What Is Gestational Diabetes?

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Gestational diabetes occurs when you develop high blood sugar levels during pregnancy. Thanks to some hormonal disruptions that interfere with your body's use of insulin, the sugar remains in your bloodstream, rather than being used for energy.

Usually, gestational diabetes goes away after you deliver your baby, but it does raise your risk of developing type 2 diabetes later in life. We consulted some experts to find out more about this condition and how you can effectively manage it while you anticipate the birth of your baby. 

Causes of Gestational Diabetes

When you become pregnant, your body begins producing hormones to support your pregnancy, and you gradually put on weight. As a result, your body needs extra insulin, a hormone produced in your pancreas, to be able to use the glucose in your food for energy.

But pregnant people usually develop some insulin resistance—that is, their cells don’t use insulin as effectively as they usually would, which means they need even more insulin. Some people are able to produce the necessary insulin to overcome this resistance, but others can’t produce enough to meet the demand. As a result, they may develop gestational diabetes.  

It's important to note that some folks already have diabetes before they get pregnant, but that's considered pre-existing diabetes, not gestational diabetes. 

Risk Factors for Developing Gestational Diabetes

The Centers for Disease Control and Prevention (CDC) estimates that somewhere between 2% and 10% of pregnancies are affected by gestational diabetes. 

“It’s very common,” notes Amy Banulis, MD, an OB/GYN for Kaiser Permanente in Falls Church, Virginia. “This is something that I talk to all of my patients about.”

But certain factors can raise your risk for developing this condition. You’re at greater risk if you:

  • Are overweight
  • Are over age 25
  • Had gestational diabetes during an earlier pregnancy
  • Gave birth to a baby who weighed more than nine pounds
  • Have a family history of type 2 diabetes
  • Have polycystic ovary syndrome (PCOS)

Additionally, people who are African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or a Pacific Islander are at greater risk.

In the U.S., universal prenatal screening is performed via blood testing between 24 and 28 weeks of gestation.

Symptoms of Gestational Diabetes

Unlike some other conditions that develop during pregnancy, gestational diabetes can be silent. That is, sometimes there aren’t any symptoms at all. When symptoms are present, they’re often mild, like increased thirst or the urge to urinate more often—both of which aren’t unusual during pregnancy anyway.

When your body is unable to make and use insulin effectively in pregnancy, it is called gestational diabetes. When you don't have that ability to use insulin, you cannot properly maintain normal glucose levels in your blood.

How Is Gestational Diabetes Diagnosed?

Testing for gestational diabetes typically occurs between weeks 24 and 28 of pregnancy. Don’t miss this appointment, because it’s vital to be screened, notes Dr. Banulis. “We can only identify people with risk factors about 50% of the time, so even my young, healthy, physically active, normal body weight patients need to be screened, because there is still a chance of having gestational diabetes,” she says. 

That said, your doctor might suggest a test as early as your first prenatal visit. “If there are risk factors of concern, you will have blood sugar testing early in your pregnancy,” adds Monte Swarup, MD, an OB/GYN and founder of HPV information site HPV HUB. 

Glucose Challenge Test

The first step is the blood glucose screening test, or glucose challenge test, that all pregnant people receive between 24 and 28 weeks. You will have to drink a super-sweet beverage containing glucose. An hour later, a nurse will draw a blood sample to measure your blood glucose level. If your blood glucose level is below 140, you’re in the clear. But if it hits or exceeds the 140 mark, your doctor will likely recommend a second test. 

Glucose Tolerance Test

That second screening is called a glucose tolerance test (GTT). The glucose tolerance is a more comprehensive—and longer—test than the glucose challenge test. First, you’ll need to fast for eight hours beforehand. Then you’ll drink another one of those extra-sugary drinks, but this time, you’ll undergo multiple blood draws over the course of three hours in order to determine if a diagnosis should be made.

Risks Associated With Gestational Diabetes

Gestational diabetes is associated with some potential risks to you and your baby. Here’s a look at what you need to know. 

Risks for the Birthing Parent

Having gestational diabetes increases your risk for developing type 2 diabetes later in life. In fact, the CDC estimates that 50% of people who have gestational diabetes eventually develop type 2 diabetes.

Other possible complications that can occur during labor and childbirth include:

  • Greater risk of needing a C-section
  • Severe tears to the vagina or perineum during a vaginal birth
  • Preeclampsia
  • Hypoglycemia

Risks for Baby

Your gestational diabetes can also pose some risk to your baby. Your baby is more likely to:

  • Weigh nine pounds or more, which can make delivery more challenging
  • Be born early and experience breathing difficulties
  • Have low blood sugar, or hypoglycemia
  • Develop type 2 diabetes later life.

There’s also an increased risk for stillbirth with babies born to people with gestational diabetes.

Treatment for Gestational Diabetes

You might not necessarily need to see your doctor in person more often, says Dr. Banulis. But you will have to carefully monitor your blood sugar levels for the remainder of your pregnancy—and a nurse may contact you weekly to make sure you’re staying on track. 

For many pregnant people with gestational diabetes, a healthy diet and regular exercise can keep their blood sugar levels under control. But others may need medication, which is typically a series of insulin injections—or in some cases, oral medication.

If you have trouble managing your blood sugar levels, you may need to speak to your physician about making adjustments. The earlier you can get control, the better your outcomes, according to a recent study for JAMA Network Open.

While you may no longer need to track your blood sugar levels on a daily basis and take any medication after delivery, don’t forget that you are still at elevated risk for developing type 2 diabetes later on. “It’s recommended that you have your blood tested six to 12 weeks after giving birth,” says Dr. Swarup. 

Depending on the results, your doctor may encourage you to undergo regular screenings afterward. Dr. Banulis usually requests that her patients undergo a follow-up glucose challenge test during their first postpartum visit, about four to eight weeks after delivery. “If that’s normal, and for the vast majority of women, it will be, we then recommend lifetime annual screenings,” she says. 

According to the CDC, people who had gestational diabetes should remind their doctors to check their blood sugar levels every one to three years.

Can You Prevent Gestational Diabetes?

You can’t change certain risk factors, like your family history, but you can try to reduce your chances of developing gestational diabetes. However, it may take a little advance planning. 

The CDC suggests losing some weight before you conceive if you’re already overweight, as well as logging regular physical activity. Research suggests that 30 minutes of walking, swimming, or cycling three or four days a week may be enough to have a positive impact on your blood sugar levels. Changing your diet may help, too—but only if you’re already overweight or obese.

According to Dr. Banulis, those healthy habits may help you even after you deliver your baby, too. 

Coping Strategies

Coping with a new diagnosis during pregnancy can be challenging. But learning about the best ways to manage your blood sugar levels and then diligently incorporating these tactics into your life may give you a better sense of control over the situation. Some key steps to take:

  • Eat a healthy diet.
  • Eat regularly to avoid big dips and spikes in your blood sugar levels.
  • Check and record your blood sugar levels as recommended.
  • Take your insulin or other prescribed medications as needed.
  • Exercise regularly as recommended by your healthcare provider.

You might find other coping strategies that help you manage. Consider these strategies:

  • Keep a journal. Some pregnant people like to track their food intake, their physical activity, and their blood sugar levels in a journal so they can get a better sense of how their body is responding. 
  • Talk it out. Find a trusted friend or a counselor in whom you can confide about your feelings.
  • Don’t blame yourself. You didn’t bring this diagnosis upon yourself. 
  • Find a support network. An online or in-person support group can be a great way to share your concerns, collect some useful ideas, and maybe even make a few new friends. 

A Word From Verywell

Many people who develop gestational diabetes are able to successfully manage their condition and go on to deliver perfectly healthy babies. You can be one of them, too. Talk to your healthcare provider about any concerns or questions that you have. No question is too small, especially since you’re grappling with some changes to your daily routine as you work to stay on top of your blood sugar levels and prepare for the birth of your baby.

10 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American College of Obstetricians and Gynecologists. Gestational diabetes: Frequent questions.

  2. Centers for Disease Control and Prevention. Diabetes during pregnancy.

  3. Centers for Disease Control and Prevention. Gestational Diabetes.

  4. Centers for Disease Control and Prevention. Diabetes Risk Factors.

  5. Centers for Disease Control and Prevention. Diabetes Risk Factors.

  6. National Institute of Diabetes and Digestive and Kidney Diseases. Tests & Diagnosis for Gestational Diabetes.

  7. Centers for Disease Control and Prevention. Diabetes Tests.

  8. Chehab RF, Ferrara A, Greenberg MB, Ngo AL, Feng J, Zhu Y. Glycemic control trajectories and risk of perinatal complications among individuals with gestational diabetes. JAMA Netw Open. 2022;5(9):e2233955-e2233955. doi:10.1001/jamanetworkopen.2022.33955

  9. Centers for Disease Control and Prevention. Gestational diabetes and pregnancy.

  10. InformedHealth.org. What can help prevent gestational diabetes?

Additional Reading

By Jennifer Larson
Jennifer Larson is a seasoned journalist who regularly writes about hard-hitting issues like Covid-19 and the nation's ongoing mental health crisis, as well as healthy lifestyle issues like nutrition and exercise. She has more than 20 years' of professional experience and hopes to log many more.

Originally written by Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.
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