Gestational Diabetes Testing Schedule: When to Test and Targets

A typical testing day

The UK NICE guideline sets out two common schedules:

Your treatment	Test every day
Diet and exercise, tablets, or one daily dose of intermediate- or long-acting insulin	Fasting, and 1 hour after each meal
Several insulin injections a day	Fasting, before each meal, 1 hour after each meal, and at bedtime

Some clinics ask for readings 2 hours after meals instead of 1 hour. Use the timing your clinic gave you, and count from when you start eating.

Target levels

Reading	NICE	ADA
Fasting	below 5.3 mmol/L (95 mg/dL)	below 95 mg/dL (5.3 mmol/L)
1 hour after meals	below 7.8 mmol/L (140 mg/dL)	below 140 mg/dL (7.8 mmol/L)
2 hours after meals	below 6.4 mmol/L (115 mg/dL)	below 120 mg/dL (6.7 mmol/L)

NICE adds that these targets apply if they can be reached without problematic lows, and that women who take insulin should keep their levels above 4 mmol/L (72 mg/dL). Your clinic may give you slightly different numbers. Theirs are the ones to follow.

What to write down

Each reading in its column.
What you ate at each meal and snack, in a few words. Your team will look at your food alongside your numbers.
Insulin or tablet doses, if you take them.
Anything unusual: a bad night, illness, a walk after dinner.

Bring your log to every appointment. Your team uses it to decide whether diet and exercise are enough or whether you need tablets or insulin.

Tips that make it easier

Set a phone timer when you start each meal, so the after-meal check is on time.
Keep the meter, strips and log together in one bag.
Print a few weeks at a time, so you never run out of pages.
If a reading looks wrong, wash your hands with water, dry them and test again. Sugar on your fingers can give a falsely high result.

After your baby is born

For most women, gestational diabetes goes away after the birth. NICE advises:

stopping blood sugar-lowering treatment immediately after the birth;
a blood sugar check before you leave hospital care, to make sure your levels have come down;
a fasting blood test 6 to 13 weeks after the birth, or an HbA1c test if that is done later;
an HbA1c test every year after that, because gestational diabetes raises the risk of type 2 diabetes later in life.

In a future pregnancy, you will usually be offered early testing.

Not medical advice. This guide is general information. Your targets, testing times and treatment come from your doctor, diabetes nurse or clinic, who know your situation.

Make a gestational diabetes logFasting and 1 or 2 hours after meals, with room for what you ate.

Questions

Do I test 1 hour or 2 hours after meals?

Follow your clinic. NICE's standard schedule uses 1 hour after meals; some clinics use 2 hours. The targets are different for each, so check which one your clinic uses.

What does fasting mean for gestational diabetes?

The first reading of the day, after waking and before you eat or drink anything except water.

What if my readings are above target?

Write them down as they are and tell your diabetes team as they asked you to, often at your next appointment or sooner if several readings in a row are high. Do not skip meals to bring the numbers down.

Will I need to keep testing after the birth?

Usually not every day. Most women stop daily testing after the birth and have a blood test 6 to 13 weeks later, then once a year.

Gestational diabetes testing schedule