When to check your blood sugar with gestational diabetes

To monitor your glucose, you will be given a blood glucose monitor. This is designed for you to measure your own blood glucose levels at home, or wherever you happen to be, by checking a drop of your blood. You produce the blood by using a finger pricker.

There are many different brands of meter on the market, but they all work in similar ways:

Step 1  Wash your hands.

Step 2  Set up a finger pricker with a clean needle.

Step 3  Insert one end of a test strip (usually a long, thin paper-type strip) into the meter.

Step 4  Use the finger pricker to prick the side of your finger.

Step 5  When a spot of blood appears where you pricked you finger, place it onto the end of the testing strip that is sticking out of the meter to transfer the blood.

Step 6  After a few seconds, the meter will display your blood glucose level.

Step 7  Clean the blood off your finger.

Step 8  Record the results in your blood glucose diary or diabetes journal, or you may have a phone app that you use.

Step 9  Throw away the test strip.

Step 10 Dispose of the needle from the finger pricker safely, by putting it in your sharps bin.

Your blood glucose level is measured in millimoles per litre (mmol/L), but you don’t need to worry about that – just about the numbers.

"The first week when I was recording my blood sugars, the dietician said ‘Once we’ve seen your results, we can go through what you’re doing right and wrong’. It turned out I was eating too much fruit and yoghurt with my lunch." Gemma, mum of one

When should I measure my blood glucose?

Throughout the rest of your pregnancy, you will need to measure your blood glucose levels at various points through the day, to check that they are within the limits you have been given at each of those times:

When you get up  You need to measure your blood glucose levels each morning when you get up, before you have anything to eat or drink. This blood glucose level is called your ‘fasting blood glucose level’ because you will have an empty stomach. You must not have eaten or drunk anything apart from water overnight, for at least eight hours.

Your team should have discussed this with you and agreed the ideal morning blood glucose level for you to aim for. 

Before or after every meal  You will probably be asked to measure your blood glucose level around the time of a meal. Some services measure before eating (‘pre-prandial monitoring’) while others measure one or two hours after a meal (‘postprandial monitoring’).

Again, you will have discussed and agreed an ideal blood glucose level after meals with your diabetes team. These levels will be higher than your fasting blood glucose levels, as you will just have eaten.

If you are taking insulin to help to control your blood glucose levels, you may need to do a separate test before you go to bed, or even during the night, although this is unusual.

"When we did go out for a special meal or two, and I'd have a little bit of cheesecake or something, it really affected my sugar levels. But that would've been just twice in the whole pregnancy." Gemma, mum of one

How do I interpret the results?

Your blood glucose levels tell you if your gestational diabetes is under control.

The blood glucose levels before breakfast and after meals should be within the ideal levels that you have discussed and agreed with your diabetes team. If they are not, you should have been given instructions about what to do next. If you are not sure about this, get in touch with your main point of contact, and ask for their advice.

Read about the risks of low blood glucose (‘hypoglycaemia’) and what to do about it.

You will have contact with your diabetes team every one-to-two weeks through your pregnancy, either by phone or in person. They are there to give you advice and support, including keeping an eye on your blood glucose levels and advising you what to do if they are not at the ideal levels. You may also have a number to call if you have questions in between those times. You can also get support from the Diabetes UK Careline 0345 123 2399 or the Tommy’s midwives on 0800 0147 800.

Follow a healthy eating plan to nourish you and your baby.

Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes. Every year, 2% to 10% of pregnancies in the United States are affected by gestational diabetes. Managing gestational diabetes will help make sure you have a healthy pregnancy and a healthy baby.

What Causes Gestational Diabetes?

Gestational diabetes occurs when your body can’t make enough insulin during your pregnancy. Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy.

During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body’s need for insulin.

All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant. They start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.

About 50% of women with gestational diabetes go on to develop type 2 diabetes, but there are steps you can take to prevent it. Talk to your doctor about how to lower your risk and how often to have your blood sugar checked to make sure you’re on track.

Symptoms and Risk Factors

Gestational diabetes typically doesn’t have any symptoms. Your medical history and whether you have any risk factors may suggest to your doctor that you could have gestational diabetes, but you’ll need to be tested to know for sure.

Related Health Problems

Having gestational diabetes can increase your risk of high blood pressure during pregnancy. It can also increase your risk of having a large baby that needs to be delivered by cesarean section (C-section).

If you have gestational diabetes, your baby is at higher risk of:

• Being very large (9 pounds or more), which can make delivery more difficult
• Being born early, which can cause breathing and other problems
• Having low blood sugar
• Developing type 2 diabetes later in life

Your blood sugar levels will usually return to normal after your baby is born. However, about 50% of women with gestational diabetes go on to develop type 2 diabetes. You can lower your risk by reaching a healthy body weight after delivery. Visit your doctor to have your blood sugar tested 6 to 12 weeks after your baby is born and then every 1 to 3 years to make sure your levels are on target.

Testing for Gestational Diabetes

It’s important to be tested for gestational diabetes so you can begin treatment to protect your health and your baby’s health.

Gestational diabetes usually develops around the 24th week of pregnancy, so you’ll probably be tested between 24 and 28 weeks.

If you’re at higher risk for gestational diabetes, your doctor may test you earlier. Blood sugar that’s higher than normal early in your pregnancy may indicate you have type 1 or type 2 diabetes rather than gestational diabetes.

Prevention

Before you get pregnant, you may be able to prevent gestational diabetes by losing weight if you’re overweight and getting regular physical activity.

Don’t try to lose weight if you’re already pregnant. You’ll need to gain some weight—but not too quickly—for your baby to be healthy. Talk to your doctor about how much weight you should gain for a healthy pregnancy.

Treatment for Gestational Diabetes

You can do a lot to manage your gestational diabetes. Go to all your prenatal appointments and follow your treatment plan, including:

• Checking your blood sugar to make sure your levels stay in a healthy range.
• Eating healthy food in the right amounts at the right times. Follow a healthy eating plan created by your doctor or dietitian.
• Being active. Regular physical activity that’s moderately intense (such as brisk walking) lowers your blood sugar and makes you more sensitive to insulin so your body won’t need as much. Make sure to check with your doctor about what kind of physical activity you can do and if there are any kinds you should avoid.
• Monitoring your baby. Your doctor will check your baby’s growth and development.

If healthy eating and being active aren’t enough to manage your blood sugar, your doctor may prescribe insulin, metformin, or other medication.

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