The aim of treatment for gestational diabetes is to keep blood sugar (glucose) levels within normal limits during the pregnancy so as to make sure that the growing baby is healthy.
Most women can manage their gestational diabetes mellitus with dietary changes and exercise. If managing your diet and exercising cannot control glucose levels then you may be prescribed antidiabetic drugs or insulin therapy, most commonly insulin therapy will be given.
Insulin therapy:
Insulin is a hormone that controls blood sugar by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. Insulin is not harmful to your baby. It cannot move from your bloodstream to the baby’s.
Insulin therapy is necessary and recommended when blood glucose levels cannot be controlled by diet and exercise and if complications like excessive fetal growth are observed.
Do I Need to Take Insulin for Gestational Diabetes?
Based on your blood sugar monitoring results, your health care provider will tell you if you need to take insulin in the form of injections during pregnancy. If insulin is prescribed for you, you will be taught to give yourself insulin.
Doctor will prescribe fast-acting insulin before meals to control the sharp rise in glucose soon after meals. All types of insulin that are available in market work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar.
Care needs to be taken to avoid low blood sugar level condition called as hypoglycemia due to excessive insulin injection.
Studies have shown that in insulin-treated women preterm delivery was more common.
As pregnancy progresses, the placenta will make more pregnancy hormones that block action of insulin and larger doses of insulin may be needed to control your blood sugar. Your health care provider will adjust insulin dosage based on your blood sugar log.
Antidiabetic Drugs
There is evidence that certain oral glycemic agents are safe in pregnancy, or at least, are significantly less dangerous to the developing fetus than poorly controlled diabetes.
-
Metformin
Metformin is safe and equally effective as insulin. Women prefer metformin tablets to insulin injections. Metformin in its oral format is used alone or with other medications, including insulin if patients do not reach sufficient control with metformin alone. But compared to those treated with insulin alone, they gained less weight and patients required less insulin dosage.
Metformin helps to control the amount of glucose (sugar) in your blood by decreasing the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body’s response to insulin.
-
Glyburide
Glyburide, a second generation sulfonylurea, has been shown to be an effective alternative to insulin therapy. Glyburide lowers blood sugar by stimulating the pancreas to secrete insulin and helping the body use insulin efficiently.
Some doctors feel more research is needed to confirm that oral drugs are as safe and as effective as injectable insulin to control gestational diabetes.