Managing gestational diabetes

Day-to-day care for gestational diabetes: checking your blood sugar, eating well for you and your baby, staying active, when insulin or other medicine is needed, and what to expect at birth.

7 min read · last reviewed October 3, 2026

Once you know you have gestational diabetes, the focus shifts to a simple goal: keeping your blood sugar in your target range for the rest of your pregnancy. That protects you and your baby. It can feel like a lot at first, with finger pricks, food logs and extra appointments. But it's for a limited time, and you'll have a team to help you.

Your care team

Depending on where you live, you may see a diabetes in pregnancy clinic, a diabetes educator (often a nurse), a dietitian, an obstetrician, a family doctor or a midwife, and sometimes a diabetes specialist. They work together, so share your readings and questions with all of them.

Something you can do today: Save the phone numbers of your diabetes clinic and your birth unit in your phone.

Checking your blood sugar

Your team will teach you to use a blood sugar meter. Most people check four times a day:

• when you wake up, before eating (fasting)
• after each meal, usually 1 hour or 2 hours after you start eating, depending on your team's advice

Diabetes Canada suggests these targets for most people:

• fasting: below 5.3 mmol/L (about 95 mg/dL)
• 1 hour after a meal: below 7.8 mmol/L (about 140 mg/dL), or
• 2 hours after a meal: below 6.7 mmol/L (about 120 mg/dL)

Your team may give you slightly different targets. Write every reading down, or use an app, and note what you ate. This helps your team see patterns and decide if you need more support. Some people who take insulin may be offered a continuous glucose monitor (CGM).

A single high reading isn't a crisis. It's information. Look for patterns, and share them with your team.

Eating well for you and your baby

Healthy eating is the first treatment for gestational diabetes. A dietitian will help you make a plan that fits your tastes and culture and gives you and your baby all the nutrition you need.

Some general tips:

• Eat regularly. Have 3 meals and 2 to 3 snacks a day, including a bedtime snack, spread out evenly. Don't skip meals.
• Spread out your carbohydrates. Carbs raise blood sugar the most, but you and your baby need them. Having smaller amounts at each meal and snack keeps blood sugar steadier.
• Breakfast can be tricky. Blood sugar often runs higher in the morning, so many people do better with a smaller amount of carbs at breakfast and more protein.
• Choose high-fibre carbs, such as whole grains, beans, lentils, vegetables and whole fruit.
• Pair carbs with protein, such as eggs, cheese, yogurt, nuts, fish, chicken, tofu or lentils.
• Avoid sugary drinks and juice. Drink water, milk or other unsweetened drinks.
• Fill half your plate with vegetables.

This is not the time for dieting or skipping food. Your baby needs a steady supply of nutrients. If you're feeling hungry, or losing weight, tell your dietitian.

Something you can do this week: Take a photo of your meals for a few days and share them with your dietitian.

Staying active

Activity helps your body use insulin and can lower your blood sugar after meals. For most people with a healthy pregnancy, it's safe and recommended.

• Aim for about 150 minutes a week of moderate activity, such as walking, swimming, stationary cycling or prenatal exercise classes, unless your provider tells you otherwise.
• A 10- to 15-minute walk after meals can help lower your after-meal readings.
• Avoid contact sports, activities with a high risk of falls, and lying flat on your back for long periods later in pregnancy.
• Stop and call your provider if you have bleeding, fluid leaking, regular painful contractions, chest pain, dizziness or calf pain or swelling.

When medicine is needed

Many people reach their targets with food and activity alone. But if your blood sugar stays above target, often after 1 to 2 weeks of trying, your team will suggest medicine. This is common, and it's not a sign you've done anything wrong. Pregnancy hormones get stronger as pregnancy goes on, so needs often increase in the third trimester.

• Insulin is a common first choice in Canada and the U.S. It's safe in pregnancy and doesn't cross to the baby. It's given with a pen and a very small needle. Your team will teach you how to use it, how to adjust it, and how to spot and treat low blood sugar.
• Metformin, a pill, is also used in some places. In the UK, NICE recommends it as the first medicine to try. It does cross the placenta, and long-term effects on children are still being studied, so ask your team about the benefits and risks.
• Occasionally, another pill called glyburide (glibenclamide) is used.

If you take insulin, keep fast-acting sugar with you, such as glucose tablets or juice, in case of a low.

Checking on your baby

Your team may offer extra ultrasounds to check your baby's growth, and may check your blood pressure and urine more often. Learn your baby's normal pattern of movements. If your baby is moving less than usual, call your birth unit right away. Don't wait until the next day.

Planning for birth

Most people with gestational diabetes can have a vaginal birth. Your team will talk with you about the best timing. Depending on your blood sugar, medicines and baby's growth, you may be offered an induction of labour, often between 38 and 40 weeks. If your baby is very large, a caesarean birth may be discussed.

During labour, your blood sugar may be checked regularly, and you may get insulin through an IV if needed. After birth, your baby's blood sugar will be checked, and early, frequent feeding helps keep it steady. See After baby is born.

Take care of your feelings

Gestational diabetes can bring worry, guilt and frustration. These feelings are normal. Talk with your partner, family, friends or team. If low mood or worry lasts more than two weeks, tell your provider. Help is available.

Questions to ask your care team

• What are my targets, and when should I check?
• Can I see a dietitian? What should a typical day of meals look like?
• How active can I be?
• When would I need insulin or other medicine?
• How will you check my baby's growth?
• What is the plan for my labour and birth?

This article is general information, not medical advice. Talk with your health care team about your own situation. In an emergency, call 9-1-1 or your local emergency number.

In an emergency, call 9-1-1 or your local emergency number.

General information, not medical advice. It does not replace your own care team. If you think you or someone else is having a medical emergency, call 9-1-1 or your local emergency number. If you are in crisis or thinking about suicide, call or text 9-8-8 (Canada and the US).

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