Treatment of Diabetes in Pregnancy
Treatment of diabetes in pregnancy focuses on keeping blood sugar levels within a healthy range to avoid complications for both mother and baby. Managing diabetes in pregnancy requires a tailored approach that balances nutrition, physical activity, and medication when necessary. Prompt and consistent treatment minimises the risk of pre-eclampsia, premature delivery, and delivery complications.
Dietary Management
The first line of treatment is usually medical nutrition therapy:
Meals are planned to include complex carbohydrates, lean proteins, and healthy fats
Simple sugars and highly processed foods are avoided
Meals are spread across three smaller meals and two to three snacks per day to maintain steady glucose levels
Carbohydrate counting or portion control tools may be used
Consultation with a registered dietitian is often recommended to develop a personalised meal plan.
Exercise and Lifestyle
Regular light-to-moderate exercise, such as walking or prenatal yoga, improves insulin sensitivity
Activity after meals helps lower postprandial glucose levels
Adequate hydration and sleep also support blood sugar regulation
Blood Glucose Monitoring
Daily monitoring is essential:
Fasting levels should ideally be ≤ 5.3 mmol/L
One-hour post-meal levels should be ≤ 7.8 mmol/L
If lifestyle changes alone do not maintain these targets, medication may be introduced.
Medication during Treatment of Diabetes in Pregnancy
Insulin injections are the most common medication used, as they do not cross the placenta
Oral medications like metformin may be considered, though they are used cautiously in pregnancy
Dosages are frequently adjusted throughout pregnancy due to hormonal changes.
Monitoring the Baby
Growth scans may be scheduled every 2–4 weeks to monitor for macrosomia (large baby)
Amniotic fluid levels and placental health are also assessed
Cardiotocography (CTG) may be used in later pregnancy to check foetal heart rate
Delivery Planning
Women with well-controlled diabetes may carry to full term
Induction may be recommended around 38–40 weeks
Caesarean delivery may be advised if the baby is large or other risks are present
In summary, treatment of diabetes in pregnancy relies on a structured and individualised care plan. With close monitoring and proactive care, most women deliver healthy babies and return to normal glucose levels postnatally.
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