Whether you have gestational diabetes or preexisting diabetes in pregnancy, the key to lowering risks is the same: keep your pregnancy blood sugar levels in control. Doing so will help you avoid high fasting blood sugar levels during pregnancy.
Maintaining tight pregnancy blood sugar levels is a balancing act. You want your levels low enough to reduce risks. However, you do not want them so low that you will be at risk for hypoglycemia or "low blood sugar attacks" as many people with diabetes call them.
Here are some ways to maintain healthy blood sugar levels:
• Test your blood sugar levels often.
• Log and observe trends and learn how to deal with them. For example, many women struggle with fasting blood sugar upon rising, levels seem to rise most sharply after breakfast and then tend to dip in the late afternoon causing lows. Everyone is different, pay attention to your own trends.
• Notice how you react to different foods. You may find foods that do not cause your levels to rise too much and others that present problems. For example, you might notice that foods with a lot of fat, such as some Mexican, Chinese and Italian foods (like pizza) may not cause blood sugar levels to peak for many hours but your one and two hour after-meal blood sugar levels may be on target.
• Breakfast can be challenging and can be the best meal to eat the lowest carbs. Many women find certain breakfasts that work for them and eat those regularly. Some eat the same breakfast every morning when they find one that works for them.
• Test your blood sugar before driving and more often while away from home, especially at times when you notice your levels tend to run the lowest. Test your blood sugar before, during and after exercise.
• If your bedtime levels are good, yet you wake up with very high blood sugar, check your blood sugar during the night (between 2:00 and 3:00 a.m.) to make sure your levels are not rebounding from a low nighttime level. This phenomenon is also known as the Somogyi Effect. Your physician may need to make adjustments to your meal or insulin plan.
• Familiarize yourself and your friends and family to the signs and symptoms of hypoglycemia or low-blood sugar and how to treat when it happens.
• Always keep candy, glucose or snacks around to counteract low blood sugar levels, especially when driving or away from home.
• Do not overdo treatment or "eat everything in the refrigerator" when you have early stage symptoms of hypoglycemia or you may end up with high blood sugar. If you notice early symptoms of hypoglycemia, eat 15 grams of carbohydrates and test immediately. Wait 15 minutes and re-test. If still too low, eat another 15 grams of carbohydrates, wait 15 minutes and re-test. Repeat as necessary.
• Do not panic if you have a high blood sugar reading and your average blood sugar levels have been mostly on target. Remember your goal is to have a good average. If you are noticing more highs, let your physician know. Your medication or insulin may need to be adjusted. Insulin resistance often gets progressively worse through pregnancy.
• Try to relax and reduce stressors. Physical, mental and emotional stresses can raise blood sugar levels.
• Learn as much as you can. There are books and websites dedicated to diabetes and pregnancy.
• Find support. Plug into social networks for women with diabetes who are pregnant. A study has shown that getting and offering peer support may help reduce blood sugar levels. In addition, you may find more strategies that work for you.