Treating gestational diabetes is crucial for safeguarding both the mother’s and the baby’s health during pregnancy. Gestational diabetes mellitus (GDM) can lead to various complications if left unmanaged, including preeclampsia, premature birth, and macrosomia. Controlling blood sugar levels through dietary adjustments, exercise, and sometimes medication helps reduce these risks. In this article, we delve deep into treatment options for GDM, such as gestational diabetes medication.
What is gestational diabetes treatment at home?
Doctors diagnose GDM in a pregnant woman by monitoring blood glucose levels between 24 and 28 weeks of pregnancy. The ACOG recommends optimal blood glucose levels in pregnancy below 95 mg/dl after fasting. A pregnant woman should have under 140 mg/dl blood glucose after 1 hour of a meal and under 120 mg/dl after 2 hours of a meal. If the glucose levels are higher, it indicates GDM.
As an important step in gestational diabetes self-care, a pregnant woman suffering from GDM should regularly self-monitor glucose levels with a glucometer. They should check it four times a day. Furthermore, they should do it on an empty stomach in the morning and 1 hour from the first bite of meals (breakfast, lunch and dinner). They should discuss their readings with the doctor and management if needed.
The next important gestational diabetes treatment guideline for the management of GDM is medical nutritional therapy. Globally, recommendations by different regulatory authorities are available:
- Pregnant women with GDM should get individualised advice from dieticians or doctors on their calorie intake based on their weight and energy requirements.
- GDM patients should take care of the percentages of macronutrients in their total energy intake (EI). Carbohydrates can form 40%, fats can form 20-35%, and proteins can form 15-20% of the daily calorie intake. Studies show that a higher protein diet for GDM does not improve glycaemic control, i.e., glucose utilisation by the body.
- In terms of carbohydrates, pregnant women with GDM should consume complex carbohydrates with a low glycaemic index. Whole grains, low-dairy foods, nuts, most vegetables, and fruits are complex carbohydrates with a low glycaemic index.
- Fibre intake, especially soluble fibre, plays a role in preventing sharp glucose peaks after eating. Instead of gestational diabetes medication, doctors first try to manage GDM with medical nutritional therapy and physical exercise.
- The DASH (Dietary Approaches to Stop Hypertension) diet focuses on whole foods and aims to limit sodium intake. It emphasizes fruits, vegetables, whole grains, and lean protein sources like low-fat dairy and fish. It discourages saturated fats, cholesterol, sugary drinks, and sweets. Studies show that this diet improves the metabolic health of pregnant women with GDM. Additionally, babies born to mothers on the DASH diet had a lower weight and head circumference.
- Studies show that another diet, the Mediterranean diet (MedDiet), reduces the incidence of GDM. Additionally, it results in improved maternal and neonatal outcomes. The MedDiet centres on whole, unprocessed foods. It encourages daily meals rich in vegetables (2 servings), fruits (3 servings), and whole grains (3 servings). Lean protein sources like low-fat dairy (3 servings) and fish (moderate to high consumption) are also key components.
Exercise is another way a woman suffering from GDM can improve how her body uses glucose (glycaemic control). The best practice is to do 30 minutes of moderate physical exercise three to four times a week. Brisk walking or rotating arms while sitting after meals for 10 minutes can reduce the glucose risk peak after meals.
Is there a gestational diabetes medication?
Medication is not the first choice to treat GDM. Healthcare professionals always try to control GDM via diet and exercise. If it is still uncontrolled, then they revert to medication.
According to the American Diabetes Association (ADA), insulin is the first line of treatment for gestational diabetes. It is important to note that the ADA does not recommend medicines like metformin and glyburide for GDM. Such medicines can cross the placenta and may impact the baby long-term.
In the case of high fasting blood glucose, research says to give slow-acting insulin before bedtime. On the other hand, if post-meal glucose is high, research says to give rapid-acting insulin before that specific meal. Always consult doctors if you require insulin therapy, which insulin to take, and when.
Keep worrying at bay by following the advice of your doctors, obstetrician, and dietician. Usually, GDM goes away post-delivery.
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