Diagnosed with Gestational Diabetes? Here’s What's Going To Happen Next

What You Can Expect Step by Step

I just had my second child. While some women absolutely love being pregnant, I am not one of those women. It’s not that I find pregnancy to be particularly difficult, but I am short and there is nowhere for things to go but out – in every direction, and it feels less like my body and more like what I imagine a sausage feels like on the inside. With my first, I gained a lot of weight, so with my second, I was focused on preventing that from happening. I was eating healthy and walking a lot, so it was a big surprise when after the routine blood sugar exam, I found out I had Gestational Diabetes. 

Diabetes is the body’s inability to produce and/or process insulin, a hormone that helps to maintain normal sugar levels in the body. Gestational Diabetes is when the hormones of pregnancy tamper with the body’s insulin capabilities. If untreated, Gestational Diabetes poses some risks to the baby, most commonly being born larger, which can affect both the delivery as well as lead to a Diabetes diagnosis for the baby as well. It also poses risks for the mom, if ignored or untreated.

I don’t know how other OB/GYNs are when it comes to their patients being diagnosed with stuff, but mine was, to put it mildly, not in a hurry.  There was a 3-week lag between finding out I had Gestational Diabetes and starting treatment, plenty of time for the internet to work its magic and illuminate worst-case scenarios. In my research, I was getting a whole lot of scary and not a lot of “here’s how to proceed.” So, I created a step by step list for women who are suddenly faced with the daunting diagnosis of Gestational Diabetes: 

Second Blood Sugar Test:

If you “fail” the routine blood sugar test, the next step is having another fasting blood sugar test. Cue that super sweet liquid again, but this time sweeter and more of it. You will also have to wait at the lab for 3 hours and have your blood drawn thrice, at the hour mark. This test will verify your results. Having been diagnosed during Covid-19, I had mine done at a lab outside the hospital, and had to wait in my car and go back and forth between blood letting sessions. If this happens to you, make sure you download some shows and dress for the weather. You cannot drink water until after the test is complete.

Referral to Endocrinologist:

Endocrinologists specialize in hormonal disorders, so you will be connected with a team that consists of: a dietician, a nurse, and a doctor. Once an appointment is made you will likely attend a seminar on what Gestational Diabetes is and what the treatment modalities entail. You will need to purchase a Glucometer, with which you will poke your fingers at least 4 times a day to measure your blood sugar levels. Don’t worry it’s not painful, and you get used to it fairly quickly.

Food Log for 5-7 days:

You will receive a nutritional guide that will help you navigate a diet in which you will need to count and record your carbohydrate intake, and eat at very specific intervals of three meals and 3 snacks, I found that I ate more times in the day and more carbs at each meal than usual. You’ll have to prick your finger to measure your blood sugar first thing in the morning, and then 2 hours after every meal, this will be the key that shows you how your body reacts to different foods. After a few days, you’ll know more about which foods to avoid (on top of the obvious, refined sugar and “junk” food). The dietician will go over the log with you and help you tweak anything that might not be working.


Diagnosis by Endocrinologist and Follow-ups (for the rest of your pregnancy):

If your blood sugar levels remain high after your carb counts remain consistent, you will be prescribed insulin, which you will need to inject in the sides of your torso with a very easy “kwikpen,” that when used correctly, does not hurt. I did it wrong a few times and it hurt, and mommy used a bad word on those days. The amount of insulin and the frequency of injection will depend on your specific blood sugar counts. There is no right or wrong, your insulin needs will increase as your hormones change; I started out taking insulin just mornings, but as my pregnancy progressed, I required an injection before every meal. I felt no side-effects from the insulin, or the Diabetes for that matter. You will check in with the doctor every two weeks and you will be required to keep a record of your blood sugar levels, as well as your carb intake for the rest of your pregnancy. In addition, you will have an ultrasound every couple of weeks, to monitor the growth of your baby.
Birth protocols:

Very close to the time of delivery, the endocrinologist will provide you with directions for your birthing team. You take your insulin as usual and bring in your Glucometer. In my case the decision was to induce at 38 weeks, as my daughter was in the 75th percentile. You will be asked to measure your blood sugar levels a couple of times during early labour.

After Birth:

You and your baby will have your blood sugar levels checked a few times. You will be asked to measure your blood sugar the following morning before eating as well as after eating. A nurse will prick your baby’s’ heel, to check blood sugar, a few hours apart. My blood sugar levels were completely within a normal range immediately after birth, as were my daughters’. You will need to follow up and do a fasting blood sugar test again, around 3 months after giving birth, as the risk of developing Diabetes increases once you have it during pregnancy. 

What started out as an alarming diagnosis, followed by what seemed to be a complex treatment, turned out to be very doable. It became so easy to manage weight gain on the Diabetes “diet,” and the extra ultrasounds were very comforting as I got see my baby grow and hear that beautiful heartbeat many times before birth. My baby girl was born a couple of months ago, she is healthy and well, and I no longer feel like a sausage stuck in its’ casing – just a zombie made of Jell-O, but that is to be expected.


Keren Dacks is a writer, comedian, and mom based in Downtown Toronto, who spends most of her time narrating life out loud to her children, in funny accents. She is currently in a relationship with her dishwasher and, yes, it's complicated.