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Gestational diabetes is diabetes that is first diagnosed during pregnancy. Although it can cause problems to either the mother or her baby, gestational diabetes can be managed and controlled by you and your healthcare provider. It usually goes away after you give birth.
According to the American Diabetes Association, about one in every 10 pregnant women develop gestational diabetes.
Like the other forms of diabetes—type 1 diabetes and type 2 diabetes—gestational diabetes occurs when your body cannot use blood sugar (also called blood glucose) properly. Glucose is the energy source for your body. In type 1 diabetes, your body is not making enough of the hormone insulin that regulates your blood sugar levels. In type 2 diabetes, your body is not using insulin properly because your cells have become resistant to it.
In gestational diabetes, your placenta is producing hormones that block insulin, which means that your cells are not able to use the sugar in your blood. This in turn means that your levels of blood sugar stay elevated.
Over time, high blood sugar levels in type 1 and type 2 diabetes can cause a lot of damage to the body, especially to the heart, kidneys, eyes, and nervous system. Gestational diabetes does not last long enough for those complications, but it has serious effects. For the mother, there is increased risk of high blood pressure and preeclampsia or of needing a cesarean section. A future risk is that women who develop gestational diabetes are more likely to have it again in a later pregnancy or to develop type 2 diabetes later.
For the baby, gestational diabetes increases the risk of a preterm birth and of being excessively large at birth. A larger than average baby is more likely to have difficulty coming through the birth canal, which is why a cesarean section is more likely to be needed for the delivery. Babies born to women with gestational diabetes may have breathing difficulties or have low blood sugar right after birth. They are also more likely to become obese or develop type 2 diabetes later in life. There is also a greater risk of stillbirth with gestational diabetes.
Although these complications can be very serious, gestational diabetes is usually managed successfully and both mother and baby stay healthy. If you develop gestational diabetes, you and your healthcare professional will create a diet and exercise plan to control it. You will have to keep to a healthy, balanced diet and get the right amounts of exercise regularly. Exercise can include 30 minutes a day of activities like walking, swimming, or yoga.
You will also have to monitor your blood sugar levels regularly during your pregnancy. Your doctor or midwife will teach you how to do this. You will need to have check-ups more often during your pregnancy than in a usual pregnancy.
If your blood sugar levels cannot be controlled with diet and exercise, you may need to also take insulin or other medications.
Certain women are at greater risk for developing gestational diabetes. Risk factors include:
- Being overweight or obese
- Not getting enough physical exercise
- Having had gestational diabetes during a previous pregnancy
- Being prediabetic
- Having a close relative who has diabetes
- Having had a baby who weighed more than 9 pounds.
Race is a factor in gestational diabetes. Women who are Black, Latino, Native American, or Asian American are at higher risk for developing the condition.
Gestational diabetes often does not have noticeable symptoms. You may be thirstier than you usually are and have to urinate more frequently. But these symptoms can be subtle. Frequently the first sign that you have gestational diabetes is through a blood or urine test.
Your doctor or midwife will screen you for gestational diabetes usually during the second trimester of your pregnancy. One of the reasons you need to give a urine sample at office visits is to check for glucose in your urine. High levels of glucose in your urine usually mean you have high levels in your blood.
There are also two blood tests for gestational diabetes. In one, you drink a very sweet drink and have blood taken about an hour later that will be tested for sugar levels. This is called a glucose challenge test. In the other, you must be fasting before a sample of blood is taken. Then you drink a sweet drink and have blood drawn one and two hours later to check on blood sugar levels.
Remember that gestational diabetes is common and can be successfully controlled if you meet with your healthcare provider regularly and follow their instructions on diet and exercise.