Gestational Diabetes: Symptoms, Diet and Treatment in Pregnancy

Many women are told in the middle of pregnancy that their sugar is high, even though they have never had diabetes. It is a shock, and often comes with guilt and a long list of foods to avoid. Gestational diabetes is very common, particularly in South Asian women, and it is usually well controlled with food, walking and, when needed, medicine. Managed properly, most women have a healthy pregnancy and a healthy baby.

What is gestational diabetes?

Gestational diabetes is high blood sugar that first appears during pregnancy. Hormones from the placenta make the body less sensitive to insulin, and in some women the pancreas cannot make enough extra insulin to keep up. It usually develops in the second half of pregnancy and normally goes away after delivery, but it raises the chance of diabetes later in life.

Symptoms

Most women have no symptoms at all, which is why testing matters. Some notice more thirst, frequent urination, tiredness or blurred vision, but these are also common in normal pregnancy, so they are not a reliable guide.

Who is at higher risk?

• South Asian ethnicity
• Being overweight before pregnancy
• A mother, father or sibling with diabetes
• Gestational diabetes in an earlier pregnancy, or a previous large baby
• PCOS, see PCOS symptoms and treatment
• Age over 30 and high blood pressure

How is it diagnosed?

Most women are tested between 24 and 28 weeks with an oral glucose tolerance test (OGTT): a fasting blood sugar, then a sweet drink, then blood sugar checks after one and two hours. If you are at high risk, your doctor may test earlier, even in the first trimester. Your doctor will interpret the numbers, and a single high value can be enough for the diagnosis.

Why it matters

Uncontrolled high sugar can lead to a very large baby, a difficult delivery or caesarean section, low blood sugar and breathing problems in the newborn, high blood pressure in pregnancy (pre-eclampsia) and early delivery. Controlled sugar greatly reduces these risks.

Managing gestational diabetes with food

You do not need to starve or give up desi food. The aim is to keep sugars steady and gain weight at a healthy pace.

• Eat three small meals and two to three snacks so that you never go long without food and never overload at once.
• Choose whole-wheat roti, daliya, oats and small portions of brown rice, and keep portions of white rice and bread modest. Spread carbohydrates through the day.
• Always pair carbohydrates with protein or fibre: daal, chana, eggs, chicken, fish, paneer, dahi and vegetables.
• Avoid sugary drinks, packaged juice, sherbet, mithai, sweet lassi and bakery items.
• Fruit is fine in controlled amounts, choosing whole fruit over juice and eating it with a meal or snack. Have dates only a small amount at a time, if your sugars allow.
• Keep a small, protein-rich snack before bed to prevent early-morning highs.
• Do not diet to lose weight during pregnancy, and ask your doctor or dietitian for a personal plan.

Be active

A 10 to 15 minute walk after each meal is one of the best ways to lower sugar after eating. Gentle exercise such as swimming or antenatal yoga is also good, unless your doctor has asked you to rest.

Checking your sugar

Many women check blood sugar with a glucometer at home, usually fasting in the morning and one or two hours after meals, and note the readings in a diary for the doctor. Your doctor will give you personal targets. Wash and dry your hands before each test.

When medicines are needed

If food and exercise do not bring sugars into target within a week or two, your doctor may start medicine. Insulin is the standard treatment, because it does not cross the placenta in a meaningful way. Metformin is also used in some women. Never use diabetes tablets in pregnancy without your doctor’s advice, and report any low sugar episodes, such as shakiness, sweating and confusion.

After the baby arrives

• Sugar usually returns to normal within days, but a blood sugar test 6 to 12 weeks after delivery is essential to check.
• Breastfeeding helps lower your risk of future diabetes.
• Women who have had gestational diabetes have a high lifetime chance of type 2 diabetes, so have a yearly check, keep a healthy weight and stay active. See early signs of diabetes.
• Tell your doctor about it at the start of any future pregnancy.

When to call your doctor

• Repeated high sugar readings despite following the plan
• Low sugar episodes
• Reduced baby movements, severe headache, swelling of the face or hands, or vision changes
• Vomiting that stops you from eating

Key takeaways

• Gestational diabetes is common and usually has no symptoms, so the glucose test at 24 to 28 weeks matters.
• Balanced desi meals, regular snacks and walking after meals control most cases.
• Insulin is safe in pregnancy when diet is not enough.
• Get tested after delivery and every year after, because the risk of type 2 diabetes stays high.

Related medicines and products on Medimart

These are used for diabetes in pregnancy only on your doctor’s advice:

• Insulin: the standard treatment for gestational diabetes
• Metformin: used in some women under medical supervision
• Folic acid: advised before and during early pregnancy

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse diabetes care products and pregnancy care on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from your doctor or diabetes educator. Please follow the plan given for your pregnancy.