Standards for Blood Sugar Control in Gestational Diabetes

Written by Chen Xie
Endocrinology
Updated on April 20, 2025
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The control of blood sugar in gestational diabetes mainly involves monitoring fasting blood glucose, postprandial blood glucose, and ketone bodies in urine. Patients can monitor their fasting and postprandial blood glucose 4-6 times daily. The target for blood sugar control is to maintain fasting blood glucose, pre-meal, or pre-sleep blood glucose levels between 3.3 to 5.3 mmol/L, postprandial blood glucose after one hour should be less than or equal to 7.8 mmol/L, and postprandial blood glucose after two hours should be less than or equal to 6.7 mmol/L. Ketone bodies should be negative, and glycated hemoglobin should be controlled below 6%. Only by meeting these standards can the control of blood sugar in gestational diabetes be considered adequate, which can reduce risk factors for both the mother and the fetus.

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What are the symptoms of gestational diabetes?

Diabetes during pregnancy, compared to diabetes outside of pregnancy, still presents symptoms such as polydipsia, polyphagia, and polyuria, but does not manifest as weight loss. Due to the increase in body weight from the enlarging uterus, fetus, and amniotic fluid during pregnancy, signs of weight loss are not evident. There are generally two types of diabetes in pregnancy. One is when diabetes pre-exists before pregnancy, which is termed diabetes mellitus with pregnancy; the other is when blood sugar levels were normal before pregnancy and diabetes develops during pregnancy, known as gestational diabetes. Over 90% of pregnant women with diabetes have gestational diabetes. Those with gestational diabetes have abnormal glucose metabolism, but most can return to normal after childbirth; however, the risk of developing Type 2 diabetes in the future increases.

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Does gestational diabetes require hospitalization?

Patients with gestational diabetes who initially have adequate blood sugar control do not need to be hospitalized; however, those with poor blood sugar control require further hospitalization for observation and treatment. In addition to diet and exercise, medication control such as insulin therapy is currently recommended for managing blood sugar in gestational diabetes. Insulin therapy must be used under strict medical supervision to avoid hypoglycemia. Since both high and low blood sugar levels can have a dual impact on pregnant women and fetuses, the need for hospitalization for patients with gestational diabetes mainly depends on their blood sugar levels.

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Will gestational diabetes get better?

Gestational diabetes refers to diabetes that appears or is diagnosed during pregnancy and is a distinct type of diabetes. Many women with gestational diabetes may see their blood sugar levels return to normal after delivery as insulin resistance diminishes. It is recommended to conduct an OGTT (oral glucose tolerance test) screening six weeks after childbirth, as the majority of women with gestational diabetes will have normal fasting blood glucose or OGTT values at six weeks postpartum. Approximately 25% to 70% of women with gestational diabetes may develop diabetes again within 16 to 25 years after delivery. Therefore, it is essential to continue monitoring the patient's blood glucose postpartum and to screen early for diabetes.

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Steps for Gestational Diabetes Testing

The screening steps for gestational diabetes involve, for most women, the recommendation to undergo a 75-gram glucose tolerance test at the hospital between 24 to 28 weeks of pregnancy. The method includes fasting blood draw, consuming 75 grams of glucose, and monitoring blood sugar levels one hour and two hours after glucose intake, to determine the presence of gestational diabetes. However, for pregnant women at high risk for diabetes, it is recommended to complete the 75-gram glucose tolerance test early in pregnancy to detect gestational diabetes early and initiate treatment promptly to reduce the risks to both the fetus and the mother.

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Gestational diabetes blood glucose monitoring

Gestational diabetes refers to individuals who were not diabetic before pregnancy but develop high blood sugar levels due to increased insulin resistance caused by elevated hormone secretion during pregnancy. These patients also need to monitor their blood sugar, typically checking fasting blood sugar, post-meal blood sugar, and bedtime blood sugar to maintain it within a target range, such as keeping fasting levels at 5.60 and post-meal levels below 7.8 to avoid hyperglycemia or hypoglycemia and minimize the risk of low blood sugar. If the blood sugar level exceeds 10 or even higher, such patients may require medication treatment. If the increase is mild, through diet and exercise interventions, blood sugar can generally be controlled within the normal range.