Managing your gestational diabetes — Canterbury

This page is for pregnant women who have recently been diagnosed with either:

• gestational diabetes — following a positive glucose tolerance test or blood glucose monitoring at home
• prediabetes — following a HbA1c (glycated haemoglobin) blood test.

Your midwife will have sent a prescription to your pharmacy. This includes:

• a glucose meter (CareSens N)
• a lancet (finger pricking device)
• a 3-month supply of testing strips.

To help you understand and manage your gestational diabetes, it is important you read through the information and watch the 3 videos on this page.

1. What is gestational diabetes?
2. The dietary management of gestational diabetes
3. How and when to test your blood glucose levels

It is important to test your blood glucose levels and record your food intake during your pregnancy. Find information below about testing your blood glucose level.

Diabetes is a disease that causes high glucose (a kind of sugar) in your blood. When you eat foods containing carbohydrates (such as bread, cereal and fruit), your body turns them into glucose. A hormone made in your pancreas called insulin then moves the glucose out of your blood and into your muscle and fat cells.

When you are pregnant, changing hormone levels increase your body's requirements for insulin. You need extra insulin to maintain your blood glucose level within the normal range. With gestational diabetes, your pancreas cannot produce enough extra insulin, and glucose builds up in your blood.  

Gestational diabetes usually develops after 24 weeks of pregnancy. 

Gestational diabetes

What is gestational diabetes — Diabetes SA on YouTubeexternal link

Prediabetes is where glucose levels in your blood are higher than normal, but not high enough to be diabetes. The treatment for prediabetes in pregnancy is similar to gestational diabetes.

Prediabetes

If your blood glucose is high during pregnancy, there are increased risks for your pēpi. These include:

• your pēpi may grow too big, which can cause problems during birth
• your pēpi may have low blood glucose levels after they are born (hypoglycaemia).

Gestational diabetes, pregnancy and your pēpi

If your fasting (waking up) blood glucose level is over the target level most days, your diabetes specialist may prescribe medication. Food and activity have little effect on the fasting level.

If you have high glucose levels after meals, you might need to make some changes to what and when you eat, or make other lifestyle changes.

Below are some questions you can ask yourself to try to work out why your blood glucose levels may be high.

Were my hands clean?

• Hand lotion or food on your hands can affect the blood glucose test result.
• Wash your hands in warm water and repeat the test if you think this may be the case.

Was the test after breakfast high?

• Carbohydrate at breakfast can often be poorly tolerated, especially breakfast cereals.
• Try grainy breads with a protein topping (for example, peanut butter, egg or cheese) or avocado.

Am I unwell, stressed, less active or sleeping poorly?

• All these things can affect blood glucose levels.

Did I eat more carbohydrate or a different type than usual?

• Did I have a larger serving size of carbohydrate, or did I have several carbohydrate foods in one meal? For example, fruit with my usual meal or potato and rice.
• Try to choose carbohydrate foods that are fibre-rich, less processed and slow release (low glycaemic index). For example grainy breads, whole fruits with skin on where possible, high-fibre cereals or long grain Basmati rice.

Did I wait long enough after eating before my blood glucose test?

• Wait an hour after eating to do your test and avoid snacks until after testing.

Was I active after the meal?

• Sitting down after a meal can cause a higher blood glucose reading than if you are active and on your feet.

Have I been taking the diabetes medication as prescribed?

• Have you missed a tablet or insulin? Remember you need to take insulin before the meal.

When you have had gestational diabetes, you have a high risk of developing type 2 diabetes in the future. Your pēpi does not have an increased risk of diabetes as a pēpi, but they may have an increased risk of type 2 diabetes as an adult.

You and your whānau need to eat well and do regular physical activity to reduce your risk of developing Type 2 diabetes in the future.

You will need to have a blood test to check for type 2 diabetes 3 months after you have your pēpi, then yearly. Your diabetes team will talk to you more about this when you are closer to giving birth.

Type 2 diabetes

If you have diabetes during your pregnancy, there is a risk your pēpi may:

• have difficulty maintaining their blood sugar levels
• experience feeding challenges.

Colostrum is the nutrient-dense first milk your breasts produce when you have your pēpi. Expressing colostrum before birth means you will have a supply of your milk available if your pēpi needs extra. This may reduce or even eliminate the need to use infant formula.

Always check with your midwife before starting antenatal colostrum collection.

This information sheet has information about how to collect, store and use colostrum.

Collecting colostrum before you give birthexternal linkPDF

This video explains how to hand express colostrum.

Hand expressing colostrum — YouTubeexternal link

You can contact the Diabetes in Pregnancy team by:

• email: diabetesinpregnancy@cdhb.health.nz
• phone: (03) 364-4420

Please leave a detailed message with your name and contact number.

The team's days of work are Monday, Tuesday and Thursday.