GESTATIONAL DIABETES
PROBLEM
Gestational diabetes develops only during pregnancy; it occurs because of the new hormones being produced. The hormonal influence makes you insulin resistant,
meaning you still produce insulin but the hormones prevent it from working effectively.
Your blood sugar needs to be controlled so that the amount of sugar going to your baby is controlled, too. High blood sugar causes a big baby at delivery, increases your risk of a cesarean birth, causes the baby to have low blood sugar after delivery, increases jaundice, and causes other issues for the baby, including lung problems. It can also cause your baby to be overweight in childhood and increases the risk he or she will develop diabetes.
CAUSE
You are producing new hormones that cause insulin resistance. The likelihood of having gestational diabetes increases with other factors, such as the mother’s age, and it is more common in certain groups, such as Latin Americans, Native Americans, and African Americans.
PREVENTION
Good control of your diet, exercise, and the possible use of medication and/or possibly insulin will help you to control your blood sugar during your pregnancy.
TREATMENT PLAN
A.You are asked to keep a record of your blood glucose values:
1.You will be shown how to test your blood.
2.You need to test your blood multiple times a day: first thing in the morning (fasting), after breakfast, after lunch, after dinner, and at bedtime.
3.You will be given specific instructions before or after meals.
4.Bring in or upload in your patient portal your blood sugar values every week. Your insulin may be changed weekly.
5.The goal of your fasting blood sugar before breakfast is 60 to 95 mg/dL.
6.Your blood sugar goal for 2 hours after meals is less than 120 mg/dL.
B.You need to test your urine for ketones every day:
1.You will be shown how to test your urine.
2.You need to test for ketones if you are unable to eat or if you have diarrhea.
3.You need to test for ketones if you feel like you have a urinary tract infection, sinus infection, or other kind of infection.
4.You need to test for ketones if your blood sugar is higher than 150 mg/dL.
5.You must follow the diet given to you by your dietitian. If you have questions or do not understand what you should be eating, contact your dietitian.
Activity: Exercise lowers blood sugar. Exercise is needed to control gestational diabetes. You need to walk at least 20 to 30 minutes a day. Try your local mall for a climate-controlled place to walk. Your heart rate should not get above 140 beats per minute.
Diet: You are placed on a __________ calorie diet. The amount of calories needs to be spread out over three meals and three snacks:
1.Breakfast, midmorning snack, lunch, midafternoon snack, dinner, and a snack at bedtime.
2.The time you eat is as important as what you eat. Try to keep on a regular schedule.
Medications: Depending on your blood sugar, you may require medication to control it. You will be instructed on how to take the medicine. If you are started on insulin, you will require extra testing for the rest of your pregnancy.
PATIENT TEACHING GUIDE