What is Gestational Diabetes and How to Identify it?
During pregnancy, it's natural to be concerned about both your health and your baby’s. So, it’s helpful to be aware of certain conditions to watch out for, one of these being gestational diabetes. Gestational diabetes involves developing high blood sugar during pregnancy, and it can potentially affect your pregnancy and your baby’s health. Your healthcare provider will monitor for this condition, but you can also lower the risk by maintaining a healthy diet and regular exercise. If you want to learn more about diabetes in pregnancy, its risk factors, how to manage it, and the potential effects on your pregnancy, keep reading.
What Is Gestational Diabetes?
By definition, gestational diabetes mellitus (abbreviated as GDM) is a form of diabetes that affects some people during pregnancy. If you’re wondering how common gestational diabetes is, on average it affects about 2 to 10 percent of pregnancies in the United States.
Similar to other forms of diabetes mellitus, gestational diabetes affects how your body uses glucose, resulting in high blood sugar during pregnancy. Here’s how: Pregnancy hormones make it harder for the body to process sugar (glucose) because they stop insulin from doing its job of keeping blood sugar levels more stable. Usually, the body produces more insulin to counteract this, but, for some pregnant people, not enough extra insulin is produced, resulting in blood sugar levels remaining high. As a result, too much glucose remains in the blood, instead of moving to cells where it’s used up as energy.
When Does Gestational Diabetes Occur?
This condition usually occurs in the second half of pregnancy, sometimes as early as 20 weeks but usually later. This is because, as the baby grows, the placenta produces more of those hormones that stop insulin from working as it should. A modest spike in blood sugar levels after eating is normal, but if you have gestational diabetes the rise in blood sugar levels can impact the growth and development of your baby.
Generally, the standard blood sugar level an hour after eating a meal is below 140 mg/dL. However, this number may vary, so it’s always important to ask your healthcare provider what they recommend as “normal” blood sugar levels.
How Is Gestational Diabetes Diagnosed?
You may not notice any signs or symptoms of gestational diabetes. However, if you have any of the risk factors listed below, your healthcare provider will probably test for gestational diabetes at a prenatal checkup. This is commonly done using the 1-hour glucose challenge. If the results show high blood sugar levels, a diagnostic glucose test will be performed on a different day.
If you’re at a lower risk of gestational diabetes, your provider may wait and do a screening test during the second half of your pregnancy, usually between 24 weeks and 28 weeks. If you’re concerned, ask your provider for advice on what’s right for your situation.
If you have gestational diabetes, your healthcare provider may want you to have more frequent prenatal visits, particularly during the last three months of pregnancy, to check that everything is going well for both you and your baby.
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Risk Factors of Gestational Diabetes
It’s not known why certain people develop diabetes during pregnancy (and some may even have none of the following risk factors); however, common risk factors for gestational diabetes include if you
are older than 25
are physically inactive
are overweight
have high blood pressure
have a history of heart disease
have polycystic ovarian syndrome (PCOS)
have prediabetes (a precursor to type 2 diabetes), or a close family member has type 2 diabetes
had gestational diabetes during a previous pregnancy have previously delivered a baby who weighed more than 9 pounds
have had an unexplained stillbirth in a past pregnancy.
Your healthcare provider might be aware that you have some of the risk factors, but make sure you mention whether any of these factors apply to you, either before trying to get pregnant, or at your first prenatal visit.
What Are the Signs and Symptoms of Gestational Diabetes (GDM)?
Gestational diabetes generally doesn’t present with noticeable signs or symptoms, though some people may experience increased thirst and more frequent urination during pregnancy, typically in the second or third trimester. It is typically diagnosed through routine screening rather than symptoms.
If diabetes in pregnancy is not managed effectively, it can lead to complications, which we will discuss further in the section, How Can Gestational Diabetes Affect the Baby and Your Pregnancy?
What Causes Gestational Diabetes?
As we mentioned earlier, gestational diabetes arises primarily due to hormonal changes during pregnancy that interfere with insulin’s ability to regulate blood sugar. As the pregnancy progresses, the body produces more hormones that block insulin, increasing the risk of insulin resistance.
The risk factors listed above, including being overweight before your pregnancy, may increase your risk of developing gestational diabetes.
How to Treat and Manage Gestational Diabetes
What happens if you have gestational diabetes? And how do you lower your blood sugar during pregnancy? Suppose you have been diagnosed with diabetes in pregnancy. In that case, your healthcare provider will provide you with the best possible diabetes treatment and care while you’re pregnant and help you keep your blood sugar under control throughout your pregnancy.
During the last three months of pregnancy, your healthcare provider may recommend more regular prenatal checkups to monitor your health and your baby’s and to test your blood sugar levels. In some cases, your provider may recommend that you check your own blood sugar on a daily basis (possibly even several times a day). If this is the case, they’ll be able to walk you through exactly how and when to do this.
To keep your blood sugar under control, it’s recommended to follow a healthy diet, exercise regularly, and take any medication your provider may prescribe you. Some pregnant people with gestational diabetes need insulin (usually in the form of injections) to help control their blood sugar levels. Your healthcare provider will prescribe insulin if this is needed.
Right after you give birth, your healthcare provider will typically check your blood sugar levels, and again 6 to 12 weeks later (sometimes more regularly). Your provider may recommend having your blood sugar levels checked every few years thereafter.
Does Gestational Diabetes Go Away?
If you were diagnosed with gestational diabetes during your pregnancy—and you didn’t have diabetes before getting pregnant—it likely won’t be an issue after childbirth. However, there’s an increased risk of developing diabetes later in life if you had gestational diabetes.
Gestational Diabetes Self-Care
As well as the gestational diabetes treatment and advice your healthcare provider gives you while you’re pregnant, here’s what you can do to help control your blood sugar levels and reduce the chance of complications from gestational diabetes:
Follow a healthy diet. Although it’s not recommended that pregnant people lose weight, eating lots of fruit, vegetables, and whole grains may help control gestational diabetes. Eat regular meals throughout the day, but keep an eye on portion sizes. Your healthcare provider may recommend a diet designed to help control gestational diabetes and can give you information on the healthy amount of weight to gain throughout your pregnancy.
Exercise. Exercise helps lower blood sugar levels and is also good for your general health. Speak to your provider about what type of exercise is OK for you during pregnancy. Walking or prenatal yoga may be good options. If your healthcare provider gives you the OK, aim for about 30 minutes of moderate exercise a day, five days a week.
Take medication. If your healthcare provider prescribes you medication for your gestational diabetes (usually insulin in the form of injections) to help control your blood sugar levels, remember to take it at the recommended times, and monitor your blood sugar levels. It’s also helpful to keep a log of your blood sugar levels to show to your healthcare provider at each appointment.
It can be stressful and upsetting to find out you have gestational diabetes, and you probably have many questions. But keep in mind your healthcare team will be available to answer your concerns and provide the best care for you and your baby.
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How to Prevent or Avoid Gestational Diabetes
If you’re planning to get pregnant soon or you’re in the early stages of pregnancy, you may be wondering “How can I prevent gestational diabetes?” There are some practical steps you can take to help prevent gestational diabetes. Adopting healthy habits before becoming pregnant may help reduce the risk, but there are no guarantees. If you can, eat healthily, exercise regularly, and lose any excess weight well before you conceive.
How Can Gestational Diabetes Affect the Baby and Your Pregnancy?
Most pregnant people with gestational diabetes will go on to have healthy babies. However, if your gestational diabetes is untreated or not carefully controlled and monitored by your healthcare provider during pregnancy, it may lead to certain risks and complications. These are some of the possible risks and effects of gestational diabetes during pregnancy on your baby’s health and your pregnancy:
Excessive weight gain for your baby. The increased glucose in your blood means more sugar is passed on to your baby, leading to your baby becoming too large. This can cause complications or injuries at birth.
Increased risk of preterm birth. Although most people with gestational diabetes deliver full-term babies, in some cases—due to the bigger size of the baby—the healthcare provider may recommend inducing labour before the due date.
Increased risk of respiratory distress syndrome. This condition can make it more difficult for a baby to breathe, and so a baby may need assistance with breathing until their lungs develop.
Low blood sugar level (hypoglycemia)
Jaundice
Developing type 2 diabetes later in life
Being overweight or obese later in childhood.
Delivery of a large baby may often involve
Labour difficulties
Increased chance of cesarean section
Heavy bleeding after delivery
Tears in the vagina or the area between the vagina and the anus (perineum) in the case of a vaginal birth.
Gestational diabetes also increases your risk of
High blood pressure and preeclampsia (a high blood pressure disorder) during pregnancy
Type 2 diabetes. Blood sugar levels should return to normal soon after giving birth but there is a higher risk of developing type 2 diabetes later in life. Between 15 and 70 percent of pregnant people who had gestational diabetes will develop diabetes later in life. The good news is that getting to your ideal body weight after delivery lowers this risk. Of those with gestational diabetes who achieved their ideal weight after pregnancy, less than 25 percent went on to develop type 2 diabetes later in life.
Some people may have had a mild form of diabetes before becoming pregnant without realizing it. For these people, diabetes may be a lifelong condition that may not go away after giving birth.
The Bottom Line
Gestational diabetes, a form of diabetes that develops during maternity, is primarily caused by hormonal changes that affect how the body processes blood sugar. While it can pose risks for the pregnant person and baby, such as increased chances of high blood pressure and the need for cesarean delivery, managing the condition through diet, exercise, and medical oversight can lead to a healthy pregnancy and delivery. If you have been diagnosed with gestational diabetes, you should work closely with your healthcare provider to monitor and manage your blood sugar levels to ensure the best outcome for yourself and your baby.
How We Wrote This Article The information in this article is based on expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.
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