Blood Sugar Management Tips for GDM

Blood Sugar Management During GDM 

(This is the text from the video shown above.)

Let’s talk about your blood sugar levels before, during, and after exercise. It is important to check your blood sugar levels before an exercise session, such as a 30 minute walk or a 15 minute stationary bike ride. We don’t want sugar levels to be either too low or too high before we exercise. If it has been 2 or more hours since your last meal or snack, it is particularly important to check your blood sugar levels before exercising. It is especially important if you use insulin or other blood sugar lowering medication.

If your blood sugar levels are 3.6 mmol/l or lower… you are hypoglycemic and need a fast source of sugar. Treat yourself for hypoglycemia and don’t exercise right now. Take 15 grams of carbohydrate in the form of glucose tablets. If you don’t have these, take 2/3 cup of juice or 1 tablespoon of sugar dissolved in water. Wait 15 minutes and check your sugar again. If it is still 3.6 or less, take another 15 grams of carbohydrate. Keep repeating these steps until your blood sugar levels come up to 4 or more. You may need to discuss how to prevent sugar lows with your doctor if this happens regularly. Your medications may need to be adjusted. If you take insulin, you may need to consistently lower your insulin dose that you take for the meal before you exercise. For example, if you exercise in the afternoon, you may have to lower your lunch time insulin dose. Speak with your doctor to have a clear understanding of your insulin dose and when you should be taking this.

If your levels are 3.7 to 4.9 mmol/l before exercising… have a snack that includes 15 grams of carbohydrate. This could be a fruit with a bit of cheese. It could be a slice of whole grain bread with peanut butter. It could be 2/3 cup of yogurt. Why? During exercise, your body will use your blood sugar and your sugar may dip too low if you are low when you start to exercise. Wait at least 15 minutes after the snack and check your blood sugar levels again to make sure your sugar level is 5 or more before you start. You want to then check your blood sugar levels after your session as well or even during the session if you feel like your blood sugar levels are low.

Symptoms for low blood sugar levels include:

• Feeling shakiness
• Anxiety
• Trembling
• Nausea
• Weakness
• Sweating excessively
• Irregular heartbeat
• Feeling as though you cannot concentrate.

If your sugar levels are 4 mmol/L or less after exercise, make sure you have a snack.

If your sugar levels are between 5 and 10 mmol/l before your exercise, go ahead and exercise if you feel well.

If your sugar levels before you start to exercise are higher than 10 mmol/l… you may exercise if you feel okay but check your sugar level again 10 minutes into exercising. If your sugar level is still at 10, or even higher, stop exercising. Wait until your sugar levels are under better control. You may have to speak with your healthcare provider if you find that your sugar values are often high.

If you are between 5 and 10, you may continue exercising.

When should you check your blood sugar?
When you are just adding movement into your day, such as taking the stairs instead of the elevator or taking a standing break at work, you do not need to check your blood sugar levels. However if you are going for a planned walk for at least 15 to 20 minutes or more, or any other continuous exercise then you need to check your blood sugars both before and after your activity, and during exercise if you start to feel like levels are low.

While you exercise, it is possible your sugars will go down so you should be aware of any symptoms that signal this. Again, symptoms for low blood sugar levels include feeling shakiness, anxiety, trembling, nausea, weakness, sweating excessively, having an irregular heartbeat and feeling as though you cannot concentrate. Some of these symptoms are actually normal during pregnancy such as feeling tired or nausea, but this is why it is important to check your blood sugar levels both before and after your exercise session.

Precautions
It may be a good idea while you exercise to have a juice box nearby or the dextrose tablets your health provider has given you. It is important to only have the juice if you require a rapid dose of sugar, otherwise continue to stay hydrated during your exercises by drinking water. You should have 8-10 cups of water throughout your day, but certainly can have more as you need it. Especially when you exercise, take a water bottle with you.

If you are using insulin during your pregnancy, please avoid injecting in a muscle group that you are exercising. It is also important not to exercise during the peak insulin time point. You can ask your health care provider when that is for you based on your insulin prescription. This is because exercise can make your body more sensitive to insulin, or in other words give you an insulin boost. You may also notice that once you become active you often have lower blood sugar levels. This could mean your insulin dose needs to change. You should let your healthcare provider know right away.