Potential Complication: Gestational Diabetes With Twins

What Is Gestational Diabetes?

Gestational diabetes is caused by a change in how your body responds to the hormone insulin. This hormone helps move glucose out of the blood and into the cells, so your body can use it for energy.

When you are pregnant, your cells become slightly more resistant to insulin. That increases the amount of sugar in your blood, which helps make more nutrients available to your babies.

However, if you become too resistant to insulin and glucose levels become too high, it can cause problems for you and your twins.

How Can It Affect My Babies and Me?

If you develop gestational diabetes, you're at greater risk for:

You're also at greater risk for having babies who have:

The good news? If you receive treatment and control gestational diabetes, your risk of problems is similar to the risks of other women. Your chances of having healthy twins are excellent.

And, after you deliver, glucose levels often return to normal. However, both you and your babies will have a higher risk of getting diabetes later. So your doctors will need to regularly monitor your blood sugar levels.

Who Is at Risk for Gestational Diabetes?

Certain things raise your risk of getting gestational diabetes. You are at increased risk if you:

  • Are Hispanic, African-American, Native American, Asian American, or Pacific Islander
  • Were overweight before your pregnancy
  • Have a family member with diabetes
  • Are age 25 or older
  • Had gestational diabetes in a previous pregnancy
  • Had a previous very large baby (9 pounds or more) or a stillbirth
  • Have had abnormal blood sugar tests before
  • Are carrying twins or multiples


Screening For Gestational Diabetes

You can expect your doctor to assess your risk for gestational diabetes at your first prenatal visit.

If you are at high risk, you should have a blood test for gestational diabetes as soon as possible. If your test is negative, you should still repeat the test about week 24-28.


If you are not at high risk, you should still get screened about week 24-28.

To test for gestational diabetes, your doctor may order a test known as the glucose challenge test. You do not need to fast for this. If you fail the test then you will have an oral glucose tolerance test with 100gm. You will fast for a certain period beforehand (your doctor will tell you for how long). This two-step approach is commonly used. 

If the Diagnosis Is Gestational Diabetes

Depending on how severe your gestational diabetes is, you may:

To reduce risks to you and your twins, your doctor may induce labor earlier than your due date. You may need a cesarean, although most women with gestational diabetes are still able to deliver vaginally.

Gestational Diabetes Follow-up

It's important that you have a test for diabetes about 6 to 12 weeks after you deliver.

If that test is normal, your doctor will likely tell you to repeat the diabetes test at least every three years.

You also need to be sure your pediatrician monitors your twins for diabetes, as their risk is higher since you have had it.

This close follow-up of you and your twins will keep you all as healthy as possible.

WebMD Medical Reference Reviewed by Nivin Todd, MD on January 13, 2019



American College of Obstetricians and Gynecologists: "FAQs on Gestational Diabetes;" "Multiple Gestation: Complicated Twin, Triplet, and High-Order Multifetal Pregnancy;" and "Committee Opinion on Screening and Diagnosis of Gestational Diabetes Mellitus."

American Diabetes Association: "Prediabetes FAQs;" "What is Gestational Diabetes?" and "How to Treat Gestational Diabetes."

Medscape: "Diabetes Mellitus and Pregnancy."

Rauh-Hain, J. Journal of Maternal, Fetal and Neonatal Medicine, April 2009.

CDC: "Diabetes and Pregnancy."

Aldasouqi, S. International Journal of Diabetes in Developing Countries, October-December 2008.

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