s and the baby’s health. Likewise, most experts agree that exercise and movement are important for overall health.

Insulin

When diet and exercise are not enough, a doctor may prescribe insulin.

Injected insulin does not cross the placenta, so it does not affect a developing fetus. Before someone starts using insulin to help manage their gestational diabetes, a doctor will teach them how to give themselves insulin shots.

Metformin

Sometimes doctors prescribe metformin alone or with other medications, such as insulin, to manage type 2 diabetes. However, metformin crosses the placenta, so it has the potential to affect fetal development.

Metformin does not have approval from the Food and Drug Administration (FDA) for treating diabetes during pregnancy, but a doctor might prescribe it off-label if the benefits outweigh the risks.

Research from 2018 suggests there is no evidence of an increase in congenital anomalies or pregnancy loss. Additionally, a 2020 study states that babies born to people taking metformin have a lower birth weight and are smaller in size. Metformin is likely safe to use short-term, but people should discuss long-term use risks with a doctor.

Typically, doctors closely monitor people who develop diabetes during pregnancy. This means a person with gestational diabetes might have more frequent doctor’s appointments than usual.

A person should contact a doctor if they are experiencing possible gestational diabetes symptoms, such as:

Any pregnant individual should seek immediate medical attention if they experience:

  • increased nausea and vomiting
  • regular contractions
  • fluid leakage
  • vaginal bleeding
  • decreased or absent fetal movement

Managing gestational diabetes is critical for a safe pregnancy and a healthy baby. If a person has gestational diabetes, their doctor will discuss their blood sugar levels with them, outline their specific blood sugar goals, and go over treatments that can help them meet those goals.

They will also explain how the person can monitor their sugar levels with a blood glucose monitor, how to record those results, and when to seek medical attention between appointments.