Gestational Diabetes: Screening, Symptoms, and What Helps
Gestational diabetes is high blood sugar that starts during pregnancy in a woman who did not have diabetes before. It often has no symptoms, so it is found with a routine test. With the right care, most women with gestational diabetes have a healthy pregnancy and a healthy baby.
This article explains who is more likely to get it, how it is tested, what it can mean for you and your baby, and how it is managed. For the full picture of prenatal visits and tests, see Prenatal Appointments and Tests: What to Expect.
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Quick Answer
Gestational diabetes can develop during pregnancy in women who do not already have diabetes, and it affects about 5% to 9% of pregnancies in the United States, according to the CDC (1). Most women are tested between 24 and 28 weeks. It is managed with healthy eating, physical activity, and checking blood sugar, and some women also need medicine such as insulin.
What Gestational Diabetes Is
During pregnancy, hormones and weight gain make the body’s cells use insulin less effectively, so the body needs more insulin than usual. Gestational diabetes happens when the body cannot make enough insulin to meet that need (1). It usually develops around the 24th week of pregnancy (1).
It often has no symptoms. When there are symptoms, they are usually mild, such as more thirst or needing to urinate more often (1). Testing is the only way to know for sure, which is why it is part of routine prenatal care.
Who Is More Likely to Get It
The CDC lists these factors that raise the chance of gestational diabetes (1):
- You had gestational diabetes in an earlier pregnancy.
- You gave birth to a baby who weighed more than 9 pounds.
- You are overweight.
- Someone in your family has type 2 diabetes.
- You have polycystic ovary syndrome (PCOS).
- You are African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander.
Having a risk factor does not mean you will get gestational diabetes, and women with no risk factors can get it too. I had it myself in my first pregnancy, with no family history of diabetes, no extra weight, and no other risk factor on this list. If you have PCOS, you can read more in PCOS: Signs and Symptoms.
How It Is Tested
Most women are tested between 24 and 28 weeks of pregnancy, and women at higher risk may be tested earlier (1). The first step is a glucose challenge test. If it shows high blood sugar, a longer test called an oral glucose tolerance test confirms the diagnosis (2).
Both tests involve drinking a sweet liquid and having blood taken from a vein in your arm, not from a finger (4). Your provider will tell you how to prepare. Some people feel nauseated after the drink (4). If you vomit, tell the staff, because the test may need to be repeated.
The steps differ between clinics. Some diagnose gestational diabetes right away when the first result is very high, without a second test. Ask your midwife or doctor how it works at your clinic, and if nobody has mentioned the test by 24 weeks, ask about it.
What It Can Mean for You and Your Baby
When blood sugar stays high, the baby can grow larger than usual, which can cause injury during birth. The baby can also have low blood sugar in the first days after birth and sometimes needs extra monitoring. Mothers with seriously uncontrolled blood sugar have a higher risk of stillbirth (3).
For the mother, gestational diabetes raises the risk of high blood pressure in pregnancy, preterm delivery, and delivery by C-section (3). One serious form of high blood pressure in pregnancy is explained in Preeclampsia: Warning Signs You Should Not Ignore. The CDC stresses that treatment and regular checks help protect both you and your baby (1).
How It Is Managed
Eating and Activity
Your care team will help you plan healthy foods in the right amounts at the right times. Being active also helps, because it lowers blood sugar and helps your body use insulin better. Do not try to lose weight during pregnancy, because some weight gain is needed for your baby’s health (1).
Checking Blood Sugar
The CDC advises checking your blood sugar regularly to keep it in a healthy range (1). Your provider will tell you how often to check and which numbers to aim for. Bring your results to each visit so your team can adjust your plan.
Medicine
If healthy eating and activity are not enough, your doctor may prescribe insulin, metformin, or another medicine (1). Needing medicine does not mean you did something wrong. Pregnancy hormones can make blood sugar hard to control for anyone.
After Your Baby Is Born
For many women, blood sugar goes back to normal after delivery. About half of women who had gestational diabetes later develop type 2 diabetes (1). The NIDDK adds that their children are also more likely to develop obesity or type 2 diabetes (2).
Ask your doctor how often to have your blood sugar checked after pregnancy. MedlinePlus advises close follow-up for signs of diabetes over the next 5 to 10 years (3). A healthy weight, healthy food choices, and regular activity may lower these risks (2). Your postpartum visit is a good time to start this conversation, and Postpartum Checkup: What to Expect After Birth explains what it covers.
When to Call Your Doctor
Contact your midwife or doctor if:
- You have unusual thirst or need to urinate much more often.
- Your blood sugar readings are often outside the target range your team gave you.
- Your baby moves much less than usual.
- You are not sure how to follow your eating plan or use your blood sugar meter.
- You feel overwhelmed by the new routine and need more support.
Conclusion
Gestational diabetes is common, it usually has no symptoms, and it is found by a routine test between 24 and 28 weeks. Healthy eating, activity, and checking your blood sugar protect you and your baby, and some women also need medicine.
It is not caused by anything you did wrong. After birth, keep up regular blood sugar checks, because about half of women with gestational diabetes later develop type 2 diabetes. Talk to your midwife or doctor about a plan that fits your life.
Sources
- Centers for Disease Control and Prevention (CDC). Gestational Diabetes.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Gestational Diabetes.
- MedlinePlus (National Library of Medicine). Gestational Diabetes.
- MedlinePlus (National Library of Medicine). Glucose Tolerance Test.
