Do you need insulin for gestational diabetes?

Written by Chen Xie
Endocrinology
Updated on January 13, 2025
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Gestational diabetes refers to the elevated blood glucose levels found during pregnancy. For patients diagnosed with gestational diabetes, we first need to control diet and exercise to manage blood sugar levels, maintaining fasting blood glucose between 4.0-5.3 mmol/L and postprandial (two hours after meals) blood glucose between 4.4-6.7 mmol/L. If blood sugar control can be achieved through diet and exercise, insulin treatment is not required. However, if blood sugar levels still do not meet the standards through diet and exercise, exceeding the figures mentioned earlier, insulin treatment is necessary. For patients receiving insulin treatment, it poses no harm to either the fetus or the mother. In fact, when blood sugar is well-controlled, it can actually reduce the risks associated with gestational diabetes.

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Written by Zhang Yin Xing
Obstetrics
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Can pregnant women with gestational diabetes eat grapes?

Fruits are natural vitamins, and consuming fruits appropriately during pregnancy is extremely significant for supplementing vitamins, which can promote fetal growth. Patients with gestational diabetes are not entirely forbidden from eating fruits; however, it's essential to control the intake of fruits, ideally between 100 to 150 grams per day. Grapes are not completely off-limits, but since grapes have a high sugar content, if consumed, the quantity should be controlled to avoid eating too much. Opting for fruits like kiwis and apples, which have lower sugar content, is a better choice for those with gestational diabetes during pregnancy. Gestational diabetes can affect both the pregnant woman and the fetus. For the pregnant woman, it can increase the rate of miscarriages and is likely to complicate with gestational hypertension. Lowered immunity can lead to infections, particularly urinary and reproductive system infections, may cause excessive amniotic fluid, and increase the likelihood of difficult labor due to a larger baby. The impact on the fetus can lead to congenital disabilities, a significantly large baby, or restricted fetal growth, so it is crucial to control blood sugar levels during pregnancy. While ensuring the pregnant woman is not hungry, insulin can be used when necessary to maintain stable blood sugar levels during pregnancy.

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Written by Liu Wen Li
Obstetrics
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How to treat gestational diabetes?

The treatment principle for gestational diabetes is to control blood sugar and then ensure the normal development of the child. There are many methods to control blood sugar. First, it involves diet management guided by a doctor, adjusting the diet's structure and quantity, followed by post-meal exercise. If after a week of adjusted diet and post-meal exercise, blood sugar levels still do not meet the standards, insulin injections can be used to keep the pregnant woman's blood sugar within the prescribed range. This can help reduce the impact of diabetes on the fetus and the pregnant woman.

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Written by Chen Xie
Endocrinology
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Gestational diabetes blood sugar standards

The diagnostic criteria for gestational diabetes involve a pregnant woman undergoing a 75-gram glucose test at any time during pregnancy to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. The thresholds are: fasting blood glucose equal to or greater than 5.1 mmol/L, blood glucose one hour after glucose intake equal to or greater than 10.0 mmol/L, and blood glucose two hours after glucose intake equal to or greater than 8.5 mmol/L. Diagnosis of gestational diabetes can be made if blood glucose levels exceed these standards at any of the three time points. In China, pregnant women typically undergo the 75-gram glucose test between the 24th to 28th week of pregnancy. Women at high risk for gestational diabetes are advised to undergo the 75-gram glucose test early.

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Written by Chen Xie
Endocrinology
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What to eat with gestational diabetes

The dietary control for gestational diabetes adheres to the same overall principles as non-pregnant diabetes management, mainly focusing on controlling total caloric intake and eating smaller, more frequent meals. This approach helps manage blood sugar levels and reduces the occurrence of hypoglycemia. Additionally, it is important to consider the nutrients required for fetal growth and development. Generally, carbohydrate intake should make up 50%-60% of the diet, proteins 15%-20%, and fats should not exceed 30%. Foods that quickly increase blood sugar levels and are high in fat should be consumed minimally. Instead, it is beneficial to consume a lot of vegetables, at least 500 grams daily, to ensure adequate intake of vitamins and fiber.

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Written by Luo Han Ying
Endocrinology
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What should I do about gestational diabetes?

As prenatal checkups are becoming increasingly popular, many expectant mothers undergo a glucose tolerance test between the 24th and 28th week of pregnancy to diagnose gestational diabetes. More and more expectant mothers are finding their blood sugar levels exceeding the diagnostic thresholds and are being diagnosed with gestational diabetes. Most of the time, gestational diabetes in expectant mothers is caused by reduced physical activity and overeating during pregnancy. For such expectant mothers, we can advise them to control their weight, strictly manage their diet, and increase their physical activity to maintain proper blood sugar levels. In fact, only a small portion of pregnant women diagnosed with gestational diabetes require insulin injections to control their blood sugar.