Diabetes Education

Gestational Diabetes

Learn more about diabetes and pregnancy

Estrogen, cortisol, and other hormones produced by the placenta begin to block the effects of insulin during pregnancy. If the pancreas can not produce enough additional insulin to overcome the effects of the hormones, diabetes results.

Goal blood glucose levels
Fasting: 60-90 mg/dL
Before meals: 60-105 mg/dL
1 hour after meals: Under 140 mg/dL
2 hours after meals: Under 120 mg/dL

Patients are usually asked to test their blood glucose levels:

  • Fasting
  • 2 hours from the start of a each meal

It is critical that these blood sugars are in the range listed above. Notify your doctor and/or dietitian/nurse if these numbers are higher.


Avoid simple carbohydrates such as fruit juice, cakes and candy. Evenly distribute carbohydrates (starch, fruit, milk) during meals and snacks. Do not drink more than ONE eight ounce glass of milk at one time. Do not have milk or fruit at breakfast when the blood sugar tends to be higher UNLESS you have tested your blood and find the results are within a healthy range. Have no more than 30 grams of carbohydrates for breakfast UNLESS you have tested your blood and find the results are within a healthy range. Do not use Sweet n’ Low (saccharine) because it crosses the placenta. Stevia has not been adequately tested so it is advisable not to use it. Equal/Nutrasweet (Aspartame) can be used moderately (2-4 servings per day) as can Splenda (sucralose). Another option available is Zsweet (contains the plant based sugar alcohol, erythritol) or other natural sweeteners with zero impact on blood glucose.

Please test your blood sugar so you can see how food, beverages, stress, exercise, etc. are affecting YOUR body. Everyone is different. And OF COURSE you must check with your doctor for specific recommendations.


Light exercise is important for your health and to lower your blood sugar. If you are already in an exercise program, you may exercise at higher intensities with the approval of your doctor.


Ketones (a toxic by-product that results from improper fat breakdown) must be checked each morning at your first urination. This is done by placing the ketone strip in the urine stream. If you have not eaten enough carbohydrates, your body must get its energy from another source. The body then breaks down fat for fuel. If your body is not utilizing the carbohydrates efficiently, high blood sugar results and ketones again are used for fuel by breaking down fat.

  • If ketones are positive and blood sugar is normal or low, CALL YOUR DIETITIAN for an adjustment in your diet.
  • If ketones are positive and blood sugar is high, CALL YOUR DOCTOR.
  • If ketones are negative and blood sugar is high, CALL YOUR DIETITIAN for an adjustment in your diet.
  • If ketones are negative and blood sugar is normal, YOU ARE DOING VERY WELL and continue what you are doing.

Sugar does pass from the mother to baby through the placenta. Insulin does not pass from mother to baby. After the 12th week of pregnancy, the baby can make its own insulin. If the mother consistently has high blood sugar, the baby will overproduce insulin. Excess sugar or insulin will cause your baby to gain weight which will result in an overweight baby.

Keep track of your baby’s movements by counting fetal movements or "kicks." After the 26th week of pregnancy when your baby is most active, start "kick counting." After a meal, sit on a comfortable chair and write down how many times your baby moves.

Marci Sloane, MS, RD, LD/N, CDE, is a registered and licensed dietitian/nutritionist and certified diabetes educator with a degree in Nutrition and Physiology from Teachers College at Columbia University. Marci is the author of The Diet Game: Playing for Life!

The goal of Destination Diabetes® is to be a useful and credible resource for the more than 20 million children and adults who have diabetes in the U.S. and their families. Destination Diabetes® provides information on a wide range of diabetes health and wellness topics. Articles are written or reviewed by diabetes advisors who have experience in diabetes education.