What treatment is available for Gestational Diabetes?
You’ve had your call to tell you that your GTT (glucose tolerance test) has come back showing that you have gestational diabetes (GDM) and you’re at a loss to what to do next. Your clinic is not until next week. So what now?? This blog was written with the help of obstetrician Victoria Medland, an incredible obstetrician who I have worked with and who was there at Nancys birth (my baby no.3). So let’s have a look into the treatment options available for GDM.
Why does GDM need treatment?
Controlling your levels of blood glucose during pregnancy and labour reduces the chances of complications for you and your baby. Depending on when in your pregnancy the diabetes is diagnosed, the interventions recommended to help gain control over high blood sugars may involve dietary changes and/ or medication.
Dietary Changes
Initially your treatment plan will involve dietary advice and diet and lifestyle changes. What we want to achieve is to reduce quick-release sugars and increase slower release sugars. This will iron out peaks in blood sugars after eating. Once you are diagnosed with Gestational Diabetes, you should be referred to a dietician for individualised advice. If this has not happened yet, speak to your midwife or consultant. Your diet is a really important part of your treatment plan for Gestational Diabetes. Understanding your diet and eating healthily is an important part of your treatment for gestational diabetes. Diet management can help you to keep your blood sugar levels in a safe range. Diabetes UK offers some helpful tips on eating well with Gestational Diabetes.
Moving your body
Having a walk after your food is a great way of keeping your blood sugars stable. When we exercise, our bodies and muscles will first use any sugar in our blood stream first. Doing a 30 minute walk after meals will help control the amount of sugar in your blood. Remember that gestational diabetes is when your bodies in pregnancy don’t have enough insulin to take the sugars out of your blood. So excess sugar is in your body and passing through the placenta to baby. Having a walk after will use the sugars in the blood stream helping to keep your blood sugars more stable. If you can, have a walk after most meals, providing that exercise is ok for you to do.
Metformin
If diet management is ineffective in keeping your blood sugars stable, then metformin may be offered. Metformin is a drug which helps to sensitise cells to the insulin your body is already producing. It basically makes your own insulin more effective in converting the sugar out of your blood. It is a tablet taken with, or after, a meal.
Insulin
Lastly, you may be recommended to have insulin injections to help keep your blood sugars in a normal range. This may just be long-acting insulin, or may also involve short acting insulin to take with meals. The diabetes nurses are excellent at showing things like injection technique, and teaching carb counting, to work out the right amount of insulin. They are also available to talk to in case you’re having trouble with blood sugars at home and need some guidance.
Are these medications safe during pregnancy?
It is really normal to have worries about taking medications during pregnancy. There is strong evidence for both the effectiveness and safety of these medications during pregnancy. Your diabetes care team can speak with you in detail if you have any concerns.
What happens after I have given birth?
You will be asked to stop all medication for diabetes after birth, but to continue monitoring your sugars for 24 to 48 hours. This gives an indication of whether the diabetes has resolved, or is persisting and may in fact be ongoing, usually type 2 diabetes. If this is the case, the Diabetes Team will come to see you to help make a plan.
If you would like more information on Gestational Diabetes, head to this blog; What does Gestational Diabetes mean for my pregnancy and birth?
