Thank you for your query.
If diagnosed with the condition, The goals of treatment are to keep fasting blood sugar
The mainstay of treatment is diet and exercise, which should be the primary aim, after which, if the sugars are not controlled, you can think of oral medications or insulin.
Most of the time, eating properly can keep your blood sugar (glucose) levels from becoming too high or too low. Eating properly can also help you avoid needing medications / insulin for further management
Your doctor and dietitian will create a diet just for you, based on:
The type of calories you need
Your weight (pregnant women who are obese may need a diet with fewer calories that other pregnant women)
How far along you are in your pregnancy
How fast and how large your baby is growing
Your activity level
Remember that "eating for two" does not mean eating twice as many calories. You usually need just 300 extra calories a day (such as a glass of milk, a banana, and 10 crackers).
In general, your diet should be moderate in fat and protein and provide controlled levels of carbohydrates through foods including fruits, vegetables, and complex carbohydrates (such as bread, cereal, pasta, and rice). You will also be asked to cut back on foods that have a lot of sugar, such as soft drinks, fruit juices, and pastries.
You will be asked to eat three small- to moderate- sized meals and one or more snacks each day. Do not skip meals and snacks. Keep the amount and types of food (carbohydrates, fats, and proteins) the same from day to day.
Your doctor, nurse, or dietitian may ask you to keep track of what you eat. Maintain a food diary.
It is important to monitor blood sugar regularly, going for atleast weekly fasting and post prandial blood sugar levels, and aiming to keep them within normal limits.
Walking is usually the easiest type of exercise, but swimming or other low-impact exercises can work just as well. Exercise is an important way to keep blood sugar in control, and physical activity in pregnancy has been found to decrease the risk of developing gestational diabetes
As she is having breathlessness on walking, she can try walking slowly instead of brisk walk. More important is the total number of calories burnt, and not the speed of walking.
If diet and exercise fail to achieve target blood sugars, then oral antidiabetic drugs / insulin maybe added later on.
Regarding the risks to your baby,
Uncontrolled gestational diabetes may be associated with an increase in the risk of intrauterine fetal death
during the last 4–8 weeks of gestation. Although uncomplicated GDM with less severe fasting hyperglycemia has not been associated with increased perinatal mortality
, GDM of any severity increases the risk of fetal macrosomia
. Neonatal hypoglycemia
, jaundice, polycythemia, and hypocalcemia may complicate GDM as well. GDM is associated with an increased frequency of maternal hypertensive disorders and the need for cesarean delivery. The latter complication may result from fetal growth disorders and/or alterations in obstetric management due to the knowledge that the mother has GDM.
Women with GDM are at increased risk for the development of diabetes, usually type 2, after pregnancy. Obesity and other factors that promote insulin resistance
appear to enhance the risk of type 2 diabetes after GDM, while markers of islet cell-directed autoimmunity are associated with an increase in the risk of type 1 diabetes
. Offspring of women with GDM are at increased risk of obesity, glucose intolerance, and diabetes in late adolescence and young adulthood.