What is gestational diabetes?
Gestational diabetes (GD) is a type of diabetes that develops in pregnancy when blood sugar levels get too high. GD usually appears during the middle of pregnancy, between 24 and 28 weeks.
Developing GD doesn’t mean you already had diabetes before you got pregnant. The condition appears because of the pregnancy. People with Type 1 and Type 2 diabetes have their own, separate challenges when it comes to pregnancy.
How common is gestational diabetes in pregnancy?
Between 2% and 10% of pregnant people in the United States develop gestational diabetes.
Symptoms and Causes
What causes gestational diabetes?
Gestational diabetes comes from hormonal changes and the way our bodies convert food into energy.
A hormone called insulin breaks down the glucose (sugar) from food and delivers it to our cells. Insulin keeps the level of glucose in our blood at a healthy level. But if insulin doesn’t work right or we don’t have enough of it, sugar builds up in the blood and leads to diabetes.
During pregnancy, hormones can interfere with the way insulin works. It may not regulate your blood sugar levels like it’s supposed to, which can lead to gestational diabetes. Genes and having overweight (a BMI greater than 25) may also play a role.
Who is at risk for gestational diabetes?
Gestational diabetes can develop in anyone during pregnancy. But people over the age of 25 who are of South and East Asian, Hispanic, Native American or Pacific Island descent are at a higher risk.
Other factors that may increase your chances of GD include:
- Heart disease.
- High blood pressure.
- Personal or family history of GD.
- Polycystic ovary syndrome (PCOS).
- Previous birth of a baby weighing nine pounds (lb) or more.
- Prediabetes (history of higher-than-normal blood glucose).
What are the symptoms of gestational diabetes?
Gestational diabetes doesn’t usually cause any symptoms. But some people experience:
- Frequent urination.
What are the warning signs of gestational diabetes?
There are usually no warning signs of gestational diabetes. Symptoms are mild and often go unnoticed until you’re tested for diabetes in the second trimester of pregnancy.
Is gestational diabetes caused by diet?
Diet can be a contributing factor to developing gestational diabetes, but your diet doesn’t cause diabetes. Gestational diabetes happens when the hormones from your placenta block your ability to use or make insulin. Insulin helps your body maintain the right amount of glucose in your blood. When you have diabetes, you end up with too much sugar in your blood.
You can help manage gestational diabetes by eating healthy foods that don’t cause your blood sugar to rise to unsafe levels.
Diagnosis and Tests
When does a healthcare provider test for gestational diabetes?
Your healthcare provider tests for gestational diabetes around weeks 24 to 28 of your pregnancy. At this stage, hormones start getting produced by the placenta. This organ forms in the uterus and supplies the fetus with oxygen and nutrients. The hormones it makes can interfere with insulin.
How is gestational diabetes diagnosed?
Your healthcare provider will test your blood sugar during pregnancy. The test may have two parts:
- Glucose challenge test: You drink a sweet liquid. After about an hour, you’ll have a blood test to check your blood sugar level. If your blood sugar is high, your healthcare provider will do a glucose tolerance test.
- Glucose tolerance test: An oral glucose tolerance test is only done if your challenge test results are unusual. You fast (don’t eat for eight hours) before the tolerance test. Your healthcare provider draws your blood before and at one-, two- and three-hour intervals after you drink a sweet liquid. The tolerance test can confirm a diagnosis of gestational diabetes.
What happens if you are diagnosed with gestational diabetes?
If you’re diagnosed with gestational diabetes, your healthcare provider may have you visit a nutritionist who specializes in gestational diabetes. At this appointment, you’ll discuss your current diet and determine what modifications to make. You may be given pamphlets to help you understand the impact certain foods have on your blood sugar. They’ll also talk to you about checking your blood sugar and what your levels should be after meals.
Then, your obstetrician will discuss a gestational diabetes management plan. People with diabetes typically have more prenatal visits to check fetal growth (via ultrasound), monitor your weight gain and discuss how well your sugar is being controlled.
Management and Treatment
Why is it important to treat gestational diabetes?
If left untreated, gestational diabetes can lead to complications for both you and the fetus.
Gestational diabetes increases your risk of:
- Cesarean birth (C-section) if the fetus gets too big.
- Preeclampsia (high blood pressure during pregnancy).
- Type 2 diabetes.
How does gestational diabetes affect my baby?
If you have gestational diabetes, your baby’s more at risk for:
- Increased birth weight (weighing nine pounds or more).
- Breathing problems at birth.
- Hypoglycemia. This can cause seizures in newborns.
- Premature birth.
- Type 2 diabetes later in life.
How is gestational diabetes managed?
If you’re diagnosed with gestational diabetes, you may need more frequent checkups during your pregnancy. Your healthcare provider will check your blood sugar levels regularly. You may need to monitor your blood sugar at home with a tool called a glucose meter.
Some people need medication such as insulin to manage gestational diabetes. But most individuals can keep their blood sugar levels under control with just diet changes and exercise.
If you do need to use insulin to control your diabetes, it’s important to take it exactly as prescribed.
How should I change my diet for gestational diabetes?
You may need to adjust your diet to keep gestational diabetes under control. Try to:
- Avoid junk food, processed foods and sugary drinks.
- Choose a healthy balance of proteins, carbohydrates, fiber and fat.
- Eat smaller meals more often.
- Schedule your meals at the same time each day.
How can I exercise safely during pregnancy?
Exercise helps your body use more glucose, which may lower your blood sugar. If you have gestational diabetes, talk to your healthcare provider about creating a safe exercise plan. Your exercise plan should be tailored to your unique needs, including your:
- Fitness level before pregnancy.
- Overall health.
Can you get rid of gestational diabetes while pregnant?
No, you can’t get rid of gestational diabetes once you have it. After you’re diagnosed with the condition, you’re not tested again for diabetes until after your baby is born. It’s recommended to get tested for diabetes within 12 weeks after your baby is born.
How can gestational diabetes be prevented?
It’s not entirely preventable, but you can take steps to reduce your risk. Eating a balanced diet and getting regular exercise before and during your pregnancy is the best way to reduce your risk of developing gestational diabetes.
Outlook / Prognosis
Can you have a healthy pregnancy with gestational diabetes?
Yes, you can still have a healthy pregnancy and a healthy baby if you have gestational diabetes. Gestational diabetes is a highly treatable and manageable condition. Work with your healthcare provider to make sure you understand your treatment plan and how you can keep your blood sugar levels at a healthy level.
Will gestational diabetes go away after pregnancy?
Your blood sugar levels should come down after you give birth when your hormone levels return to normal. But about 50% of those with gestational diabetes develop Type 2 diabetes later in life. Diet and exercise can help lower your risk. Your healthcare provider may recommend blood glucose tests every six to 12 weeks after pregnancy to watch for diabetes.
What can I do to make living with gestational diabetes easier?
Make diabetes management part of your daily routine. Create a schedule and stick to it. Try to:
- Check your blood glucose levels at the same time each day.
- Choose three days each week to get 30 minutes of light exercise.
- Plan small, balanced meals ahead of time.
- Talk with your healthcare provider or a diabetes educator about other tips for daily diabetes management.
Frequently Asked Questions
Does gestational diabetes make the fetus more active?
Researchers aren’t entirely sure if gestational diabetes makes the fetus more or less active. Some studies suggest that gestational diabetes has little impact on their movement. However, we know that the food you consume is passed to the fetus so it’s possible that fetuses feel the side effects of high-sugar foods. Some people find that the fetus’s movement changes once its diabetes is controlled, while others don’t notice changes at all.
Because there’s no definitive answer, any changes in fetal movement should be reported to your healthcare provider.
A note from Cleveland Clinic
Gestational diabetes (GD) develops during pregnancy when there’s too much glucose in your blood. GD is usually diagnosed during the middle stage of pregnancy with a few simple blood tests. If left untreated, GD can cause health complications for you and the fetus. Most individuals can manage gestational diabetes with diet and exercise. Some will need medication. Gestational diabetes increases your risk of developing Type 2 diabetes later in life. Talk to your healthcare provider about ways to reduce your risk of diabetes before, during and after pregnancy.
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