Gestational diabetes occurs when the body cannot produce the insulin it needs during pregnancy. People with this condition develop high blood sugar levels during pregnancy.
During pregnancy, some people may develop high blood sugar levels. This condition is known as gestational diabetes mellitus (GDM) or gestational diabetes. Gestational diabetes typically develops between the
The Centers for Disease Control and Prevention (CDC) estimates gestational diabetes occurs in
If you develop gestational diabetes, it doesn’t mean you had diabetes before your pregnancy or will have it afterward. But developing it does raise your risk of developing type 2 diabetes in the future.
If poorly managed, gestational diabetes can also raise your child’s chance of developing diabetes. It can increase the possibility of complications for you and your baby during pregnancy and delivery.
It’s rare for gestational diabetes to cause symptoms. A doctor may test for gestational diabetes if you have certain risk factors.
If you do experience symptoms, they’ll likely be mild. Diabetes symptoms may
- human placental lactogen (hPL)
- other hormones that increase insulin resistance
These hormones affect your placenta and help sustain your pregnancy. Over time, the amount of these hormones in your body increases. They may start to make your body resistant to insulin, the hormone that regulates your blood sugar.
Insulin helps move glucose out of your blood into your cells, where it’s used for energy. In pregnancy, your body naturally becomes slightly insulin resistant so more glucose is available in your bloodstream to be passed to the baby.
If the insulin resistance becomes too strong, your blood glucose levels may rise abnormally. This can cause gestational diabetes.
You may have a
- have high blood pressure
- have a family history of diabetes
- were overweight before you became pregnant
- are not physically active
- gain a larger than typical amount of weight during pregnancy
- are expecting multiple babies
- have previously given birth to a baby weighing more than 9 pounds
- have had gestational diabetes in the past
- have had an unexplained miscarriage or stillbirth
- have been taking steroids, like glucocorticoids
- have polycystic ovary syndrome (PCOS), acanthosis nigricans, or another condition associated with insulin resistance
Research data on race and ethnicity
The risk of gestational diabetes rises with an increase in body mass index (BMI) across racial and ethnic groups. But people with both high and low BMIs can get gestational diabetes.
Still, in studies, it has been found that even in cases of low BMI among people who are Asian and Hispanic, there is an increased risk of gestational diabetes.
Additionally, though People of Color are disproportionately affected by type 2 diabetes, non-Hispanic Black women have the
None of the participants had type 1 or type 2 diabetes before pregnancy. Researchers adjusted for the known risk factors of the condition.
Study results showed the following prevalence rates:
- 15.5% of Asian American women
- 9.0% of Hispanic women
- 10.7% of non-Hispanic Black women
- 7.9% of non-Hispanic white women
No evidence suggested other factors, including acculturation, affected the rates of gestational diabetes.
However, studies that discuss gestational diabetes and use race and ethnic differences for clarity can be limited. Additional research is still needed to consider environmental, behavioral, genetic, and socioeconomic factors as well as access to healthcare.
If you have no known history of diabetes and optimal blood sugar levels at the beginning of your pregnancy, a doctor will likely screen you for gestational diabetes when you’re 24 to 28 weeks pregnant.
Glucose challenge test
Some doctors may begin with an oral glucose challenge test.
First, you’ll drink a glucose solution. After 1 hour, you’ll get a blood test. If your blood sugar level is high, a healthcare professional may perform a 3-hour oral glucose tolerance test. This is considered two-step testing.
Some doctors skip the glucose challenge test altogether and only perform a 2-hour glucose tolerance test. This is considered one-step testing.
- A doctor will start by testing your fasting blood sugar levels.
- They’ll ask you to drink a solution containing 75 grams (g) of glucose.
- They’ll test your blood sugar levels again after 1 hour and 2 hours.
A doctor will likely diagnose gestational diabetes if you have any of the following
- fasting blood sugar level greater than or equal to 92 milligrams per deciliter (mg/dL)
- 1-hour blood sugar level greater than or equal to 180 mg/dL
- 2-hour blood sugar level greater than or equal to 153 mg/dL
- For the two-step test, you will not need to fast.
- A healthcare professional will ask you to drink a solution containing 50 g of sugar.
- They’ll test your blood sugar after 1 hour.
If the value falls below 135 mg/dL, the results are considered to be acceptable. A doctor will not perform any more tests.
If your blood sugar level ranges between 130 and 140 mg/dL, a doctor may recommend a second test on a different day. The cut-off for this range may depend on your risk factors.
- During the second test, a doctor will start by testing your fasting blood sugar level.
- They’ll ask you to drink a solution with 100 g of sugar in it.
- They’ll test your blood sugar 1, 2, and 3 hours later.
A doctor will likely diagnose gestational diabetes if you have at least two of the following values:
- fasting blood sugar level greater than or equal to 95 mg/dL or 105 mg/dL
- 1-hour blood sugar level greater than or equal to 180 mg/dL or 190 mg/dL
- 2-hour blood sugar level greater than or equal to 155 mg/dL or 165 mg/dL
- 3-hour blood sugar level greater than or equal to 140 mg/dL or 145 mg/dL
Many people who experience gestational diabetes will develop type 2 diabetes outside of pregnancy. There are two other types of diabetes:
- Type 1 diabetes: This occurs if the pancreas does not naturally produce enough insulin on its own.
- Type 2 diabetes: This occurs if the pancreas produces insulin but your cells don’t respond effectively to insulin, called insulin resistance. This causes your blood sugar to rise.
The ADA also encourages doctors to screen for type 2 diabetes at the beginning of pregnancy. If you have risk factors for type 2 diabetes, a doctor will likely test you for the condition at your first prenatal visit.
These risks factors
- being overweight
- being sedentary
- having high blood pressure
- having low levels of HDL (good) cholesterol in your blood
- having high levels of triglycerides in your blood
- having a family history of diabetes
- having a history of gestational diabetes, prediabetes, or signs of insulin resistance
- having previously given birth to a baby who weighed more than 9 pounds
According to the
The CDC also notes that some Pacific Islanders and Asian American people may also have a higher risk.
Gestational diabetes is divided into
- Class A1 is used to describe gestational diabetes that can be managed through diet alone.
- Class A2 is used to describe gestational diabetes where insulin or oral medications are needed to manage the condition.
If you receive a diagnosis of gestational diabetes, your treatment plan will depend on your blood sugar levels throughout the day.
In most cases, a doctor will advise you to test your blood sugar before and after meals. They’ll also advise managing your condition by eating a nutrient-rich diet and exercising regularly.
It’s recommended to perform
A doctor may also prescribe insulin injections for you until you give birth. Ask them about properly timing your insulin injections in relation to your meals and exercise to avoid low blood sugar.
A doctor can also tell you what to do if your blood sugar levels fall too low or are consistently higher than they should be.
A balanced diet can help manage gestational diabetes. In particular, people with gestational diabetes can pay special attention to their carbohydrate, protein, and fat intake.
You may also need to avoid certain foods if you have gestational diabetes.
According to a
For people with gestational diabetes, the American College of Obstetrics and Gynecologists (ACOG) recommends eating complex carbohydrates over simple ones. Complex carbs are digested more slowly, are less likely to produce high blood sugar, and may help reduce insulin resistance.
A doctor can help you determine exactly how many carbohydrates you should eat each day.
Health-promoting carbohydrate choices can include:
The recommended dietary allowance (RDA) of protein during pregnancy varies by trimester and may vary based on your individual needs.
During the first trimester of pregnancy, the RDA is about
Good sources of protein can include:
However, ACOG lists certain types of fish that should be avoided due to their high mercury content, including tuna and swordfish.
Healthy sources of fat can provide nutrients, such as vitamins and minerals. Health-promoting fats to incorporate into your diet include:
If gestational diabetes is not managed well or left untreated, blood sugar levels may remain higher than they should be throughout your pregnancy. This can lead to complications that affect the health of you and your baby before, during, and after birth.
Complications that can affect you may include:
- high blood pressure
- perinatal depression
- preterm birth
- cesarean delivery
Complications that can affect your baby can include:
- high birth weight (macrosomia)
- birth injuries, such as shoulder dystocia
- breathing problems, including respiratory distress syndrome
- low blood sugar (hypoglycemia)
- higher risk of developing diabetes later in life
To avoid these complications, you can take steps to manage your gestational diabetes. For example, attend all of your prenatal care checkups and follow a doctor’s recommended treatment plan.
Your blood sugar should return to typical levels after you give birth. But developing gestational diabetes raises your risk of type 2 diabetes later in life. A doctor will test you for diabetes
If you’re planning to become pregnant in the near future and have overweight or obesity, consider talking with a doctor about ways to safely lose weight while preparing for a pregnancy.
A doctor can help you create a plan to reach and maintain a moderate weight. Even losing a small amount of weight can help reduce the risk of gestational diabetes.
Furthermore, it’s important to seek prenatal care and attend all doctor-recommended visits to get the necessary screenings and evaluations during your pregnancy.
Gestational diabetes occurs when the body cannot produce the insulin needed during pregnancy, resulting in high blood sugar.
If you have gestational diabetes, a doctor may recommend changes to your diet along with blood sugar monitoring to help manage the condition. In some cases, you may need insulin injections.
In many cases, if you have gestational diabetes during pregnancy, your blood sugar should return to your typical levels after you give birth. However, you may have a higher risk of developing type 2 diabetes later in life.