Diabetes is a condition in which your body can’t properly process and absorb the sugar (glucose) available in your food, so it builds up in your blood instead. There are several types of diabetes. Gestational diabetes is diabetes that is diagnosed for the first time during a pregnancy.
Why does gestational diabetes occur?
The exact cause of gestational diabetes isn’t known. However, we do know that gestational diabetes is related to the hormonal changes of pregnancy.
Gestational diabetes is worrying - but treatable
Like other types of diabetes, gestational diabetes leads to high blood sugar levels, which can negatively affect both you and your baby. This sounds worrying, but diet, exercise, and occasionally medication are effective ways to manage gestational diabetes. Note too that gestational diabetes often goes away a few weeks after delivery.
By working with your doctor and taking care of your health, you can expect to have a healthy and safe pregnancy.
Gestational diabetes: symptoms and risk factors
Symptoms are rare
Gestational diabetes usually doesn’t cause symptoms. This is why it is so important to get regular prenatal checkups and talk with your doctor about your risks.
If your blood sugar levels are very high, you may experience one or more of the following symptoms:
- Increased thirst and hunger.
- Increased urge to urinate, or more urination than normal.
- Blurred vision.
- Nausea and vomiting.
- Weight loss, even though you are hungrier.
Those at increased risk
While we don’t know the exact reason gestational diabetes happens, we do know that some people have an increased risk of developing it.
Risk factors for gestational diabetes include:
- Being overweight or obese when you become pregnant.
- Being pre-diabetic (having impaired glucose tolerance).
- Having gestational diabetes with a previous pregnancy.
- Having a family history of diabetes.
- Having high blood pressure.
- Having polycystic ovary syndrome (PCOS).
- Previously delivering a baby with a birth weight over 9 pounds (4.1 kilograms).
- Being African American, American Indian, Asian American, Hispanic or Latino, or Pacific Islander.
Talk with your doctor
Just because you have risk factors for gestational diabetes does not mean you have it.
However, if you are at risk, make sure to talk with your doctor and get tested.
How is gestational diabetes diagnosed?
You will likely be screened for gestational diabetes around your 24th to 28th week of pregnancy. If you are at increased risk, your doctor may recommend getting tested earlier.
Your doctor will perform one or more of the following tests to screen you for gestational diabetes.
- One-hour glucose tolerance test. You drink a special, high-sugar beverage. One hour later, your provider measures your blood sugar (glucose) levels. If your levels are higher than a certain level, this is considered an abnormal result, and you may need a second test. Generally, a blood glucose level over 190 milligrams per deciliter (m/dL) is considered abnormal.
- Three-hour glucose tolerance test. If the 1-hour test is abnormal, you will have a second glucose tolerance test. You will drink another, sweeter beverage and have your blood sugar measured every hour for three hours. If at least two of three glucose measurements are higher than normal, you have gestational diabetes.
If you are diagnosed with gestational diabetes, you should get tested for diabetes 4 to 12 weeks after your baby is born. You should also get this screening at least every 3 years for the rest of your life. This way, you can manage your risk for type 2 diabetes.
Treating gestational diabetes
Gestational diabetes is a very manageable condition. With diet and exercise, and sometimes medication, you can ensure you have a safe and happy pregnancy.
Target blood sugar levels
The American Diabetes Association recommend that your blood glucose levels are within the following ranges while you are pregnant:
- Before meals: 95 mg/dL or less
- One hour after meals: 140 mg/dL or less
- Two hours after meals: 120 mg/dL or less
To manage gestational diabetes, your doctor may recommend that you regularly check your blood glucose levels throughout the day and after meals.
You can do this with a blood glucose meter, a small device that pricks your finger to test your blood sugar. Your healthcare provider can teach you how to use this device.
Gestational diabetes medication
Diet and exercise alone may not be enough to manage gestational diabetes. If this is the case, your doctor may prescribe insulin injections or another medication to help you control your blood sugar levels.
- Insulin injections. The insulin in an insulin shot is the same hormone that your body makes naturally. It helps keep your blood sugar levels from getting too high. You will use a needle or a pen to give yourself an injection in your arm or leg. Your doctor will walk you through the process of giving yourself an injection.
- Oral medications. Your doctor may recommend an oral medication to be taken along with your insulin or as an alternative. Be sure to talk to your doctor about the potential risks and side effects of any medication.
Gestational diabetes and diet
Diet and exercise are the first line of defenses when it comes to managing gestational diabetes. With your doctor’s help, you’ll come up with a diet plan and exercise routine to help ensure a healthy pregnancy. You may also want to make an appointment with one of our registered dieticians, who can give you even more specific guidelines for managing diet during pregnancy.
When it comes to gestational diabetes, diet, and exercise, there are a few general rules to keep in mind:
- Lower your refined sugar intake. The refined sugars in cookies and sweet snacks can cause your blood sugar levels to rise rapidly. Swap these for fruits, vegetables, and high-fiber complex carbohydrates like brown rice and sweet potato
- A varied diet is a healthy diet. Try to include a variety of whole, minimally processed foods in every meal. Combine lean proteins like chicken, complex carbs like greens and whole grains, and healthy fats like olive oil for a nutrient-dense and satisfying meal.
- Don’t skip meals. Skipping meals or eating at irregular times stops you and your baby from getting the nutrients you need. It can also cause your blood sugar levels to drop too low (hypoglycemia). Instead, eat 2-3 meals at regular times of the day, and have 1-2 healthy snacks in between meals.
- Stay active. Physical activity is key to managing gestational diabetes. It helps you lower your blood sugar levels and maintain a healthy weight. Talk to your doctor about the amount of exercise that’s right for you. Often, it’s recommended to get 30 minutes of low-impact activity (like swimming or yoga) several times a week.
Weight loss is usually not the goal
Doctors do not generally recommend losing weight during pregnancy. Your body is working hard to support you and your growing baby, and gaining weight is a natural part of any pregnancy. However, you will want to work with your doctor to set healthy weight gain goals, based on how much you weighed before pregnancy.
You and your doctor will need to closely monitor your health and your baby’s health throughout your pregnancy. In addition, you will need to get screened for diabetes 6-12 weeks after your delivery to make sure your blood sugar levels have returned to normal. After that., you should get a diabetes screening every 3 years.
In all, working closely with your doctor can help ensure you have a healthy pregnancy, safe delivery, and many happy years to come.
Complications from gestational diabetes
Gestational diabetes is a very manageable condition. However, left untreated, it can have serious effects on both you and your baby.
Preeclampsia. Having gestational diabetes increases your risk of developing preeclampsia, or abnormally high blood pressure during pregnancy. Preeclampsia can increase your risk for other pregnancy complications.
Higher than normal birth weight (macrosomia). Gestational diabetes increases the likelihood that you will give birth to a large baby (one that weighs more than 9 pounds). Having a high birth weight increases the risk of:
- The need for a surgical delivery (C-section), potentially before the baby’s due date (preterm birth).
- Birth injuries for both you and your baby.
Preterm birth. Preterm birth means a baby is born before its due date. If your blood sugar levels remain high in your last trimester of pregnancy, you are at greater risk for early labor.
Your doctor may also recommend that you deliver or have a C-section before your due date if the baby is too large. Preterm birth can cause complications.
- Breathing difficulties. If you have a preterm birth, your baby’s lungs may not be fully developed. This can cause respiratory distress syndrome, and your baby might need intensive care.
Hypoglycemia. Your baby may be born with too low blood sugar (hypoglycemia). If this happens, your doctor may give your baby an IV with glucose to help raise their blood sugar to prevent more serious complications, like a seizure.
Stillbirth. If you have untreated gestational diabetes, you are more likely to have a stillbirth, or the death of the baby before delivery.
Increased risk for type 2 diabetes. Gestational diabetes increases both you and your baby’s risk for developing type 2 diabetes later in life. Type 2 diabetes is a long-term condition where your cells don’t respond correctly to insulin, leading to high blood sugar.
Because of this risk, you should get screened for type 2 diabetes more regularly following your pregnancy. You and your baby should also work to eat well and stay active to reduce your risk.
Center for Disease Control and Prevention (CDC). Gestational Diabetes (https://www.cdc.gov/diabetes/basics/gestational.html)
American Diabetes Association. Gestational Diabetes (https://diabetes.org/diabetes/gestational-diabetes)
MedlinePlus: National Library of Medicine. Diabetes and Pregnancy (https://medlineplus.gov/diabetesandpregnancy.html)
American College of Obstetricians and Gynecologists. Gestational Diabetes (https://www.acog.org/womens-health/faqs/gestational-diabetes)