Managing Gestational Diabetes During Pregnancy

Medically Reviewed By William C. Lloyd III, MD, FACS
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Gestational diabetes is a temporary condition that affects up to 9% of pregnant women. Women with gestational diabetes produce insulin as they did before they became pregnant, but their body can’t use the insulin properly, similar to people with type 2 diabetes. (People with type 1 diabetes can’t produce insulin at all. Your body needs insulin to break down blood sugar (glucose). If the blood sugar levels are too high, this results in diabetes.

Causes of Gestational Diabetes

Your placenta, which provides your baby with nourishment while you’re pregnant, produces hormones to help your baby grow and develop. In some women, these hormones also block insulin from working properly, causing blood sugar levels to spike. Gestational diabetes goes away once the baby is born, though, because your body no longer needs to produce those hormones.

Testing for Gestational Diabetes

Unlike type 1 and type 2 diabetes, there typically aren’t any symptoms from gestational diabetes. It’s usually detected through a routine test. Most pregnant women are screened for gestational diabetes between the 24th and 28th week of pregnancy. However, some women have a higher risk of developing the condition than others. Your doctor or nurse practitioner may want to test you earlier if you fall into one of these categories: 

  • Your pre-pregnancy body mass index, or BMI, was 30 or higher. (A healthy BMI for women is usually between 18.5 and 24.9.)

  • You had gestational diabetes in a previous pregnancy.

  • You have a first-degree relative (parent, sibling or child) who has diabetes.

For the initial screening test, you’ll drink a syrupy, sweet liquid and an hour later, a sample of your blood is taken to measure the amount of blood sugar in your system. If your blood sugar level is higher than normal, you will be booked for a second test, called the glucose challenge test.
You must fast overnight before the challenge test. First thing in the morning, you’ll give a blood sample and then you will drink another syrupy, sweet liquid. Once you’ve consumed this, three separate blood samples will be taken, one an hour for three hours. If your blood sugar levels are still high, your doctor or nurse practitioner will treat you for gestational diabetes.

Managing Gestational Diabetes

Once you’ve been diagnosed with gestational diabetes, you will need to monitor your blood sugar regularly. This may mean pricking your finger for a drop of blood a few times a day, every day, to test it. Some women are able to keep their blood sugar levels under control by changing their diet and exercising. Since all women are different, so are their dietary needs. If you have gestational diabetes, it’s recommended you consult with a dietitian to tailor a diet specific to you. The general recommendations include eating three small or moderate meals per day, as well as one or two snacks. The foods should include:

  • Whole fruits and vegetables
  • Lean proteins, such as skinless chicken
  • Whole grains

Foods that should be avoided include:

  • Products with added, refined sugar
  • Foods with a lot of starch, such white bread and white rice

If changing your diet and exercising don’t help bring your blood glucose levels down, you may need to inject yourself with insulin throughout the rest of your pregnancy.

Possible Complications for You and Your Baby

Gestational diabetes can affect both you and your baby, which is why it is so important that you try to keep your blood sugar levels as normal as possible. 

The most common problem associated with gestational diabetes is that the babies tend to be larger than usual. This in itself may not be a problem, but mothers of exceptionally large babies may have trouble delivering them, which can cause injuries to the baby, or the mother may need to deliver via cesarean section. Other problems for the baby could include:

  • Premature birth, which can cause breathing problems and other complications
  • Low blood sugar after birth
  • Higher risk of type 2 diabetes when the baby is older

Complications for you could include:

  • High blood pressure 
  • Preeclampsia (high blood pressure and signs of damage to organs, such as the kidneys)
  • Increased risk of type 2 diabetes later in life

Most women who have gestational diabetes that is well managed go on to deliver healthy babies. You and your healthcare provider are a team, and by working together to treat your diabetes, you increase your chances of a successful pregnancy.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 6
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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  3. About Adult BMI. Centers for Disease Control and Prevention.