Gestational diabetes can sometimes be prevented through exercise and dietary changes, particularly for people with overweight or obesity.

Gestational diabetes mellitus is a common pregnancy condition characterized by high blood sugar levels. It poses risks for gestational hypertension, preeclampsia, and delivery complications.

Gestational diabetes affects about 14% of pregnancies globally and can lead to long-term complications for both the pregnant person and the child, including cardiovascular issues and an increased risk of type 2 diabetes.

Although preventive measures, including a healthy lifestyle, are recommended, complete avoidance isn’t guaranteed. Regular prenatal care is vital for early detection and effective management.

Language matters

You’ll notice that the language used to share stats and other data points is pretty binary, with the use of “women.”

Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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Gestational diabetes occurs when the body can’t produce enough insulin to meet the extra needs during pregnancy. Here’s how it happens:

  • Insulin resistance: During pregnancy, the placenta produces hormones that can lead to insulin resistance. This means the body’s cells don’t respond well to insulin, causing an increase in blood sugar.
  • Increased insulin needs: As the pregnancy progresses, the placenta produces more of these hormones, requiring more insulin to keep blood sugar levels in check.
  • Insufficient insulin production: In some cases, the pancreas can’t produce enough insulin to meet the increased demand, leading to elevated blood sugar levels.
  • Onset during pregnancy: Gestational diabetes typically develops around the 24th–28th week of pregnancy when the insulin resistance is at its peak.

Risk factors for gestational diabetes

Research shows that risk factors for gestational diabetes include:

  • Older age: Risk is higher for women ages 35–39.
  • Large baby at birth: A large baby increases the risk of both gestational diabetes and type 2 diabetes by up to 20%.
  • Having multiple pregnancies: Having more than one pregnancy increases your risk of developing gestational diabetes.
  • Previous case of gestational diabetes: If you had gestational diabetes before, your risk of getting it again increases sixfold.
  • High body mass index (BMI) (≥30 kilograms per square meter): Being significantly overweight raises the risk to 12.3%.
  • Family history of gestational diabetes: Having relatives with gestational diabetes increases your risk, especially if combined with a high BMI.
  • Polycystic ovary syndrome (PCOS): If you were treated for PCOS, your risk is more than doubled.
  • Seasonal variation: Prevalence is higher in the summer compared with the winter.
  • In vitro fertilization (IVF): If you get pregnant through IVF, the risk is 50% higher.

It’s worth noting that the effects of weight discrimination can also contribute to negative health effects.

Gestational diabetes often doesn’t show noticeable symptoms; but some women may experience symptoms such as the following:

  • increased thirst
  • frequent urination
  • fatigue
  • blurred vision

Adopting a healthy lifestyle, including regular exercise and a balanced diet, especially for people with overweight or obesity, can play a crucial role in reducing the risk of gestational diabetes. Although it may not guarantee complete prevention, these measures contribute to overall maternal and fetal well-being.

Managing weight before and during pregnancy is particularly important, emphasizing the significance of personalized advice from healthcare professionals.

Complications of gestational diabetes may include:

Maternal complications

  • increased risk of developing type 2 diabetes later in life
  • higher likelihood of developing preeclampsia (high blood pressure during pregnancy)
  • increased chances of requiring a cesarean section during delivery

Fetal and neonatal complications

Long-term effects

  • increased risk of obesity and type 2 diabetes in the child later in life

Treatment for gestational diabetes generally includes dietary adjustments and increased physical activity, supplemented by insulin therapy when necessary. If these don’t work, medications may be required.

  • Insulin therapy: Administered through subcutaneous (under the skin) injections, insulin therapy is considered the safest form of treatment during pregnancy.
  • Metformin: An oral medication, metformin crosses the placenta but is unlikely to cause developmental issues for a fetus. But studies have shown mixed results on long-term outcomes for offspring.

In a randomized controlled trial, pregnant women who received a diagnosis of gestational diabetes before 20 weeks were assigned to either immediate or deferred treatment based on oral glucose-tolerance tests at 24–28 weeks (control).

Immediate treatment for gestational diabetes slightly lowered the chance of newborn complications, but there was no big difference in pregnancy-related hypertension or the baby’s body mass compared with that in the group that received deferred treatment.

To prevent gestational diabetes, it’s essential to adopt a healthy lifestyle with a balanced diet and regular exercise. Nutritional advice suggests well-rounded meals to keep blood sugar normal, ensure moderate weight gain, and support the baby’s growth.

If you have gestational diabetes or are at risk, aim for three main meals and two to three snacks, include low glycemic index carbs, get enough fiber, and focus on lean proteins.

Protein should make up about 30% of caloric intake, with a focus on plant protein, lean meat, and fish. A high fat diet (20–30%) is discouraged, favoring omega-3 and omega-6 fatty acids.

Weight gain during pregnancy should generally be within 18–26 pounds, and supplementation of folic acid, vitamin D, calcium, and iron is advised. It’s also recommended that you limit processed foods and maintain proper hydration.

In a United Arab Emirates study involving high risk pregnant women, a 12-week moderate-intensity lifestyle intervention significantly lowered the relative risk of gestational diabetes by 41%. The lifestyle intervention included dietary counseling, leading to reduced calorie, carbohydrate, and fat intake as well as increased physical activity.

Does gestational diabetes go away?

Gestational diabetes typically goes away after childbirth, but people with a history of the condition in prior pregnancies have a higher likelihood of experiencing it again in subsequent pregnancies. They also face an increased risk of developing type 2 diabetes later in life.

Gestational diabetes is a form of diabetes that occurs during pregnancy. It poses risks like preeclampsia, preterm labor, and increased chances of type 2 diabetes for both the pregnant person and child.

Preventive measures involve a healthy lifestyle, but the condition isn’t always avoidable. Early detection and proper management through prenatal care are necessary to avoid potential complications.