Gestational Diabetes in Pregnancy — How to Manage It and Keep Your Baby Safe

What is gestational diabetes? GDM is a form of glucose intolerance that first develops during pregnancy. It occurs when pregnancy hormones (particularly human placental lactogen) cause insulin resistance — meaning your body cannot produce enough insulin to maintain normal blood sugar levels. When is it screened? At Maatritva IVF, all pregnant patients undergo a glucose challenge test (GCT) at 24–28 weeks. High-risk patients (PCOS, family history, obesity, previous GDM) are screened earlier. Risks of uncontrolled GDM: - Baby: Macrosomia (large baby), difficult delivery, neonatal hypoglycaemia, increased risk of childhood obesity and diabetes - Mother: Pre-eclampsia, increased C-section risk, future risk of Type 2 diabetes Management approach: Step 1 — Diet: Low glycaemic index eating (same principles as PCOS diet). Spread carbohydrates evenly across 6 small meals. Avoid all sugary drinks, white rice in large quantities, sweets. Step 2 — Blood sugar monitoring: Self-testing before meals and 1 hour after meals. Fasting target: <95 mg/dL; 1-hour post-meal: <140 mg/dL. Step 3 — Medication: If diet alone does not control levels within 1–2 weeks, insulin is added. Insulin in GDM is completely safe for the baby. Do not delay this step if diet is insufficient. Step 4 — Delivery planning: Discuss timing at 36 weeks. Induction at 38–39 weeks is usually recommended if macrosomia or blood sugar control is difficult. C-section planned if baby position or size warrants it.