Gestational Diabetes During Pregnancy

Gestational diabetes mellitus is the onset of elevated blood sugar levels during pregnancy. It develops when the body is not able to make and effectively use the insulin it needs for pregnancy. With little insulin, glucose builds up in the blood to high levels. This is called hyperglycemia.

Women with unmanaged gestational diabetes have a higher risk of having infants with excessive birth weight, which can lead to complications during labor. There is an increased risk for obesity, high blood pressure, and type 2 diabetes for both the woman and child.

Gestational diabetes typically develops during the last half of pregnancy. Blood sugar levels usually return to normal soon after delivery. However, having gestational diabetes puts you at higher risk for developing type 2 diabetes. Your doctor should continue to monitor and manage your blood sugar even after delivery.

How Often Does Gestational Diabetes Happen?

Gestational diabetes affects approximately 1 in 7 births and affects 5 to 18 percent of women worldwide.

What Are Some Symptoms of Gestational Diabetes?

For most women, gestational diabetes does not cause noticeable signs or symptoms.

What Are Some Causes of Gestational Diabetes?

It is not known what specifically causes gestational diabetes. During pregnancy, the placenta produces high levels of various hormones, many of which impair insulin’s ability to control blood sugar levels. Gestational diabetes develops when the pancreas, which makes the insulin, cannot make enough insulin to keep blood sugar levels within a target range.

While any woman can develop gestational diabetes, some of the risk factors include:

Age over 25: Women older than age 25 are more likely to develop gestational diabetes.
Family or personal health history: Your risk for developing gestational diabetes increases if you have prediabetes or if an immediate family member has type 2 diabetes. You're also more likely to develop gestational diabetes if you had it during a previous pregnancy.
Excess weight: You're more likely to develop gestational diabetes if you have a body mass index of 30 or higher.
Nonwhite race: Women who are African American, Hispanic, Native American or Asian are at higher risk to develop gestational diabetes.

How Can Gestational Diabetes Be Treated?

Your doctor will have to test you to determine if you have gestational diabetes. However, there are some changes you can make at home to manage your gestational diabetes. Some of these treatments include:

Eating a healthy diet. Changing what, how often, and how much you eat can help keep your blood sugar levels in a good range. After you are diagnosed with gestational diabetes, you may meet with a registered dietitian to determine an individualized healthy eating plan.
Getting regular exercise. Regular, moderate exercise during pregnancy helps control your blood sugar level. Aim for at least two and a half hours a week of moderate exercise, or 30 minutes a day, 5 days a week. Talk with your doctor before you start exercising to determine the best workouts for you that won’t place too much stress on your body.
Check your blood sugar. Your doctor will have you test your level with home blood sugar monitoring. You may be asked to check it as often as four times a day. Knowing your blood sugar levels is an important part of managing gestational diabetes.

When Should I See My Doctor for Gestational Diabetes?

When you're pregnant, your doctor should check you for gestational diabetes as part of your prenatal care. If you develop gestational diabetes, you may need more-frequent checkups. To ensure your blood sugar level has returned to normal, your doctor should check your blood sugar after delivery and again in six weeks. Once you've had gestational diabetes, it's a good idea to get your blood sugar level tested regularly.

If you have been diagnosed with gestational diabetes, you should call your doctor right away if:

You cannot control your blood sugar.
You have been vomiting or have had diarrhea for more than 6 hours.
You have a blood sugar level that stays higher than the level the doctor set for you.
You have blood sugar level that stays lower than the level the doctor has set for you.
You have symptoms of low blood sugar, such as sweating; feeling nervous, shaky, and weak; extreme hunger and slight nausea; dizziness and headache; blurred vision; and confusion.

Your obstetrician or primary care provider can test you for gestational diabetes and help you manage symptoms. If you are diagnosed with gestational diabetes, you may be referred to additional health professionals who specialize in diabetes, including an endocrinologist, a registered dietitian or a diabetes educator.

Learn more about Multidisciplinary Obstetric Medicine Service (MOMS) at Lifespan