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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Endocrinology
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Can you drink yogurt if you have gestational diabetes?

Regarding yogurt, there are two scenarios. Currently, you can make yogurt at home with a yogurt maker. If it's homemade yogurt and you haven't added sugar, it is okay to eat because it contains probiotics and nutritious ingredients, which are actually beneficial for pregnant women. However, the yogurt sold in stores contains very high sugar levels because anyone who has made yogurt would know that unsweetened yogurt is very sour. The kind sold in stores tastes that way because a large amount of sugar is added, not to mention various additives. This is very unfavorable for blood sugar control in patients with gestational diabetes. Therefore, we recommend that pregnant women should drink less or even avoid commercial yogurt. In fact, we can obtain these nutrients by drinking regular milk, like pure milk.

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Written by Luo Juan
Endocrinology
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Can you eat oranges if you have gestational diabetes?

Pregnant women with gestational diabetes can eat oranges, but they should limit the quantity. Since oranges are high in sugar, they should not be consumed in large amounts. In fact, just like mothers with diabetes or those who are pregnant, they need nutrients such as calories, protein, calcium, iron, folic acid, vitamin B, etc. However, attention should be paid to meal frequency. Under a constant total caloric intake, it is advisable to eat small and frequent meals, focusing on the quality and quantity of the diet to maintain stable blood sugar levels. It is necessary to limit the quantity of fruit consumed and avoid fruits that are high in sugar as they should not be consumed in large amounts. Therefore, pregnant women with gestational diabetes can eat oranges, but should not consume them in large quantities and should maintain proper portion control.

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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 Chen Xie
Endocrinology
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Steps for Gestational Diabetes Testing

The screening steps for gestational diabetes involve, for most women, the recommendation to undergo a 75-gram glucose tolerance test at the hospital between 24 to 28 weeks of pregnancy. The method includes fasting blood draw, consuming 75 grams of glucose, and monitoring blood sugar levels one hour and two hours after glucose intake, to determine the presence of gestational diabetes. However, for pregnant women at high risk for diabetes, it is recommended to complete the 75-gram glucose tolerance test early in pregnancy to detect gestational diabetes early and initiate treatment promptly to reduce the risks to both the fetus and the mother.

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Written by Chen Xie
Endocrinology
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High-risk factors for gestational diabetes

High-risk factors for gestational diabetes include: women older than 35 years, those with a history of gestational diabetes, history of delivering large babies, obesity, patients with polycystic ovary syndrome, first-degree relatives with a family history of diabetes, early pregnancy checks showing fasting hyperglycemia or positive glucosuria, patients who have had multiple spontaneous miscarriages without obvious causes, fetal malformations, stillbirths, and patients with a history of delivering newborns with respiratory distress syndrome. Women with the above high-risk factors should undergo early testing for fasting blood glucose and a 75-gram glucose tolerance test to diagnose gestational diabetes and initiate early intervention.