What should I do about gestational diabetes?

Written by Li Lang Bo
Endocrinology
Updated on June 24, 2025
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In general, to diagnose gestational diabetes, the first step is to control the diet and engage in appropriate exercise to observe the reduction in blood glucose levels. If through dietary and exercise control, fasting and pre-meal blood glucose levels are below 5.3 mmol/L, and post-meal blood glucose levels after two hours are less than 6.7 mmol/L, and nighttime blood glucose should be higher than 4.4 mmol/L. If one can reach these standards through diet control and exercise, then continue as currently managed. However, if blood glucose levels cannot reach this range through diet and exercise, it is recommended to use insulin treatment as soon as possible. This is because uncontrolled blood glucose levels during pregnancy can significantly impact both the expectant mother and the fetus. Thus, if diet and exercise cannot normalize blood glucose levels, early treatment with insulin is advised. (Please take medications under the guidance of a qualified physician and do not self-medicate.)

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Written by Lin Xiang Dong
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How to control diet for diabetes

The diet for diabetes mainly involves setting reasonable blood sugar reduction targets. Before achieving these targets, strict dietary control is necessary. All fruits, nuts, fried foods, and barbecued foods must be avoided. Meals should be regular and quantified without any extra meals or snacks. The amount of rice for lunch and dinner should be controlled, approximately a couple of ounces per meal, while intake of sufficient vegetables is encouraged to satiate hunger. However, vegetables like pumpkin should not be eaten. A certain amount of lean meat can be included, but fatty meats are to be avoided. Additionally, dry foods are recommended for diabetics, while liquid diets, like soups and porridges, should be avoided. For breakfast, if blood sugar control is poor, one should temporarily avoid noodles and rice noodles. Instead, consuming some pure milk and an egg, along with buns or dumplings such as steamed dumplings or wontons, is acceptable.

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What should pregnant women with diabetes eat?

If a pregnant woman has been diagnosed with gestational diabetes during pregnancy, it is still necessary to decide what food to eat based on the specific blood sugar levels. If the current blood sugar level is relatively stable, she can follow a diabetic diet, eat smaller meals more frequently, and consume more fresh fruits and vegetables. It's important to avoid foods that cause high blood sugar, and it is essential to walk or engage in appropriate exercise 30 minutes after eating to help metabolize the blood sugar. However, if the blood sugar remains high and does not decrease significantly, insulin might be needed to lower the blood sugar levels.

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Screening time for gestational diabetes

For women without high-risk factors, the general practice is to conduct a 75g glucose tolerance test between 24 to 28 weeks of pregnancy, measuring fasting blood glucose, blood glucose one hour after glucose ingestion, and blood glucose two hours after glucose ingestion. The fasting blood glucose should not exceed 5.1 mmol/L, blood glucose one hour after glucose ingestion should not exceed 10.0 mmol/L, and blood glucose two hours after glucose ingestion should not exceed 8.5 mmol/L. For women with high-risk factors, it is advisable to screen for blood glucose levels during the first prenatal visit to detect gestational diabetes early, control blood sugar levels, and reduce the occurrence of complications. Who are the women considered to be at high risk? Those who have a history of gestational diabetes, history of delivering a macrosomic infant, are obese or have polycystic ovary syndrome, have a family history of diabetes among first-degree relatives, are found to have positive fasting and ketone bodies early in pregnancy, have a history of unexplained recurrent miscarriages, have a history of fetal anomalies and stillbirths, and those who have a history of delivering newborns with respiratory distress syndrome. These women need to undergo diabetes screening after becoming aware of the pregnancy to detect any abnormality in blood sugar levels early and treat accordingly.

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Can frequent urination be diabetes?

If the amount of urine increases, the first thing to consider is the possibility of diabetes. In this case, a routine urine test will reveal a significant increase in urinary glucose. If a blood test for blood glucose is performed, an increase in blood glucose will also be found. For this situation, it is necessary to go to the hospital's endocrinology department for hypoglycemic treatment in a timely manner. Secondly, diabetes insipidus should be considered, which also causes an increase in urine volume, and the patient will have obvious thirst. Routine urine tests find that blood sugar in the urine is not high, the specific gravity of urine will initially decrease, and the patient's daily urine output will exceed 2500 milliliters, even reaching more than 4000 milliliters.

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Gestational diabetes range

Gestational diabetes refers to abnormal blood sugar levels occurring during pregnancy. This term is used if the diagnosis is made during pregnancy, and does not include patients who were already diabetic before pregnancy, who are referred to as having diabetes concurrent with pregnancy. The criteria for diagnosing gestational diabetes are based on the results of the OGTT (Oral Glucose Tolerance Test) conducted between 24-28 weeks of pregnancy. According to the OGTT results, a fasting blood sugar level ≥ 5.1 mmol/L, a one-hour blood sugar level ≥ 10.0 mmol/L, or a two-hour blood sugar level ≥8.5 mmol/L, meeting any one of these criteria confirms a diagnosis of gestational diabetes.