Gestational Diabetes Mellitus (GDM)

How is gestational diabetes mellitus (GDM) treated? 

When you have GDM, you will be under the care of a specialist healthcare team comprising obstetricians, endocrinologists, specialised nurses and dietitians.

• GDM usually improves with lifestyle measures such as healthy eating and exercise.
• Despite best efforts at achieving a healthy lifestyle, if your blood sugar levels are very high, treatment with either oral medications or insulin injections may be required. You may also be referred to a doctor who specialises in diabetes for further monitoring during your pregnancy.
• You will be taught how to use a glucometer to monitor your sugar levels at different time points within the day (pre-meals, two hours after meals and at bedtime), and how to self-inject insulin if you need insulin therapy.
• You will be referred to a dietician for dietary advice.
• At every doctor’s visit, a blood test (HbA1c) will be done to measure your average blood glucose level over a three-month period.
• Your blood pressure and urine will be checked at every visit as you have an increased risk of developing pre-eclampsia (a high blood pressure condition that develops only during pregnancy).
• Ultrasound scans may be performed more frequently to monitor the baby’s growth.
• Your specialist team will give you advice about the timing and type of delivery. This will depend on various factors such as blood sugar control, growth of the baby, size of the baby, blood pressure measurements and previous surgeries, etc.
• During labour, blood glucose levels will be monitored frequently and some women may require an insulin drip for optimal control.
• After delivery, most patients who require tablets or insulin injections during pregnancy are able to stop their medications. However, some women may have persistent diabetes after pregnancy. Therefore, a repeat OGTT is needed about six to 12 weeks after delivery to check if the GDM has resolved.
• Breastfeeding after delivery is encouraged.