I have Gestational Diabetes -
Now What?
If you’re reading this, you’ve likely been told your blood sugar is elevated—either “borderline” or diagnostic for gestational diabetes (GDM).
Our goal is to help you safely regulate your blood sugar with nutrition, movement, and monitoring so you can continue a healthy pregnancy and birth.
Important: Your blood sugar must be well controlled by 32 weeks to continue midwifery care. If not, we will refer you for physician consultation.
Your 3-Step Plan
Step 1: Learn About Blood Sugar
Understanding how food affects your blood sugar gives you control.
We recommend:
Real Food for Gestational Diabetes by Lily Nichols. We may have a copy in our lending library, or you can pick one up on Amazon.
Step 2: Track Your Blood Sugar
Monitoring Options
Continuous Glucose Monitor (Freestyle Libre 3)
→ Text us your pharmacy number for a prescriptionOR glucometer (available at any pharmacy)
How Often to Check
Fasting (first thing in the morning)
1 hour after each meal
Target Goals
Fasting: <95
1-hour: <140(ideal <130 if achievable)
2-hour (if used): <120
Tracking
Record food + glucose daily on our GLUCOSE TRACKING LOG
Submit logs weekly through the portal
Bring printed logs to appointments
When to Call Us
Fasting >100 for 5 days in a row
OR if ~25% of readings are elevated in a week
Step 3: Your Ongoing Care Plan
Lifestyle Treatment (First-Line)
Nutrition Guidelines
Goal: prevent spikes, not eliminate all carbs
Core Principles
Pair carbs + protein + fat at every meal
Avoid carbs alone (especially breakfast)
Eat every 2–3 hours
Carbohydrate Ranges
Breakfast: 15–25g carbs
Lunch/Dinner: 30–45g carbs
Snacks: 10–20g carbs
Daily Goals
80–100g protein per day
Protein snack between meals + bedtime
Include healthy fats (avocado, nuts, seeds)
Limit
Juice, soda, processed foods
Large portions of bread, pasta, rice, potatoes (adjust based on tolerance)
Movement
Walk 10–30 minutes after meals
Daily movement improves blood sugar control
Supplements (Dietary Support)
Ovasitol Inositol (Therologix) - 2000 mg in the morning, 2000 mg at night. (FullScript)
Magnesium (glycinate or citrate): 200–400 mg daily
Vitamin D3: ~2,000 IU daily
Omega-3 (EPA/DHA): ~1,000 mg daily
Work With a Nutritionist (Highly Recommended)
Please schedule as soon as possible.
Nikki Bisbee (Nutritional Therapy Practitioner)
https://originwellnessntp.comWhitney Stuart (RD, Diabetes Educator)
https://whitneystuart.com
Guide:
https://whitneystuart.com/gestational-diabetes-guide
Monitoring Your Progress
Daily
Track meals + glucose
Weekly
Submit logs through portal
Once Controlled
Check fasting daily
Check 1 meal per day (rotate meals)
If Diet Alone Isn’t Enough
We will escalate care if:
Fasting remains ≥95–100
Post-meal values are frequently elevated
Blood sugar is not controlled by ~32 weeks
This may include:
Co-management with a physician
Medication (often insulin). This will require transfer of care
Baby Monitoring
We are watching for:
Baby growing too large
Or signs of placental stress
Plan
Growth ultrasound at 34–36 weeks
Additional scans if needed
Maternal Fetal Medicine may recommend:
Monthly ultrasounds
Weekly scans in the last month (if indicated)
Day-to-Day Summary
Check fasting + post-meal glucose
Eat whole foods with protein + fat
Limit sugar and processed carbs
Eat regular meals + snacks
Walk after meals
Take supplements if desired
Send logs weekly
Labor & Birth
Eat light, balanced foods in early labor
Avoid high sugar intake
Goal glucose: 70–110
After Birth
For Baby
May need frequent feeding early
Possible low blood sugar after birth
Consider collecting colostrum starting at 34 weeks
Lactation support: Brianna Krall @ First Feeds
For You
Blood sugar usually returns to normal
Follow-up testing at 6–12 weeks postpartum (2-hour GTT)
Long-term screening every 1–3 years
Final Note
This is manageable. Most women successfully control their blood sugar with these steps.
We will walk with you through this and adjust your plan as needed to support a safe, healthy pregnancy and birth.