Everything You Need to Know About Gestational Diabetes

Content medically reviewed by Rachel Bakken, RN, CDCES

Each year, as many as 10% of pregnant women develop diabetes, a condition that is diagnosed when blood sugar levels are higher than normal. If you did not have the condition before you became pregnant, it’s called gestational diabetes. Gestational diabetes in pregnancy can cause complications if left untreated, but the good news is there are many ways to manage your blood sugar level so you and your baby stay as healthy as possible. The experts at Essentia Health are here to help.

What Causes Gestational Diabetes?

A hormone called insulin, which is made in the pancreas, helps blood sugar (glucose) enter your cells to give them energy. Hormonal changes during pregnancy can cause your body to develop insulin resistance, which means the cells don’t use insulin as well as they should. While all pregnant women have some degree of insulin resistance late in pregnancy, most women make enough extra insulin to make up for it. If this doesn’t happen, you can develop gestational diabetes. 

“All pregnant women are at risk of developing gestational diabetes,” said Rachel Bakken, certified diabetes care and education specialist at Essentia Health. “However, it is more likely in women who are higher weight, are older than age 25, have previously had gestational diabetes, have a family history of diabetes, or have had a baby who weighed more than nine pounds at birth. It is also more common in women who are Latina, African American, Native American, South or East Asian, or Pacific Islander.”

While there is no surefire way to prevent gestational diabetes, maintaining an optimal weight before pregnancy can help lower your risk. After you become pregnant, you will likely need to gain weight. Gaining too much weight, however, can put you at higher risk of developing gestational diabetes, so following a healthy diet and exercising regularly can help. 

The Importance of Managing Blood Glucose Levels

Having gestational diabetes puts you and your baby at risk for certain complications. With gestational diabetes, you are more likely to develop high blood pressure during your pregnancy. Gestational diabetes can raise the risk of your baby –

• Weighing nine pounds or more, making delivery more difficult and increasing the chances of delivery via cesarean section
• Being born prematurely, which can lead to problems with breathing and feeding, developmental delays, and other difficulties
• Having low blood glucose levels

Babies of mothers with gestational diabetes may also have a higher risk of developing Type 2 diabetes later in life.

“These risks can be scary to hear, but if blood sugars are well-managed, these risks are the same as with any other pregnancy,” Bakken said. “We work with moms-to-be to ensure their blood sugars are as normal as possible. Women can still have happy, healthy pregnancies with gestational diabetes.”

Diagnosing Gestational Diabetes

It is important for all pregnant women to be tested for gestational diabetes as it often has no symptoms. The condition typically develops around the 24th week of pregnancy, so most women are tested between 24 and 28 weeks. However, if you have certain risk factors, your doctor might recommend testing earlier. Testing for gestational diabetes is done through blood tests that measure blood sugar levels, including–

• Glucose screening test. For this test, you will drink a liquid that contains glucose. After one hour, your blood sugar will be tested.
• Glucose tolerance test. This test requires you to fast prior to drinking a liquid containing glucose. You will then have your blood tested one, two, and three hours afterward. 

Treatment for Gestational Diabetes

Many women diagnosed with gestational diabetes can manage their blood sugar through lifestyle changes. You will need to –

• Eat healthy foods. Your doctor and health care team will help you determine an eating plan that is right for you. This plan can include what foods you should eat, how much to eat, and what times of day to eat.
• Get regular physical activity. Aim for 30 minutes of exercise, five days per week. Your doctor can help you decide what types of pregnancy exercises are best for you. If you were physically active before your pregnancy, you should be able to continue your routine.

Checking your blood sugar regularly can tell you whether these methods are effectively managing gestational diabetes. A blood glucose meter can measure your blood glucose using a small drop of blood from your finger. 

“For about 80% of women, lifestyle changes work well and no other treatment is needed. Sometimes diet changes and exercise are not enough to keep blood sugars within normal range, due to the increasing insulin resistance caused by the placenta,” Bakken said. “In these cases, there are safe medication options.”

If diet and exercise are not enough, you may need insulin injections or another diabetes medication. A diabetic educator will show you how to give yourself insulin shots. 

“Insulin is usually our first choice as it has little to no side effects for the mother and does not cross the placenta, meaning the baby is not exposedto the medication,” Bakken said. 

For women with pregestational or preexisting diabetes (having Type 1 or Type 2 diabetes prior to pregnancy), treatment can often be similar to a gestational diabetes treatment plan, including an advised diet, glucose monitoring, insulin, and adjustments to other medications if needed. Those with pregestational diabetes also tend to take low-dose aspirin to prevent preeclampsia.

Staying Healthy After Pregnancy

About half of women who had gestational diabetes will develop Type 2 diabetes after pregnancy. 

“Diabetes prevention starts with continuing the healthy lifestyle changes made during pregnancy,” Bakken said. “Continue to follow healthy eating habits, focusing on fruits, vegetables, whole grains, and lean proteins. Limit sugary and processed foods and distribute carbohydrates throughout the day, pairing them with healthy proteins or fats to prevent spikes in blood sugar. Continue eating smaller and more frequent meals and exercise regularly.”

If you developed gestational diabetes during pregnancy, follow up with your doctor six to 12 weeks after delivery to have your blood sugar levels tested. It is recommended to continue screening every one to three years thereafter.