
Managing gestational diabetes often feels like walking a tightrope, and fasting blood sugars are often the trickiest part of that balance.
Despite adjusting your diet, medications, and routines, those morning numbers may stay stubbornly elevated.
If you’re feeling frustrated or discouraged, know that you’re not alone—and it’s not your fault!
Today we're talking about why this happens, what it may mean for your pregnancy, and what steps you can take to address it with your healthcare provider.
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Our mission is to help you maintain healthy blood sugar levels and make informed choices for your health and your baby’s well-being.
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Now back to it...
Why Are Fasting Blood Sugars So Hard to Control?
Fasting blood sugars reflect how your body manages blood sugar during long periods without food, such as overnight.
This is influenced by several factors, especially during pregnancy:
Your Body’s Built-In “Thermostat” for Blood Sugar
For some mamas, the body behaves like a thermostat set at a specific temperature—it likes fasting blood sugars at a certain level and does everything it can to keep them there, even with increasing medications.
Your body’s regulatory systems are influenced by a combination of hormones, genetics, and how your liver produces and stores glucose. For some mamas, their bodies “decide” on a fasting blood sugar level and may resist changes, even with aggressive insulin therapy or other medications.
It’s important to remember that this isn’t something you can always control!
Your body’s physiology is doing what it thinks is its job to support your baby’s growth, even if it creates a frustrating situation for you.
The Role of Hormones
Pregnancy hormones are another major reason fasting blood sugars are so difficult to control. These hormones, including human placental lactogen (hPL), progesterone, and cortisol, naturally increase insulin resistance as your pregnancy progresses and affect fasting blood sugars.
The Liver
During fasting periods, the liver releases glucose into your bloodstream to provide energy. In pregnancy, this process is amplified to ensure both you and your baby have enough fuel. However, for some mamas, this natural process keeps fasting blood sugars elevated, even with medication adjustments.
Individual Variations
Remember, every pregnancy and body is different. Factors like your genetics, placenta, and how your body responds to insulin all play a role. This means some people may have more difficulty managing fasting blood sugars than others, even when following all the recommendations.
Why Stressing About It Can Make Things Worse
It’s completely normal to feel stressed or upset when your numbers aren’t where you want them to be—but it’s important to understand that stress can actually raise your blood sugars further.
When you’re stressed, your body produces more cortisol and adrenaline—hormones that increase blood sugar levels to give you energy for a "fight or flight" response.
For someone managing gestational diabetes, this can add another layer of difficulty to controlling fasting values.
How to Manage Stress
Adopt a “What Will Be, Will Be” Mindset: I know it's easier said than done, but try to approach your fasting blood sugar with the attitude of “it is what it is.” Worrying about what the number will be when you wake up may actually make it worse.
Skip the Immediate Glance at the Meter: Instead of checking your fasting blood sugar and seeing the number right away, consider stepping away. Have your partner record the reading for you each morning and review your weekly trends together later. This can help reduce some of the anxiety and pressure tied to individual numbers.
Practice Relaxation Techniques: Try deep breathing exercises, prenatal yoga, or mindfulness meditation especially before bed.
Get Moving: Gentle evening movement, like a short walk after dinner, can help lower blood sugar and reduce stress hormones.
Lean on Support: Sharing your feelings with a loved one, a counselor, and your healthcare provider can make a big difference.
Remember, the goal is progress, not perfection. Managing stress, even in small ways, can have a positive ripple effect on your overall blood sugar management.
What Can Be Done About Persistent Fasting Blood Sugars?
If your fasting blood sugars remain elevated despite your lifestyle efforts, it’s time to talk with your healthcare provider.
Here are some options they may consider:
Frequent Insulin Adjustments
Insulin needs often increase significantly in the third trimester due to rising hormone levels.
Adjustments may need to happen weekly—or even more often—to stay ahead of these changes.
So if you notice your weekly adjustments aren't helping, consider asking your provider if you can check in more frequently than weekly to evaluate and make medication changes.
Adding Metformin
For some mamas, adding metformin alongside insulin can improve insulin sensitivity and help control fasting blood sugars. This is because metformin works differently than insulin, targeting the liver’s glucose production and improving how your body uses insulin. If you're wondering if this is good option for you, be sure to ask your healthcare provider.
Considering Earlier Delivery
In certain cases, if fasting blood sugars remain persistently elevated and difficult to control, your provider might discuss delivering your baby a little earlier. This decision is made carefully, weighing the risks and benefits for both you and your baby. If you're unsure when or how that recommendation would be made, ask your healthcare provider for clarification.
Remember, You’re Not Failing!
It’s important to understand that for some mamas, it may not be possible to achieve consistently normal fasting blood sugars before delivery, no matter how many changes are made.
Your body’s regulatory systems are incredibly complex, and some factors—like hormone levels and liver glucose production—are simply out of your control.
Fasting elevations don’t mean you’ve failed.
They’re simply a reflection of how your body is working to support your baby’s growth. What matters most is that you’re doing your best—taking your medications, managing stress, staying active, and working closely with your care team.
Reach out to your healthcare provider, lean on your support system, and remember that every step you take is helping you and your baby stay healthy.
You’ve got this, mama—and we’re here to help support you every step of the way!
Disclaimer: The information provided in this blog post is intended for general informational and educational purposes only. It is not intended to replace or
substitute professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider with any questions you may have regarding a medical condition or your health. Never disregard professional medical advice or delay seeking it because of something you have read in this blog. GDMamas, LLC assumes no liability for inaccuracies, errors, or omissions in the information presented.
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