The Benefits of Exercise

Exercise is possibly the most important technique for managing gestational diabetes. 30 minutes per day of moderate exercise is recommended.

American College of Obstetricians and Gynecologists Recommendations

Exercise recommendations for previously inactive women:

For previously active women: 

It's usually OK to continue:

                 Activities w/risk of falls or abdominal trauma,

                 Holding breath while lifting weight,

                 Very high intensity exercises,

                 Lying flat on the back

Medications Used to Treat GDM

Glyburide, taken to stimulate the pancreas to increase insulin production, appears to be safe to use during pregnancy, and the dose is 2.5 mg-20 mg daily in single or divided doses. Metformin is not recommended because it can cross the placenta.

Mild hypoglycemia may occur if the woman skips or delays meals or snacks.

There is some evidence that glyburide may be less effective in obese patients or those with hypoglycemia early in pregnancy.

Regular insulin is the most commonly used, but is not perfect because its action starts 30-60 minutes after injection, with its peak 2-3 hours after injection. More research is needed on the use of insulin analogs in gestational diabetes—insulin glargine currently is not approved in pregnancy. And if multiple insulin injections are needed, NPH (Neutral Protamine Hagedorn Insulin) is commonly used.

Weight-based Insulin Dosing

Insulin dosing is based on weight. The guidelines below come from the “Sweet Success Guidelines for Care” from the California Diabetes & Pregnancy Program.

Current weight (kg) x total daily requirement based on gestational age  =

 total daily dose

Give 2/3 TDD pre breakfast (2/3 NPH & 1/3 short or rapid acting insulin).

Give 1/3 TDD (1/2 short or rapid acting insulin pre dinner &

 ½ NPH at bedtime).