My Pregnancy

Diabetes of pregnancy, how to control blood glucose

Doctor told you you have diabetes of pregnancy then what to do

The first step is the lifestyle modification by diet and exercise.

If you are not sure how to be on modified diabetic diet then consult dietician.

Exercise could be 30 minutes walk after a meal or after each meal if you can.

Try lifestyle modifications for a week if do not work then doctor may add metformin (diabetic drug safe in pregnancy) even if that doesn’t work doctor might add insulin.

Depending on sugar level doctor may suggest insulin along with diet and exercise as first step.

Control without insulin

Usually it is 4 point profile, fasting and 1 hour after each meal.

You must send your blood sugar monitoring chart to your doctor every 1 to 2 weeks.

If you maintain a good control then dpending on other factors your doctor may advice you to decrease frequency of blood sugar monitoring.

The 4 point monitoring chart looks like this.

On insulin injections specially rapid acting

If you are in multiple insulin injections then you will be adviced to do 7 point profile, fasting, before meal and 1 hour after each meal and bed time.

You could be at risk of hypoglycemia and there is impaired awareness of hypoglycaemia in pregnancy, particularly in the first trimester.

Always have available a fast acting form of glucose for example, dextrose tablets or glucose containing drinks.

If you have type 1 diabetes then keep gucagon for use if needed.

Test urgently for ketonaemia if a pregnant woman with any form of diabetes presents with hyperglycaemia or is unwell, to exclude diabetic ketoacidosis.

The 7 point monitoring chart looks like this

Continuous glucose monitoring

If you are on insulin therapy and you have problematic severe hypoglycemia or unstable blood glucose levels its better to do continuous glucose monitoring.

Continuous subcutaneous insulin infusion (insulin pump therapy)

If adequate blood glucose control is not obtained by multiple daily injections of insulin without significant disabling hypoglycaemia then better to have insulin pump therapy.