Gestational Diabetes: Your Care Plan

Gestational Diabetes

I have Gestational Diabetes - Now What?

If you’re reading this link, you probably have been told that your blood sugar is high enough that you either have “borderline gestational diabetes” or you actually have Gestational Diabetes. Our goal is to help you manage your blood sugar with diet and exercise.

IMPORTANT: We need to make sure your blood glucose is well regulated by 32 weeks; otherwise, we will refer you to a physician for consultation.

This article is intended to be a quick reference for you to refer back to. We have linked tools and plans for you here.

Step 1: Learn about Gestational Diabetes so you can take charge of your health.

Step 2: Document how changes you make are affecting your metabolism by tracking your blood sugar.

Step 3: Learn about our plan to observe your health for the remainder of your pregnancy.

Learn About Gestational Diabetes

The first step to managing your glucose is understanding the ins-and-outs of gestational diabetes. Here are some resources to help you learn about blood sugar and nutrition so you can succeed.

• Lilly Nichols wrote Real Food for Gestational Diabetes to help pregnant women learn about their metabolism and manage glucose with healthy food and movement. We may have a copy of her book available in our lending library. You can also purchase one on Amazon. Click HERE to visit her website and view videos and resources.

Track Your Blood Sugar

• Beginning immediately, monitor your blood glucose.

  • We recommend a Continuous Glucose Monitor, but you can also use a glucometer.

  • If you want a Continuous Glucose Monitor, please text us the phone number for your pharmacy. We will phone in a prescription for the Freestyle Libre 3.

  • If you prefer to use a glucometer, you can buy one at any local pharmacy. You will need to buy enough lancets and test strips to test your blood 4x a day 2 weeks, and then continue to check 1x a day for the rest of your pregnancy..

  • You’ll record your blood sugar first thing in the morning (fasting), and 1 hour after meals throughout the day. Record everything you eat and your blood sugar on THIS FORM.

  • Please text us a photograph of your form after the 1st 7-days of testing. Please print all your diet journals and bring them with

• Click HERE to learn about the targets for your blood glucose according to the American Diabetes Association.

·    Fasting - before breakfast or before any meal should be 95

·    1 hour after a meal should be less than 135

·    2 hours after a meal should be 120 or less.

• Work with a Nutritionist to monitor glucose levels with diet and exercise.  

In order to continue with midwifery care, your blood sugar must be well managed by 32 weeks. There’s no time to lose. Please immediately set an appointment with a nutritionist. We have two that we recommend in Dallas. You can choose the one that fits your schedule the best:

Nikki Bisbee at Origin Wellness is a certified Nutritional Therapy Practitioner. She can help you manage your gestational diabetes through lifestyle adjustments. She also practices homeopathy so she may have other ways to help you feel healthy..  You can schedule an appointment with her HERE.

Another great option is Whitney Stuart. She’s a Registered Dietitian, Nutritionist & Diabetes Educator. She’s very knowledgable. You can review her website HERE.

Whitney Stuart has prepared “The Ultimate Guide to Mastering Gestational Diabetes” on her website. You can read that HERE

Basic Lifestyle Changes

DIET:

• Remove processed foods and carbohydrates from your diet.

• Increase protein and healthy fats at every meal.

• Add a 20 gram protein snack after dinner nightly

SUPPLEMENTS:

• Diabenil (1-2 capsules 2x a day) is a product by Thorne that may promote healthy blood glucose management. We can put this in a FullScript cart for you to consider.

• Ovasitol (4000 mg 1x daily) stirred into water at bedtime.

EXERCISE:

• Begin walking for 30 minutes after your biggest meal 7-days a week

• Other low impact exercises can be added to help you expend the blood glucose

MONITOR YOUR PROGRESS:

• Attempt to adjust your nutrition based on your results.

• Share your diet journal with your midwife in your portal every week. IMPORTANT If your fasting blood glucose numbers are above 100 for 5 days in a row, please call us.

• Continue with daily glucose checks after all meals and fasting until your blood sugars are well controlled by diet. Then, you can reduce to just checking your fasting glucose in the mornings daily, and checking one other meal per day.

We will also refer you for an ultrasound to make sure the baby is healthy and well nourished at 34-36 weeks.

If your fundal height is above the expected height, we will also refer you for an ultrasound. The Maternal Fetal Medicine Specialist we refer you to will measure the baby and check the function of the placenta to make sure the glucose isn’t causing harm to the placenta or over-feeding the baby. They will most likely recommend monthly ultrasounds until 36-weeks, and weekly scans in the last month to make sure you and baby are still healthy enough to birth out of hospital.

Summary - Day To Day

1.  Record your meals and record your blood glucose before breakfast and 1-hour after every meal.

2.  Eat a healthy, whole food diet with 80-100 grams of protein each day.

3.  Remove bread, pasta, and potatoes and "root vegetables" as well as processed sugars from your diet

4.  Eat a protein snack between meals and at bedtime.

5.  Include healthy fats like avocado, nuts and seeds in your diet for satiety.

6.  Begin walking or other light exercise after meals that seem to be the most challenging for your blood sugar. You may find it helps to do yoga or walk for 30 minutes each day.

7.  Take 4000 mg of Ovasitol every night. We will create an order in FullScript so you can order a high quality supplement asap.

RECOMMENDED RESOURCES: You can get Lilly Nichols' book Real food for Gestational Diabetes on Amazon.com. She has great information on how to use glucose.

Next Assessments

We will send you for an upper level ultrasound to measure the baby's growth. We will also add a glucose test to your 36-week labs.

I know this is a lot of information. We want you to feel confident that we will team up with you to have a safe, healthy birth. Managing your blood glucose is a big part of that picture.

We're here if you have any questions.

Best,

Margie Wallis, Midwife
Frisco Midwifery & Birth Center