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Treatment Options for Diabetes During Pregnancy

Carrie Mccorkindale, MPH, RD, CDE
May 29, 2020

Early diagnosis and treatment of gestational diabetes is associated with improved short and long term outcomes for mother and fetus. There are many treatments for gestational diabetes, from pills to injections, but different treatments may be safer than others. Here we will discuss some of the options out there to keep you and your baby safe during pregnancy.

What Treatments Are Out There?

The two main medications proven to be safe, effective, and are used in treating diabetes during pregnancy are metformin and insulin. Although insulin is the time tested first line therapy, its use involves practical challenges. Metformin, when compared with insulin, is associated with less weight gain, better satisfaction, acceptance and a lower risk of maternal hypoglycemia.

The aim for management of GDM is to keep glycemic levels within specific targets to avoid adverse outcomes. An active lifestyle, glucose monitoring, limiting carbohydrate intake and use of insulin can produce healthy results for both mother and baby. Diet, exercise and insulin have been the main approaches in management of GDM.

How Can My Lifestyle Help Reduce my Dependence on Medications?

Dietary recommendations include the reduction in the amount of simple sugars and replacing with complex carbohydrates to avoid post meal elevation in blood glucose levels as well as to increase lean protein and vegetable consumption.

It is very important for the GDM patient to see a dietitian or certified diabetes educator regularly so they can check in on your glucose readings, as these may fluctuate from month to month with hormonal and weight changes.

A daily walk of 15-30 minutes after each meal to achieve good glycemic control is recommended for physical activity. Research has shown that the most physically active women have the lowest prevalence of GDM.

Depending on the OB-Gynecology consensus, either orals or insulin can be used to control blood sugars with GDM, but should be combined with the techniques above to lead a healthy lifestyle. Though lifestyle is often not enough when faced with powerful hormones during pregnancy that raise blood sugars, having this combination of diet, exercise and medication management will improve outcomes and reduce your risks of future pregnancies having gestational diabetes.