DIABETES IN PREGNANCY
The test, the targets, a meal plan you can follow, insulin only if it is needed, and the check after your baby is born.
Dr. Khizer Hussain Junaidy, Diabetologist & Bariatric Physician, with our nutritionists and our 24-hour laboratory, in Vijay Nagar Colony, Hyderabad.
Gestational diabetes is high blood sugar that first appears in pregnancy. It needs two doctors working together. Your obstetrician stays in charge of your pregnancy and your delivery. We look after the sugar.
Diabetologist & Bariatric Physician · TSMC 04937. Diagnosis, sugar targets, the decision about medicines and insulin, and the plan after delivery.
Farheen Begum and Manzoor Tayaba, MSc Nutrition & Dietetics, Certified Diabetes and Obesity Educators. A pregnancy meal plan built around the food you already eat. Included with any consultation.
Our laboratory, in the same building and open 24 hours, for the glucose tolerance test and every follow-up test.
For your baby after birth: sugar and feeding checks, jaundice, growth and immunisation.
You leave every visit with a written plan you can show your obstetrician. Hours and fees for each doctor are on the doctors page.
Every pregnant woman in India should have her sugar tested at the first antenatal visit, and again between 24 and 28 weeks if the first test was normal. Two tests are in use, and your doctor will tell you which one you need.
| Test | How it is done | Gestational diabetes if |
|---|---|---|
| Single-step test (DIPSI) | 75 g of glucose in water, at any time of day, whether or not you have eaten. One blood sample at 2 hours. | 2-hour value 140 mg/dL or more |
| Fasting test (IADPSG) | After an overnight fast, 75 g of glucose in water. Blood samples at 0, 1 and 2 hours. | Any one: fasting 92 or more, 1 hour 180 or more, 2 hours 153 or more (mg/dL) |
How to prepare, and what to bring, is on our glucose tolerance test sheet. HbA1c is not used to diagnose diabetes that starts in pregnancy.
Once the diagnosis is made, you check your sugar at home with a glucometer, usually first thing in the morning and after meals. These are the levels we aim for in most women:
| When | Target |
|---|---|
| Fasting, on waking | below 95 mg/dL |
| 1 hour after the start of a meal | below 140 mg/dL |
| 2 hours after the start of a meal | below 120 mg/dL |
Your doctor may set slightly different targets for you. How to use a glucometer correctly is on our glucometer sheet. Some women use a glucose sensor instead of finger pricks, which shows the sugar through the day and night.
Keep your readings in our gestational diabetes planner. It checks your glucose test result, marks each reading against these targets, tells you when to show the log to your doctor, and dates the test after delivery. Nothing you type leaves your phone.
Most women reach their targets with changes to food alone. This is not a starvation diet. You and your baby need enough to eat. The nutritionist spreads your food across three meals and two or three small snacks, chooses the rice, roti and fruit portions with you, and adjusts the plan to your sugar readings.
A 10 to 15 minute walk after each main meal lowers the sugar after that meal, unless your obstetrician has asked you to rest.
Insulin is the medicine of choice in pregnancy. It does not reach the baby. We start with a small dose, teach you and a family member how to give it, and adjust it to your readings. Some women are offered metformin tablets instead; your doctor will explain why for you. Medicines are reviewed again soon after delivery, and most women can stop them then.
If you are on insulin, keep glucose with you. A reading below 70 mg/dL is a low sugar. Take 15 g of glucose and check again after 15 minutes. Our low sugar sheet explains what to do.
Go to your obstetrician or the labour room straight away if you have:
We do not have a labour room, an obstetrician or a neonatal unit here.
In most women the sugar returns to normal after delivery. The risk does not. A woman who had gestational diabetes has a much higher chance of developing type 2 diabetes later in life, and of gestational diabetes again in the next pregnancy.
Your baby can be seen by Dr. Amreen, our paediatrician, in the same building.
Bring your antenatal card, your scan reports, any sugar test results and the list of medicines you take. If you already have a glucometer, bring it.
Our Medical Director, Dr. Khizer Hussain Junaidy, has written a plain-language book on this: It's Not Forever. It takes you through gestational diabetes one day at a time, from the numbers to the birth and the follow-up afterwards. It is on Kindle at ₹189, free on Kindle Unlimited, and the opening chapters can be read free on Amazon. Reading it is entirely optional and makes no difference to your care here.
Medically reviewed by Dr. Khizer Hussain Junaidy, Diabetologist & Bariatric Physician, Telangana State Medical Council 04937. General information for patients of Caspian Healthcare: your own doctor's advice comes first.