What is a normal glucose level for pregnancy

To monitor your glucose, you will be given a blood glucose monitor. This is designed for you to measure your own blood glucose levels at home, or wherever you happen to be, by checking a drop of your blood. You produce the blood by using a finger pricker.

There are many different brands of meter on the market, but they all work in similar ways:

Step 1  Wash your hands.

Step 2  Set up a finger pricker with a clean needle.

Step 3  Insert one end of a test strip (usually a long, thin paper-type strip) into the meter.

Step 4  Use the finger pricker to prick the side of your finger.

Step 5  When a spot of blood appears where you pricked you finger, place it onto the end of the testing strip that is sticking out of the meter to transfer the blood.

Step 6  After a few seconds, the meter will display your blood glucose level.

Step 7  Clean the blood off your finger.

Step 8  Record the results in your blood glucose diary or diabetes journal, or you may have a phone app that you use.

Step 9  Throw away the test strip.

Step 10 Dispose of the needle from the finger pricker safely, by putting it in your sharps bin.

Your blood glucose level is measured in millimoles per litre (mmol/L), but you don’t need to worry about that – just about the numbers.

"The first week when I was recording my blood sugars, the dietician said ‘Once we’ve seen your results, we can go through what you’re doing right and wrong’. It turned out I was eating too much fruit and yoghurt with my lunch." Gemma, mum of one

When should I measure my blood glucose?

Throughout the rest of your pregnancy, you will need to measure your blood glucose levels at various points through the day, to check that they are within the limits you have been given at each of those times:

When you get up  You need to measure your blood glucose levels each morning when you get up, before you have anything to eat or drink. This blood glucose level is called your ‘fasting blood glucose level’ because you will have an empty stomach. You must not have eaten or drunk anything apart from water overnight, for at least eight hours.

Your team should have discussed this with you and agreed the ideal morning blood glucose level for you to aim for. 

Before or after every meal  You will probably be asked to measure your blood glucose level around the time of a meal. Some services measure before eating (‘pre-prandial monitoring’) while others measure one or two hours after a meal (‘postprandial monitoring’).

Again, you will have discussed and agreed an ideal blood glucose level after meals with your diabetes team. These levels will be higher than your fasting blood glucose levels, as you will just have eaten.

If you are taking insulin to help to control your blood glucose levels, you may need to do a separate test before you go to bed, or even during the night, although this is unusual.

"When we did go out for a special meal or two, and I'd have a little bit of cheesecake or something, it really affected my sugar levels. But that would've been just twice in the whole pregnancy." Gemma, mum of one

How do I interpret the results?

Your blood glucose levels tell you if your gestational diabetes is under control.

The blood glucose levels before breakfast and after meals should be within the ideal levels that you have discussed and agreed with your diabetes team. If they are not, you should have been given instructions about what to do next. If you are not sure about this, get in touch with your main point of contact, and ask for their advice.

Read about the risks of low blood glucose (‘hypoglycaemia’) and what to do about it.

You will have contact with your diabetes team every one-to-two weeks through your pregnancy, either by phone or in person. They are there to give you advice and support, including keeping an eye on your blood glucose levels and advising you what to do if they are not at the ideal levels. You may also have a number to call if you have questions in between those times. You can also get support from the Diabetes UK Careline 0345 123 2399 or the Tommy’s midwives on 0800 0147 800.

Gestational Diabetes Information

Gestational diabetes is when high blood sugar levels arise during pregnancy, then typically disappear after pregnancy. Gestational diabetes, which affects about 7 percent of all pregnant women, usually appears around the 24th week of pregnancy, when the placenta begins producing large quantities of hormones that cause insulin resistance.

Diabetes Management Program, Newton-Wellesley Hospital
2014 Washington Street – 3 South
Newton, MA 02462
Phone: 617-243-6144 

Who is at Risk?

You may be at greater risk for gestational diabetes if you:

• Are obese
• Are over the age of 30
• Have a family history of diabetes

Potential Concerns for the Mother and Baby

If you have gestational diabetes, your baby can have an increased risk of:

• Large birth weight
• Hypoglycemia, or low blood sugar
• Jaundice

In addition, you can have an increased risk of:

• Preeclampsia, or high blood pressure during pregnancy
• Urinary tract infections

The development of ketones, substances that the body produces when it breaks down fat for energy, also can affect your baby. Ketones cross the placenta and enter the baby’s bloodstream, which may happen when your diet is low in carbohydrates or if your body cannot use glucose properly. You will need to check your urine every morning during pregnancy for the presence of ketones.

Treatment

Do not skip meals or decrease calories. East three meals and three snacks a day, as outlined by your dietitian. If you have moderate or large amounts of ketones for two mornings in a row, call your diabetes nurse educator or dietician — you probably need more calories.

Blood Glucose Testing

Below are guidelines to follow when testing your blood sugar levels:

• Fasting: A blood sugar between 95 and 100 mg/dl
• If you are on insulin: The fasting blood sugar should be between 85 and 92 mg/dl
• One hour after finishing a meal: A blood sugar of less than 130 mg/dl 

Check your blood sugar when fasting and one hour after every meal. Call your doctor or diabetes nurse educator if your blood sugar is above 100 in the morning or above 130 one hour after meals for two days in a row. An endocrinologist may need to evaluate you  to see if you need insulin.

Follow-Up

• In 98 percent of women with gestational diabetes, the diabetes goes away after delivery.
• Checkups are important. Fifty percent of women with gestational diabetes risk developing diabetes in later years. This risk increases to 70 percent if you are obese.
• You should get your blood sugar checked once a year when you see your primary care physician.
• You must be monitored closely if you plan on becoming pregnant again.
• Staying active and at a healthy weight are the most important tools to prevent diabetes.

Your Regular Schedule

To continuously ensure you are successfully managing your gestational diabetes:

• Check urine ketones every morning before breakfast: If ketones are moderate or high for two mornings in a row, call your diabetes nurse educator or dietitian.
• Test your blood sugar four times a day: Before breakfast and one hour after breakfast, lunch, and dinner.