Gestational diabetes mellitus (GDM) develops when the body cannot make enough insulin during pregnancy. Healthcare teams monitor the condition through regular appointments, tests, and scans. Lifestyle modifications can also help.
In the human body, the pancreas produces insulin and sends blood sugar into the cells to use as energy. During pregnancy, it can be difficult for cells to process insulin, causing insulin resistance. This makes the body need more insulin than it can produce.
Insulin resistance
The Centers for Disease Control and Prevention (CDC) reports that
This article focuses on care plans for people with GDM. It explains the goals of a care plan and the methods through which healthcare teams closely monitor a person with the condition throughout their pregnancy.
A GDM care plan aims to keep a person’s blood sugar levels the same as someone without GDM.
This will help prevent complications from untreated GDM, such as a fetus growing larger than usual. A large fetus can lead to health risks for both the pregnant person and the fetus during delivery.
Untreated GDM can also increase a baby’s chance of developing the following later in life:
A healthcare team will put together a treatment plan to treat GDM, including regular monitoring at home and in a healthcare setting.
Learn more about untreated GDM.
People with GDM will need more appointments, tests, and scans during pregnancy than someone without the condition. They will likely see a healthcare professional every 1–2 weeks.
During these appointments, their care team will assess signs and symptoms of low blood sugar, which doctors call hypoglycemia, and high blood sugar, which they call hyperglycemia.
They will also:
- perform blood glucose checks
- teach the person how to monitor glucose levels
- discuss how to treat low and high blood sugar
- prescribe diabetic medications if necessary and provide appropriate training in how to take them
- provide information about GDM and answer the person’s questions
- talk with the person about diet and physical activity
- ask about the person’s support system and explain how the healthcare team can help
Learn about how high blood sugar feels.
Having blood sugar levels that are too high or too low can make a person feel unwell. Many people with GDM check their blood sugar levels daily. A doctor will advise about when and how often to check glucose levels.
A blood glucose monitor is a small, portable machine for checking blood sugar. Some monitors beep when the levels are too low or high. Readings appear in milligrams per deciliter (mg/dL) of blood.
With hyperglycemia, blood sugar levels are too high. A monitor will show
Hypoglycemia is when blood sugar is too low. Diabetes medications can cause low blood sugar. A monitor will show a reading
Learn more about blood sugar monitors.
Blood sugar targets during pregnancy
The American Diabetes Association suggests the following targets for people testing blood glucose levels during pregnancy:
- before a meal: 95 mg/dL or less
- 1 hour after a meal: 140mg/dL or less
- 2 hours after a meal: 120 mg/dL or less
Read more about GDM blood sugar goals.
Healthcare professionals usually recommend certain lifestyle modifications for people with GDM. These changes support their health and that of the fetus.
Diet
A person with GDM will need to follow diet guidelines to stabilize their blood sugar levels and avoid gaining excess weight. It will help to choose a variety of whole foods, such as fruit and vegetables, and limit fats and carbohydrates.
Read about the best diet for GDM.
Physical activity
It is important for people with GDM to do their best to stay active during their pregnancy.
Exercise allows the body to use glucose without needing extra insulin, which helps with insulin resistance. People can discuss exercising with a doctor if they are unsure how to incorporate it into their lives.
Read more about exercise and GDM.
Below are answers to some common questions about GDM.
Will I need extra scans with gestational diabetes?
People with GDM typically have more scans than those without the condition. From 28 weeks on, doctors usually recommend a growth scan every 4 weeks. Scans allow doctors to monitor the size of the fetus and check the amniotic fluid surrounding the fetus.
Should I record fetal movements with gestational diabetes?
A pregnant person may find that fetal movements change once they change their diet or increase their physical activity.
A person can record fetal movements during the third trimester by noting how many movements they feel at the same time daily. If a fetus is moving less than usual, it is best for people to speak with their healthcare team.
Learn about fetal heart monitors.
Pregnancy and parenthood resources
Visit our dedicated hub for more research-backed information and in-depth resources on pregnancy and parenthood.
A person with GDM can have a healthy pregnancy and delivery by following a treatment plan.
Every few weeks, a pregnant person typically attends a healthcare setting where a prenatal team can monitor their health and the health of the fetus. The healthcare team will teach a person with GDM how to monitor their blood sugar and what to do if it is high or low.
People can manage GDM at home by eating a nutritious diet that stabilizes blood sugar. Physical activity is also important as it allows the body to use glucose without extra insulin.