Know Your Numbers: Gestational Diabetes

Last Updated on by Kari Garner, MS RDN LD CDCES

Today, On The Blog, I am talking about blood sugar goals related to gestational diabetes numbers! I will be answering questions such as “does my A1c matter?”, “where should blood sugars be after meals,” and “how do I meet targets set by my OB-GYN?”

Keeping your blood sugars within range is important to keep you healthy, while also keeping your baby’s health at the forefront.

What is Gestational Diabetes?

Gestational diabetes is a condition that can develop in women during pregnancy who do not already have diabetes. It is when your body cannot make enough insulin during pregnancy, resulting in a state of hyperglycemia that can be harmful to both the mother and child.

GDM is often a symptom of underlying β-cell dysfunction, which is why you will see the increased risk of the mother and child developing diabetes later in life.

If you have gestational diabetes, your baby is at a higher risk of being very large at birth, being born early, having low blood sugar, and ultimately developing type 2 diabetes down the road.

Related: Gestational Diabetes Blog: GDM Explained

diabetes materials

Understanding Diabetes

The definitions below are how I explain the following concepts to my clients to enhance understanding and eliminate confusion around diabetes care.

Insulin

A hormone that helps glucose get into your cells to give them energy. It is the hormone that brings elevated blood sugar down to normal levels.

Carbohydrates

Carbohydrates are the sugars we eat that make blood sugar go up.

Blood glucose

Blood glucose or blood sugar is the amount of sugar in our blood stream at any given moment.

Pancreas

An organ that makes insulin and other hormones needed to regulate blood sugar levels.

Liver

An organ that stores sugar and can affect blood sugar by putting sugar into the blood stream if there is not enough.

Hypoglycemia

Hypoglycemia (also known as low blood sugar) occurs when there is not enough glucose in your bloodstream for your body to optimally function. Blood sugar is under 70mg/dL.

Hyperglycemia

Hyperglycemia (also known as high blood sugar) is a condition when there is too much glucose in the bloodstream. Blood sugar is over 180 mg/dL.

Fasting Plasma Glucose (FPG)

A blood test to measure a person’s blood sugar level after fasting for at least 8 hours.

Oral Glucose Tolerance Test (OGTT)

A test completed in a fasted state to determine your body’s ability to absorb glucose.

B-cells

B-cells or beta cells are cells located in the pancreas that are responsible for the storage, production and release of insulin.

Hemoglobin A1c

A hemoglobin A1c is a blood test to determine what your average blood sugar has been over the past 2-3 months. This is an insight into how your blood sugars have been controlled and your risk for adverse effects of diabetes.

eAG

eAG stands for Estimated Average Glucose and provides insights to your average blood sugars over the period of 2-3 months. Unlike the A1c, the eAG will be reported in mg/dL instead as a percentage.

How Do I Know My Numbers?

Blood tests are needed for you to know your numbers. You can use a glucometer or a continuous glucose monitor (CGM) to check your blood sugar daily.

What Are Blood Sugar Targets?

Blood sugar targets are going to be a range of values to work toward to maintain or even improve your health.

The targets below are general recommendations for majority of adults. Keep in mind that there is not a one size fits all target. You will need to work with your diabetes care team to determine your specific target range for blood sugars.

Glycemic Targets in Pregnancy

Your diabetes care team should also work with you to manage both fasting and postprandial blood glucose levels for optimal health. Here are glucose targets to aim for:

  • Fasting plasma glucose (before meals, at bedtime, overnight) <95 mg/dL
  • 1-hr postprandial glucose (after a meal) <140 mg/dL
  • 2-hr postprandial glucose (after a meal) <120 mg/dL

Glycemic target limits defined above apply to GDM that is treated with and without insulin. 

A1c Goal for Gestational Diabetes

With prediabetes and type 2 diabetes, a hemoglobin A1C blood test can be taken to check your average blood sugar over a 2-3 month period. These results will indicate your current numbers and provide insight to determine a target range.

However, with gestational diabetes, A1c is not reliable at 15 weeks of gestation or later because of the inaccuracies in the values. Due to increased red blood cell turnover, A1c is slightly lower in pregnancy than in normal nonpregnant women.

How Can I Treat Blood Sugars Out Of Range?

Work with your diabetes care team! This team is essential for diabetes management as it is this group of providers that should be working to support you each and every day. This team may include:

  • OBGYN
  • Endocrinologist
  • Nurse(s)
  • Registered Dietitian/Certified Diabetes Educator
  • Dentist
  • Podiatrist
  • Counselor
  • Ophthalmologist
  • Social Worker

Sharing your daily numbers with your team can help you determine the best actions to take to stay within your blood sugar range. Your diabetes care team should know your routine and challenges in life and be there to support you in finding your approach to diabetes management.

They may recommend any of the following actions:

  1. Monitoring food choices, amounts consumed and timing of meals 
  2. Checking blood sugars on a regular basis via a blood glucose meter
  3. Increasing physical activity within the first trimester 
  4. Insulin as the preferred medication to treat hyperglycemia 
  5. Monitoring your baby by scheduling routine telehealth or standard in-person physician visits

As a Registered Dietitian and Certified Diabetes Care and Education Specialist, I am here to support you in creating a healthy eating plan for you. You are not alone on this journey! Schedule a Education Session today to determine which of my 1:1 nutrition counseling programs is best for you!

I am now offering a self-paced guide as another affordable option to start your journey to simplify mealtime. Download my 25/75 Method today and receive bonus lunch and dinner meal ideas!

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Flourish with Diabetes!

If you are ready to take the leap and transform your health, check out my Resources Page. I can help you grow & flourish with diabetes!

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Springtime Nutrition, LLC was founded on my passion to partner with individuals to eliminate the stress, frustration and overwhelm of changing their nutrition lifestyle. I am committed to supporting you at every step of your journey. Ready to transform your life?  Get started today!


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Certified Diabetes Care & Education Specialist/ Registered Dietitian/ Owner / Springtime Nutrition, LLC

Kari is a diabetes expert with more than 18 years of experience. Kari currently works as a diabetes educator with a large hospital system in Charleston, SC and is committed to improving the lives of people with any type of diabetes.

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