Gestational Diabetes

Even if you didn’t have diabetes before you were pregnant, you can still get gestational diabetes. Pregnancy-related changes in your hormones can affect how your body makes insulin. Gestational diabetes sometimes develops midway through pregnancy and means you have high blood sugar levels.

We test everyone who’s pregnant to make sure they don’t have gestational diabetes. Without treatment, this condition can cause large birth weights, which can increase your need for a cesarean birth (C-section). You’ll also have a higher risk of having a premature birth. Or you might get a complication known as preeclampsia, which causes severe high blood pressure and other conditions.

Pregnancy glucose testing

You’ll take an oral glucose challenge test when you’re between 24 and 28 weeks pregnant. During this screening (you don’t have to fast first), you’ll drink a sugary beverage an hour before we take a blood sample. We want to see how your body reacts to the sugar in the drink.

If your blood sugar is high, you’ll need to do an oral glucose tolerance test. This blood test will confirm if you have gestational diabetes. To prepare for it, you can’t eat for eight hours (fast) before the test.

We’ll draw blood when you arrive at your appointment. You’ll then drink another sugary beverage and wait. We’ll draw and test your blood one, two and three hours after you drink this liquid.

Meet Our Gestational Diabetes Team

When you come to Cleveland Clinic for gestational diabetes diagnosis and treatment, you’ll work with a care team who’ll confirm your diagnosis and plan your treatment. Together, we’ll help you control your blood sugar. This team could include:

• Obstetricians.
• Midwives.
• Maternal fetal medicine specialists (high-risk pregnancy specialists).
• Dietitians.
• Diabetes educators.

If you have gestational diabetes, you might wonder if you did something wrong. You didn’t. Gestational diabetes doesn’t happen because of something you ate or drank. But if you have it, you have a high-risk pregnancy and will need to follow a personalized treatment plan.

Regular blood sugar tests

You’ll work with our diabetes educators and other providers to learn how to track your blood sugar levels throughout the rest of your pregnancy at home using a glucose meter or a continuous glucose monitor (CGM). Each day you’ll test:

• First thing in the morning (after fasting during sleep).
• Two hours after breakfast.
• Two hours after lunch.
• Two hours after dinner.

Your levels can go up and down during the day and throughout the week. Keeping track of this helps guide us in crafting a treatment plan that works for you.

Making lifestyle changes

Our expert dietitians will help you create personalized meal plans with foods that can help manage your blood sugar. These include lean proteins, vegetables and whole grains. You’ll learn how to recognize and limit the kinds of (refined) carbohydrates that can increase your blood sugar.

We’ll also help you develop a plan for healthy exercise during pregnancy. Regular exercise can help you lower your blood sugar and maintain a healthy blood pressure, relieve stress and stay at a weight that’s healthy for you.

Using insulin for gestational diabetes

If we can’t control your blood sugar with lifestyle changes, your provider may recommend insulin therapy. Our diabetes educators will teach you how to give yourself insulin pen injections to help keep your blood sugar in a healthy range.

Taking the Next Step

Chances are, you’re likely worrying about your gestational diabetes diagnosis. But you can feel better knowing that it’s treatable. Our high-risk pregnancy team is here to help you manage your blood sugar (and stress) with personalized treatment that matches your needs. We’re here to support you throughout your pregnancy journey — from your first visit, through labor and delivery, and beyond.