Gestational Diabetes

What Is Gestational Diabetes?

Gestational diabetes is a form of diabetes that develops during pregnancy. It occurs when your body can’t make enough insulin—a hormone that helps regulate blood sugar—to meet the increased needs of pregnancy. As a result, blood sugar levels rise, which can affect both mother and baby.

Gestational diabetes typically appears in the second or third trimester and usually goes away after childbirth. People who have experienced gestational diabetes have an increased risk of developing type 2 diabetes later in life.

Who Is Affected?

Gestational diabetes affects 2% to 10% of pregnancies in the U.S. each year. Any pregnant woman can develop it, but some are at higher risk due to genetic or lifestyle factors.

What Causes Gestational Diabetes?

During pregnancy, hormonal changes from the placenta make it harder for insulin to work—this is called insulin resistance. In some women, the pancreas can’t produce enough insulin to keep up, leading to elevated blood sugar levels and gestational diabetes.

Risk Factors

Not Controllable

• Age 25 or older
• Family history of type 2 diabetes
• Being of certain ethnicities (African American, Hispanic/Latino, Native American, Asian American, Pacific Islander)
• Having had gestational diabetes in a previous pregnancy
• Polycystic ovary syndrome (PCOS)
  
  

Controllable

• Being overweight or obese before pregnancy
• Lack of physical activity
• Unhealthy eating habits
• Excessive weight gain during pregnancy
  
  

Who Is Most at Risk?

You’re more likely to develop gestational diabetes if you:

• Are over age 25
• Have a BMI over 25
• Have a close relative with diabetes
• Had a baby weighing more than 9 pounds in a previous pregnancy
• Had gestational diabetes before
  
  

How to Reduce Your Risk

To reduce your risk:

• Eat a healthy, balanced diet
• Exercise regularly before and during pregnancy (with your doctor’s approval)
• Achieve a healthy weight before pregnancy
• Attend all prenatal visits and screenings

What Are the Signs and Symptoms?

Many women don’t notice any signs or symptoms of gestational diabetes, which is why screening is essential. If symptoms do occur, they may include:

• Increased thirst
• Frequent urination
• Fatigue
• Blurred vision
• Nausea

How Is Gestational Diabetes Diagnosed?

Gestational diabetes is usually diagnosed between 24 and 28 weeks of pregnancy through routine screening. Women at high risk may be tested earlier.

Common Diagnostic Tests

• Glucose Challenge Test (GCT): You drink a sugary solution and have your blood sugar checked after one hour. If it’s elevated, you’ll move on to the next test.
• Oral Glucose Tolerance Test (OGTT): This measures your blood sugar after fasting, and then one, two, and sometimes three hours after drinking a sugary drink.

How Is Gestational Diabetes Treated?

The goal is to keep blood sugar within a healthy range to protect both mother and baby.

Lifestyle Changes

• Healthy diet: Emphasize whole grains, vegetables, lean proteins, and healthy fats while limiting sugar and refined carbs.
• Regular physical activity: Walking or prenatal-safe exercises can help lower blood sugar.
• Weight management: Following healthy weight gain guidelines during pregnancy is crucial.
  
  

Devices

• Home glucose monitors: Used to track your blood sugar multiple times per day.
• Continuous glucose monitors (CGMs): May be recommended for women with higher risk or insulin use.
  
  

Medical Treatment

• If lifestyle changes aren’t enough, insulin injections may be prescribed.
• In some cases, oral medications like metformin may be used under medical supervision.
  
  

Surgical Treatment

• Surgery is not used to treat gestational diabetes.
  
  

Other Support

• Nutrition counseling with a registered dietitian
• Diabetes education and self-management programs
• Emotional and mental health support, if needed

When to Seek Care

Signs That Require Medical Attention

• Excessive thirst or urination
• Noticeably elevated blood sugar levels on your monitor
• Baby moving less than usual
• Vision changes, headaches, or swelling (signs of pre-eclampsia)
  
  

When to Call 911

Call 911 immediately if you experience:

• Sudden difficulty breathing
• Chest pain or extreme dizziness
• Seizures or loss of consciousness These symptoms may suggest a medical emergency such as severe pre-eclampsia or diabetic complications.

Concerned You May Have Gestational Diabetes?

If you are concerned that you or a loved one may have gestational diabetes, the best thing to do is speak with your OB/GYN about your concerns. They can order the required testing and identify any other issues that may be occurring.

If You Have Been Diagnosed Gestational Diabetes

If you have been diagnosed with gestational diabetes, it is important to manage your blood sugar levels to protect the health of you and your baby.

• Develop a personalized management plan with the help of your OB/GYN and diabetes educator. Learn how to track and manage blood sugar, take medication if needed, and respond to changes in glucose levels.
• Meet with your healthcare provider regularly to ensure your disease is well managed.
• Explore diabetes education and self-management resources.
• Schedule follow up care with your primary care provider after delivery as gestational diabetes may increase your risk of developing certain conditions later in life, including type 2 diabetes and other cardiovascular conditions.