Gestational diabetes is a disruption in the body’s sugar metabolism that occurs for the first time during pregnancy. A two-hour glucose tolerance test is used to detect gestational diabetes. In gestational diabetes, the mother’s insulin production cannot cover the increased need during the pregnancy. Because of this, the mother’s blood sugar increases and the foetus may grow larger than normal. During pregnancy, the amount of pregnancy hormones in the blood and the level of body fat increase. Due to these changes, insulin may lose some of its effectiveness during pregnancy.
Risk factors for gestational diabetes include:
- being overweight
- diabetic family history
- being over 40 years of age
- having previously given birth to a baby weighing over 4.5 kg
- previous history of gestational diabetes
- sugar in the morning urine
- polycystic ovary syndrome (PCO).
Read more on the Naistalo website (in Finnish).
During pregnancy, it is important to keep the mother’s blood sugar at a normal level and weight gain should remain reasonable. These objectives are usually achieved through diet, exercise and, if necessary, insulin treatment. Good treatment of gestational diabetes secures the natural progression of pregnancy and prevents the excessive growth of the foetus. Weight control after birth can prevent both the relapse of gestational diabetes and the onset of Diabetes mellitus type 2 (adult-onset diabetes).
Raskausdiabetes - Asiakaspolku Helsingissä (pdf, in Finnish)
The treatment of an expectant mother’s gestational diabetes
Familiarise yourself with the diet instructions you have received and pay special attention to a regular eating rhythm, small meals, fat quality and the content and quality of fibre and carbohydrates.
Good sources of carbohydrates include whole grain products, vegetables, potatoes, liquid dairy products, fruits and berries.
Poor sources of carbohydrates are sugars, food products with high sugar content and refined grain products (white wheat).
The blood sugar of a woman suffering from gestational diabetes increases easily in the morning and after breakfast. This is why the breakfast is smaller than normally. Blood sugar remains at a suitable level, when the mother eats small meals often and ensures that she eats plenty of fibres.
Aim to exercise at least 30 minutes every day. The exercise can be divided into periods of ten minutes.
Monitoring blood sugar at home
A two-hour glucose tolerance test is carried out for nearly all expectant mothers between the 24th and 28th week of pregnancy. If the test result is abnormal, the public health nurse will guide the mother to participate in group guidance, which gives more information on gestational diabetes and the significance of diet and exercise, teaches the parents how to measure their blood sugar and gives them the blood sugar meter and instructions for monitoring blood sugar.
The target value of blood sugar during home monitoring are below 5.5. mmol/l before breakfast or some other meal and below 7.8 mmol/l after a meal. If the value in the morning is ≥ 5.5 mmol/l twice in one week or the value after a meal is repeatedly ≥ 7.8 mmol/l, contact the maternity clinic.
- Every second week, measure the morning fasting value of your blood sugar on four mornings (fasting time no longer than 10 hours).
- Every second week, make a daily monitoring of eight samples. The daily measuring graph can be produced by measuring blood sugar before breakfast, lunch, dinner and evening snack and an hour after every meal.
- Note down the values into the blood sugar control notebook and take it with you, whenever you visit the maternity clinic or hospital.
- If the two-hour glucose tolerance test shows three abnormal values or if the fasting blood sugar is ≥ 6.0 mmol/l, the maternity clinic refers the expectant mother to a maternity outpatient clinic and she will be contacted by the clinic’s midwife specialised in gestational diabetes.
The test strips and lancets for testing blood glucose levels you will get from the maternity health clinic nurse at the first guidance visit. If you should need an insulin pen, you will get it from the Koskela distribution of self-treatment product with a referral from a hospital diabetes midwife. Call and make an appointment.
You will receive 40 strips for 4 weeks or some other amount defined in the referral. If you wish to measure your blood sugar more often than the instructions recommend, you can buy more strips from Helsingin diabetesyhdistys diabetes association, for example.
If you should need an insulin pen, you will get it from the Koskela distribution of self-treatment product with a referral from a hospital diabetes midwife. Call in advance to make an appontment. You can find more information here: Distribution of self-care supplies.
Measuring your blood sugar: