This is the second post in a series on gestational diabetes. The first post covered what gestational diabetes is and controversies over the diagnosis. It also covered some options for testing. This post will cover standard treatment for gestational diabetes. Part 3 covers alternative treatment options.
If you're diagnosed with gestational diabetes you'll be given a pretty standard set of treatment recommendations.
Blood Glucose Monitoring
You'll use a small monitor at home to keep track of these levels. You use a tool called a lancet to prick your finger, then soak up a droplet of blood on the monitor's test strip. The monitor then reads your blood glucose level. It takes time and you need to remember to do it, but it gives you a good overview of what your blood glucose levels are doing throughout the day.
Usually you will take your blood glucose levels upon rising and again after each meal and snack you have. You record your levels for yourself and your care provider to reference.
At this point the standard treatment for gestational diabetes becomes similar to the recommendations for Type 2 Diabetics – and the advice is not really sound or evidence-based.
If you read any article on gestational diabetes you'll be advised to eat a diet focused on fruits, vegetables, and whole grains. This is just restating the advice that modern government nutrition “experts” give everybody about what makes up a “healthy” diet for humans. The resulting diet has an extremely high level of carbohydrate intake.
As a basic review, there are two types of carbohydrates. There are complex carbohydrates and simple carbohydrates. Simple carbohydrates are simple sugars – they start as basic sugars and end up as basic sugars in your body. Complex carbohydrates have to be broken down into simple sugars. Don't get a mistaken impression, however… they still get broken down into sugar, and generally pretty rapidly. Take it this way: a carbohydrate, no matter how it's dressed, is sugar.
Carbohydrate = sugar.
Since pregnancy includes a natural level of insulin resistance on purpose (Please see LINK from last week for more) you don't need massive amounts of carbohydrates to take in the levels of glucose your baby needs to thrive. You certainly don't need the 300 or more grams one frequently ends up getting following standard diet recommendations.
These recommendations end up being a roller-coaster of sugar for pregnant women, especially those who are showing higher levels of insulin resistance (and thus high blood sugar levels).
Conventional wisdom recommends exercise to help control gestational diabetes. I don't argue with this. I think all pregnant women should be getting out and moving some during pregnancy. But unless you really desire heavy, vigorous exercise routines during pregnancy, I don't agree that a pregnant mother should start exercising chronically. Daily walking with a spirited prenatal dancing or belly dancing session a couple of times a week is an excellent routine for pregnant woman. If you're used to more exercise that's fine – just remember to respect your body, your energy levels, and your growing baby.
Insulin or oral glucose control medications may be prescribed. Insulin must be injected. If you are not able to control blood sugar levels with diet and lifestyle alone, these measures may be used. This generally means that you'll need to be under an obstetrician's care, and it's possible you'll see a perinatologist or a maternal-fetal medicine specialist. Most midwives will not attend a home birth if you need these interventions.