Gestational Diabetes

Gestational diabetes is diabetes that develops during pregnancy and tends to resolve after giving birth. Your provider can diagnose it with a glucose tolerance test.

Treatment includes regular glucose testing and keeping blood sugar levels in a healthy range. Gestational diabetes may put the mother and baby at higher risk for certain health conditions, but most people with gestational diabetes have a healthy pregnancy and birth.

What Is Gestational Diabetes?

Gestational diabetes develops during pregnancy, usually between 24-28 weeks. It tends to resolve on its own after birth, but could put you at higher risk of developing conditions including Type 2 diabetes later in life.

Gestational diabetes is relatively common and affects between 4-10% of pregnancies in the U.S. but is expected to grow alongside rising rates of maternal obesity in America.

Causes of Gestational Diabetes

During pregnancy, the placenta produces hormones that prevent the body from using insulin properly. This results in insulin resistance and high blood sugar.

People who are pregnant also tend to:

• Store more fat in their bodies
• Get less exercise than usual
• Consume more calories

All of these can lead to higher blood sugar levels and insulin resistance.

Symptoms of Gestational Diabetes

Gestational diabetes itself doesn’t cause any symptoms, but high blood sugar caused by gestational diabetes may cause:

• Increased urination
• Increased hunger and thirst
• Unexplained weight loss
• Blurred vision

Risk Factors for Gestational Diabetes

While anyone can develop gestational diabetes, you may be at a higher risk if you:

• Are overweight or obese
• Have a family history of diabetes
• Have African American, Native American, Asian, Hispanic or Pacific Islander heritage
• Are age 40 or older
• Have prediabetes
• Have polycystic ovary syndrome (PCOS)
• Have high blood pressure
• Had gestational diabetes in a previous pregnancy

Diagnosing Gestational Diabetes

Your provider will test for gestational diabetes at a routine prenatal care appointment, usually around 24-28 weeks gestation

Your provider may also test you for Type 2 diabetes if you’re at risk for it.

Oral Glucose Tolerance Test

To diagnose gestational diabetes, your provider will administer an oral glucose tolerance test. Your provider will draw your blood to measure your glucose. Then, you’ll drink a sugary beverage. Your provider will draw your blood and measure your blood glucose one hour after you’ve drunk the beverage.

Treatment and Management

If you’re diagnosed with gestational diabetes, you may need to attend more prenatal appointments and pay closer attention to your health leading up to the birth of your baby.

Treatment for gestational diabetes will depend on your age, symptoms and overall health. Your health care provider will create a treatment plan to keep your blood sugar levels in a healthy range.

You can’t reverse gestational diabetes, but your health care provider will test you for diabetes in the months after your baby is born.

Medical Treatments for Gestational Diabetes

Your provider will show you how to use a glucose meter at home to keep a log of your blood sugar readings.

Monitor your blood sugar levels daily to keep them in a healthy range:

• Fasting: 95 mg/dL or lower
• 1 hour after eating: 140 mg/dL or lower
• 2 hours after eating: 120 mg/dL or lower

*(Mg/dL stands for milligrams per decilitre.)

Your doctor may recommend insulin injections or oral medications to control your blood sugar.

Monitoring the Baby’s Size

Your provider may recommend more frequent ultrasounds to monitor how big your baby is growing. A big baby may have a more complicated birth, so your provider will want to start planning for that.

Diet and Nutrition for Gestational Diabetes

A registered dietitian can help you create meal plans with whole grains, lean proteins and healthy fats. You should avoid processed food and sweet drinks as much as possible.

Exercise Recommendations

Doctors recommend about 150 minutes of moderate exercise each week for people who are pregnant. Some low-impact exercise options include:

• Swimming
• Dancing
• Bicycling
• Yoga

Ask your doctor before starting a new workout regimen.

Preventing Gestational Diabetes

Many people with gestational diabetes had no risk factors, so there is no surefire way to prevent it. But eating nutritious meals, exercising regularly and making healthy choices will promote health before, during and after your pregnancy.

Exercise, eat healthy and lose extra weight before even getting pregnant. This will help your body use insulin and manage blood sugar levels to lower your chances of developing gestational diabetes.

Effects of Gestational Diabetes on the Mother

In the short-term, gestational diabetes may increase a mother’s risk for C-section and preeclampsia.

Research shows that gestational diabetes may also have long-term effects on the mother, including increased risk for:

• Type 2 diabetes
• Cardiovascular disease
• Some cancers
• Eye conditions (glaucoma, diabetic retinopathy)
• Kidney disease

Effects of Gestational Diabetes on Babies

Gestational diabetes may have short-term impacts on a baby’s health, including:

• Excessive birthweight
• Birth trauma
• Breathing problems
• Low blood sugar immediately postpartum
• Shoulder dystocia (the baby’s shoulder gets stuck during a vaginal delivery, which could lead to nerve damage in the baby)

Gestational diabetes may also increase the baby’s long-term risk for:

• Impaired glucose tolerance and type 2 diabetes
• Childhood and adulthood obesity
• Endocrine disorders
• Cardiovascular conditions
• Impaired neurodevelopment outcomes
• Eye conditions

Outlook and Prognosis

A gestational diabetes diagnosis doesn’t mean you’ll have a difficult pregnancy or that your baby will be unhealthy. Most people with gestational diabetes have healthy pregnancies and births if detected early and treated properly. Your health care team will monitor your health more closely to ensure you and your baby are as healthy as possible.