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What should I do if I have gestational diabetes? (Cont'd)

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Take insulin and/or other medications as prescribed

What is it?

Even if you do everything your health care provider tells you to manage your gestational diabetes, you still might need to take insulin during your pregnancy to keep it under control. You already know that insulin moves glucose out of your bloodstream and into your cells to use as energy; you may need extra insulin to lower your blood glucose level. The only way to get extra insulin into your body is to inject it under your skin with a needle. Taking insulin is the same as any other part of this treatment plan. It's just another way to help you stay healthy.

Why do I have to do it?

You may have to include small amounts of insulin in your treatment plan if:

  • Your blood sugar level is too high.
  • Your blood sugar level is high too many times.
  • Your blood sugar level remains high, but you are not gaining much weight or are not eating poorly.
  • You cannot safely add physical activity to your treatment plan.

In these cases, the best action for maintaining a healthy pregnancy is to add insulin. Insulin does not hurt the fetus. The daily records that you keep help your health care provider decide when and if it's time to begin insulin. That's why it's important to keep good records.

Here are some other things you should know about insulin:

  • If you need to take insulin, it does not mean that you didn't try hard enough or that you failed at taking care of yourself. It just means that your body has a high level of insulin resistance and needs some help getting glucose level back into healthy range. (Refer to the Knowing your blood sugar level and keeping it under control: How do I know I'm doing it right? section of this booklet for more details on the healthy range for glucose.)
  • Taking insulin does not mean you have type 1 diabetes. People with type 1 diabetes have to take insulin shots every day of their lives because their bodies don't make enough insulin. As a woman with gestational diabetes, taking insulin does NOT mean that you now have type 1 diabetes. It only means that your body needs some extra help to balance its insulin and glucose levels. After your baby is born, your diabetes will likely go away, and with it, your need to take insulin.
  • An increase in the amount or dosage of insulin you need does not mean that your pregnancy is in danger. The amount of insulin you take will probably increase as your pregnancy goes on. Because your insulin resistance increases as your pregnancy continues, your body needs more insulin to overcome this resistance. The goal is to keep your blood sugar under control, no matter how much insulin it takes. Most women take two insulin shots each day, but you may get better glucose control with three injections.
  • You may need more insulin if you are under high amounts of stress or if you are sick because your blood sugar level gets higher on its own in these cases. Some medicines can also cause blood sugars to rise above the healthy range.

How do I do it?

Your health care provider will teach you how to give yourself insulin shots, if you need them. Use this answer sheet to write down what your health care provider tells you about your insulin treatment.

When do I do it?

How often you need insulin shots will depend on your body. Your health care provider will tell you how often to take the shots and at what times of day. Make sure you follow his or her advice about taking insulin to help ensure the safety of your pregnancy.

Special instructions for women taking insulin

  • Follow a regular eating schedule. Your health care provider can tell you when to take the insulin and when to eat your meals so that the timing of both is correct. Do not skip or delay meals and snacks when taking insulin because this can affect your glucose-insulin balance.
  • Know the symptoms of low blood sugar. If your blood sugar level drops below 60 at any time, you have hypoglycemia ( hypo means low, and glycemia means sugar). Low blood sugar can be dangerous. Hypoglycemia is not common in women with gestational diabetes, but you are at greater risk for it if you take insulin. The table shown here describes some reasons that low blood sugar might occur and some of its symptoms.


Why does low blood sugar occur? How might I feel if I have low
blood sugar?
  • Too much exercise
  • Skipping meals or snacks
  • Delaying meals or snacks
  • Not eating often enough
  • Too much insulin
  • Very hungry
  • Very tired
  • Shaky or trembling
  • Sweating or clamminess
  • Nervous
  • Confused
  • Like you're going to pass out or faint
  • Blurred vision
Or…You might feel fine.
  • Know when your insulin is working its hardest. Low blood sugar is more common at these times, depending on how your body uses insulin and glucose.
  • Be careful about doing physical activity, but remain active. Because both insulin and physical activity lower your blood sugar level, when combined they can cause your blood sugar level to drop very quickly. Test your blood sugar before you do any physical activity. If your level is low, eat something and test again to make sure your level is higher before you start an activity. Be smart about how much physical activity you do, how much you eat, and how much insulin you take.
  • Be prepared. Take your insulin supplies with you when you go out, especially if you are going to be gone a long time. You should also take some form of sugar with you, in your purse, in your car's glove compartment, or in your pocket, in case your blood sugar drops too low. The best form of sugar for an emergency is glucose paste or glucose tablets. You can buy these at the drug store or pharmacy. Ask your health care provider for more information.
  • Test your blood sugar if you start to feel dizzy, faint, or tired.
  • Report any abnormal blood sugar level to your health care provider right away, in case a change in your treatment plan is needed.

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Last Reviewed: 08/17/2006
Vision National Institutes of Health Home BOND National Institues of Health Home Home Storz Lab: Section on Environmental Gene Regulation Home Machner Lab: Unit on Microbial Pathogenesis Home Division of Intramural Population Health Research Home Bonifacino Lab: Section on Intracellular Protein Trafficking Home Lilly Lab: Section on Gamete Development Home Lippincott-Schwartz Lab: Section on Organelle Biology