Most GDM Needs No Medicine
Reviewed by CDE Mehandi Sharma · Updated
The first treatment for GDM is not a drug. It is a healthy eating plan and being physically active, with daily blood glucose testing to see whether it is working.
For a great many women that is the whole treatment, right through to delivery.
What it consists of in practice: carbohydrate spread across the day rather than concentrated in one or two large meals, meals built with enough protein and vegetables to slow the glucose rise, some movement after eating, and readings recorded so the plan can be adjusted from evidence.
The reason this works is that the problem is a mismatch between how much insulin your pancreas can produce and how much the pregnancy demands. Reducing the size of each glucose load reduces the demand.
Two honest caveats. First, it does not always work, and when it does not, that is the physiology rather than your effort — the placenta's hormone output rises whatever you eat. Second, this is not a weight-loss diet. Eating too little in pregnancy carries its own risks, and the goal is steadier glucose, not fewer calories.
If your readings stay above target despite a genuine attempt, medication is added rather than the diet being tightened indefinitely.