Gestational Diabetes Treatment in Singapore

Gestational diabetes develops during pregnancy when blood sugar levels rise if the mother’s pancreas is unable to handle the increased insulin demands during pregnancy. This condition typically emerges between weeks 24 and 28 and affects approximately 2–10% of pregnancies each year. While it usually resolves after childbirth, proper management is necessary to minimise complications for both mother and baby during pregnancy and delivery.

Dr Ben Ng

Senior Consultant Endocrinologist

Dr Donovan Tay

Senior Consultant Endocrinologist

Symptoms of Gestational Diabetes

Gestational diabetes symptoms may develop gradually or go unnoticed, making routine glucose screening a necessary part of prenatal care. In Singapore, women are routinely checked for gestation of diabetes, typically in the 2nd trimester. When present, symptoms may include:

Increased Thirst

Excess glucose in the bloodstream draws water from tissues, leading to dehydration and persistent thirst.
Frequent Urination

The kidneys work harder to filter and remove excess glucose, increasing urination frequency.
Fatigue

When the body cannot use glucose efficiently for energy, it can lead to persistent tiredness and a lack of energy.
Blurred Vision

Elevated blood sugar levels can cause temporary swelling of the eye’s lens, leading to difficulty focusing and fluctuations in vision clarity.
Nausea

Changes in blood sugar levels, particularly fluctuations between high and low glucose, may contribute to nausea, especially in the morning.

Causes and Risk Factors

Several factors influence the likelihood of developing gestational diabetes, with some women at higher risk than others.

Age Over 25

Women over the age of 25 have a higher risk of developing gestational diabetes due to changes in insulin sensitivity and metabolism. The risk increases further with age.
Family History of Diabetes

A family history of type 2 diabetes, particularly in first-degree relatives such as parents or siblings, raises the risk of developing gestational diabetes.
Higher Body Mass Index (BMI)

A pre-pregnancy BMI of 30 or higher is linked to an increased risk of gestational diabetes. Higher body fat levels can contribute to insulin resistance, making it more difficult for the body to regulate blood sugar levels effectively.
Previous Gestational Diabetes

Women who have had gestational diabetes in a previous pregnancy have a higher chance of developing the condition again in future pregnancies.
Multiple Pregnancy

Carrying twins or triplets leads to more significant hormonal changes, which can make the body less responsive to insulin and increase the likelihood of developing gestational diabetes.

Diagnostic Methods

Screening for gestational diabetes is typically conducted between weeks 24 and 28 of pregnancy, though earlier testing may be recommended for those at higher risk.

Oral Glucose Tolerance Test (OGTT): In Singapore, all pregnant women will be offered screening for GDM with an oral glucose tolerance test. If the glucose challenge test indicates high blood sugar levels, an OGTT provides a more detailed assessment. This test requires fasting overnight before consuming a glucose solution. Blood sugar levels are then measured multiple times over a few hours to assess how the body processes glucose over time.

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Management and Treatment

Managing gestational diabetes requires maintaining stable blood sugar levels through personalised treatment, including dietary adjustments, regular monitoring, and, if necessary, medication.

Capillary (Finger Prick) Blood Sugar Monitoring

Routine blood sugar checks help assess glucose patterns and make necessary adjustments to diet, activity levels, or medication. Testing frequency may vary based on glucose trends, but it often includes fasting glucose levels and post-meal readings.

Continuous Blood Sugar Monitoring

For women diagnosed with gestational diabetes, regular blood sugar monitoring at home helps track glucose levels and assess how well dietary changes, physical activity, and medications (if needed) are working. Testing is typically done first thing in the morning (fasting glucose) and after meals.

Dietary Modifications

A well-balanced diet helps regulate blood sugar levels. Meal plans focus on a balanced intake of carbohydrates, proteins, and fats, with evenly spaced meals to prevent spikes. Lower glycaemic index foods, such as whole grains, legumes, and non-starchy vegetables, are preferred over refined carbohydrates, while reducing sugary foods and drinks helps stabilise glucose levels.

Physical Activity

Moderate exercise improves insulin sensitivity and helps regulate blood sugar. Walking, swimming, or prenatal yoga can be included in daily routines, with intensity adjusted based on individual health and medical guidance. Even short periods of movement support better glucose control.

Medication

If blood sugar levels cannot be managed through diet and exercise alone, medication may be required. Insulin is the standard treatment to regulate glucose levels during pregnancy, with dosage adjusted based on individual needs. In some cases, oral medications may be considered under medical supervision.

Postpartum Care and Long-Term Management

Gestational diabetes typically resolves after childbirth, but it increases the risk of developing type 2 diabetes in the future. Maintaining a balanced diet, engaging in regular physical activity, and managing weight can help regulate blood sugar levels and reduce long-term risks. A follow-up glucose test at 6–12 weeks postpartum confirms whether blood sugar levels have returned to normal, and ongoing screening in the following years helps detect any changes early.

For future pregnancies, maintaining healthy lifestyle habits before conception may lower the risk of gestational diabetes recurrence.

Frequently Asked Questions

Will gestational diabetes affect my baby after birth?

When blood sugar levels are well controlled during pregnancy, most babies are born with normal glucose levels. However, babies born to mothers with gestational diabetes may have a higher risk of developing obesity and type 2 diabetes later in life.

Can I breastfeed with gestational diabetes?

Yes, breastfeeding is encouraged for mothers who have gestational diabetes. It can help regulate the mother’s blood sugar levels postpartum and may lower the baby’s risk of developing diabetes in the future.

How soon after delivery does gestational diabetes resolve?

In most cases, blood sugar levels return to normal within 24–72 hours after childbirth. A follow-up glucose test at 6–12 weeks postpartum confirms whether blood sugar regulation has returned to pre-pregnancy levels.

Dr Ben Ng

Senior Consultant Endocrinologist

As a senior consultant endocrinologist with over 20 years of clinical experience, Dr Ben Ng provides comprehensive care for patients managing various endocrine conditions. His expertise includes the diagnosis and treatment of diabetes, thyroid disorders, obesity, and a range of other metabolic and endocrine conditions.

Dr Ben Ng Jen Min graduated from the Queens University of Belfast Northern Ireland, United Kingdom (UK).
He completed his postgraduate training with the certificate of completion of training (CCT) from the Royal College of Physicians (UK) with dual accreditation in diabetes and endocrinology and in general internal medicine.
In 2010, he was awarded an MD with honours by the University of Hull, UK, in recognition for his research in diabetes mellitus

Dr Donovan Tay

Senior Consultant Endocrinologist

As a senior consultant endocrinologist with over 20 years of clinical experience, Dr. Donovan Tay provides comprehensive care for patients managing various endocrine conditions. His expertise includes the diagnosis and treatment of diabetes, thyroid disorders, osteoporosis, and a range of other metabolic and endocrine conditions.

Dr. Donovan Tay graduated from the National University of Singapore (NUS) and obtained his membership in the Royal College of Physicians (UK), Master of Medicine (NUS), and Master of Clinical Investigation (NUS).
After completing training in endocrinology, he was conferred as a Fellow of the Academy of Medicine, Singapore (FAMS).
He further specialised in endocrinology with a fellowship at the prestigious Columbia University Medical Centre in New York City.

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