Gestational Diabetes and Insulin- Why It’s Not A Failure

Gestational diabetes is a common condition in pregnancy, causing elevated blood sugar levels. While it can be challenging to deal with, there are various strategies to manage it effectively, and it’s crucial to remember that starting medications does not equate to failure. 

gestational diabetes women giving herself insulin

In this blog, we will discuss the importance of diet and lifestyle interventions, factors out of our control, and when medication like insulin or metformin may be necessary. 

Diet and Lifestyle Interventions

When diagnosed with gestational diabetes, the first step is usually to implement dietary and lifestyle changes. A well-balanced diet can help stabilize blood sugar levels by focusing on consuming whole foods, lean proteins, complex carbohydrates, and healthy fats while monitoring portion sizes. Check out the following blogs to learn more about the gestational diabetes diet.

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Lifestyle interventions include regular physical activity, stress management, and adequate sleep. These measures can significantly contribute to managing gestational diabetes, often without the need for insulin.

Sometimes, lifestyle isn’t enough. Meeting with your provider to strategize a routine and diet that works specifically for your case is VITAL.  However, other factors like stress, genetics, having a toddler at home, and lack of sleep can all work against you, and additional intervention may be useful. 

The Importance of Professional Guidance

It’s vital to work closely with a registered dietitian nutritionist (RDN) specializing in diabetes care and education. A certified diabetes care and education specialist can provide personalized guidance, helping you fine-tune your dietary and lifestyle routine for better blood sugar control. 

Specialists in gestational diabetes can help you understand how different foods affect your blood sugar levels and develop strategies to keep them in check. If you don’t have help please check out my free resources and program. 

Medications: When and Why

Sometimes, despite efforts with diet and lifestyle changes, we require medication to lower blood sugars. The decision to start medications like insulin or metformin is not a sign of failure but rather a recognition that pregnancy hormones are causing excessive stress on the body’s ability to regulate blood sugar levels. In my office, we typically start medication with 30% of fasting or postprandial are high, and no lifestyle intervention works.

Insulin is a hormone that helps regulate blood sugar by allowing cells to absorb glucose from the bloodstream. If your pancreas cannot produce enough insulin to compensate for the increased demands during pregnancy, insulin injections may be necessary to maintain healthy blood sugar levels.

Metformin is an oral medication that can help lower blood sugar by improving insulin sensitivity and reducing the amount of glucose produced by the liver. It may be prescribed when dietary and lifestyle changes alone are insufficient.

Here are a few questions I get a lot in regards to gestational diabetes and insulin:

  1. Can I refuse insulin from my doctor?

Technically, you can refuse anything in health care. It’s important to have an open conversation with your provider about insulin use and what your fears are. The goal of your healthcare team is to keep you and your baby safe. 

In rare cases where the doctor strongly believes you need to start insulin to protect your baby’s health, they may discharge you from their practice if you refuse to start since this is a liability risk. 

  1. Will I become dependent on insulin for every if I  start insulin for gestational diabetes?

No, once you deliver the placenta, your hormones should return to pre-pregnancy levels, and your blood sugars should return to normal. If someone needs to continue insulin postpartum, they likely had diabetes before pregnancy, and it was caught during the time of pregnancy. 

  1. Can I choose Metformin instead of insulin for gestational diabetes?

That is between you and your doctor. ACOG recommends starting with insulin; however, many doctors will do both. It’s important to remember that Metformin goes through the placenta to the baby and has been recognized as safe. Insulin does not go through the placenta and is metabolized by the kidneys.

Postpartum Recovery

The good news is that for many women with gestational diabetes, once they deliver their baby and the placenta, blood sugar levels often return to normal. Any medications started in pregnancy and typically stopped at delivery. 

Gestational diabetes can be challenging, but it’s manageable with the right approach. Start with diet and lifestyle changes, working closely with a certified diabetes care and education specialist. 

Medications like insulin and metformin can complement these efforts without implying failure. Remember, the goal is to keep you and your baby healthy during pregnancy, and with the right support, you can achieve that. For more in-depth guidance on managing gestational diabetes, enroll in my comprehensive course and coaching program to get my ten years of experience in one course!

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Ginger Cochran is a Registered Dietitian Nutritionist, functional medicine practitioner, Certified Diabetes Educator & Care Specialist, Certified Wellness Coach, Certified Exercise Physiologist, and owner of Nutritious Ginger, an integrative and functional nutrition practice focusing on full body self-care and nourishment. Ginger’s primary specialty is women’s health, with a special emphasis on gestational diabetes, weight management, infertility, digestive wellness, and overall health + happiness.
Ginger serves on the board of director for the Nutrition Care Manual by the Academy of Nutrition and Dietetics.