Question
After being diagnosed with gestational diabetes, I have been self-testing my blood glucose at home every day. Generally, it stays below 6.7, but occasionally one or two readings go over 6.7. Is this okay?
Answer
The standard for blood glucose control during pregnancy is: fasting 3.3-5.6 mmol/L, 30 minutes before meals 3.3-5.8 mmol/L, 2 hours after meals 4.4-6.7 mmol/L, and at night 4.4-6.7 mmol/L. Therefore, the blood glucose control is not ideal. It is recommended that oral hypoglycemic agents are not currently recommended during pregnancy as their safety has not been fully confirmed, and insulin is primarily used to control blood glucose levels. The dosage currently has no unified standard and generally starts with a low dose, adjusting according to the condition, the progress of pregnancy, and the blood glucose values to control the blood glucose to a normal level. In addition, attention should be paid to dietary treatment. Gestational diabetes patients should provide sufficient calories and nutrients for both the mother and the fetus, allowing for appropriate weight gain, achieving ideal blood glucose control, and preventing preeclampsia as well as reducing the incidence of preterm labor, miscarriage, and difficult childbirth. Nutritional needs are similar to those of normal pregnant women, but more attention should be given to calorie intake, nutrient distribution ratios, and meal distribution. Sweet foods and high-fat foods should be avoided, and dietary fiber should be increased. During the early stages of pregnancy, there is no need to increase calories significantly; during the middle and later stages, it is necessary to increase 300 calories per day according to the pre-pregnancy calorie needs. It is not advisable to lose weight during pregnancy to avoid an increase in ketone bodies in the mother’s body, which can have adverse effects on the fetus. Meal distribution is very important for maintaining stable blood glucose levels and avoiding ketonemia. Large meals can cause a rapid rise in blood glucose levels, and prolonged fasting in the mother can lead to the production of ketone bodies, so it is recommended to eat small and frequent meals, dividing daily food into 5-6 meals. Special attention should be given to avoiding a long gap between dinner and the next morning’s breakfast.