What Is Gestational Diabetes?
Gestational diabetes is a condition in which your blood sugar levels become high during pregnancy. It affects up to 10% of women who are pregnant in the U.S. each year. It affects pregnant people who haven’t ever been diagnosed with diabetes.
There are two classes of gestational diabetes. Those with class A1 can manage it through diet and exercise. Those who have class A2 need to take insulin or other medications.
Gestational diabetes goes away after you give birth. But it can affect your baby’s health, and it raises your risk of getting type 2 diabetes later in life. You can take steps so you and your baby stay healthy.
Gestational Diabetes Symptoms
If you have gestational diabetes, you usually don’t have symptoms or might chalk them up to pregnancy. Most find out that they have it during a routine screening.
You may notice that:
- You’re thirstier than usual
- You’re hungrier and eat more than usual
- You pee more than usual
Normal Blood Sugar Levels During Pregnancy: Chart
Gestational Diabetes Causes
When you eat, your pancreas releases insulin, a hormone that helps move a sugar called glucose from your blood to your cells, which use it for energy.
During pregnancy, your placenta makes hormones that cause glucose to build up in your blood. Usually, your pancreas can send out enough insulin to handle it. But if your body can’t make enough insulin or stops using insulin as it should, your blood sugar levels rise, and you get gestational diabetes.
Gestational Diabetes Risk Factors
You’re more likely to get gestational diabetes if you:
- Were overweight before you got pregnant
- Are Black, Asian, Hispanic or Latinx, Alaska Native, Pacific Islander, or Native American
- Have blood sugar levels that are higher than they should be but not high enough to be diabetes (this is called prediabetes)
- Have a family member with diabetes
- Have had gestational diabetes before
- Have polycystic ovary syndrome (PCOS) or another health condition linked to problems with insulin
- Have high blood pressure, high cholesterol, heart disease, or other medical complications
- Have given birth to a large baby (weighing more than 9 pounds)
- Have had a miscarriage
- Have given birth to a baby who was stillborn or had certain birth defects
- Are older than 25
Gestational Diabetes Tests and Diagnosis
Gestational diabetes usually happens in the second half of pregnancy. Your doctor will check for it between weeks 24 and 28, or sooner if you're at high risk.
Your doctor will give you a glucose tolerance test: You’ll drink 50 grams of glucose in a sweet drink, which will raise your blood sugar. An hour later, you’ll take a blood glucose test to see how your body handled all that sugar. If the results show that your blood sugar is higher than a certain level, you’ll need a 3-hour oral glucose tolerance test. For this test, you’ll take a blood glucose test after you have fasted for at least 8 hours (your doctor’s office will tell you exactly how long to fast for) and then drink a beverage containing 100 grams of glucose. After that, you’ll take a blood glucose test every hour for the next 3 hours. Your doctor can also test you by having you fast for at least 8 hours, take a blood glucose test, drink a drink containing 75 grams of glucose, and then take a blood glucose test once an hour for the next 2 hours.
If you’re at high risk but your test results are normal, your doctor might test you again later in your pregnancy to make sure you still don’t have it.
Gestational Diabetes Treatment
If you have gestational diabetes, you’ll need treatment as soon as possible to keep yourself and your baby healthy during your pregnancy and delivery. Your doctor will ask you to:
- Check your blood sugar levels four or more times a day
- Check your urine for ketones, chemicals that mean that your diabetes isn’t under control
- Eat a healthy diet
- Make exercise a habit
Your doctor will keep track of your weight and your baby’s development. They might give you insulin or another medicine to keep your blood sugar under control.
Target Blood Sugar Levels for Women During Pregnancy
The American Diabetes Association recommends these targets for pregnant women who test their blood sugar:
- Before a meal: 95 mg/dL or less
- An hour after a meal: 140 mg/dL or less
- Two hours after a meal: 120 mg/dL or less
Diet and Exercise for Gestational Diabetes
Take these simple steps to stay well:
Eat a healthy, low-sugar diet. Talk to your doctor to be sure you’re getting the nutrition you need. Follow a meal plan made for someone with diabetes:
- Trade sugary snacks like cookies, candy, and ice cream for natural sugars like fruits, carrots, and raisins. Add vegetables and whole grains, and watch your portion sizes.
- Have three small meals along with two or three snacks about the same times every day.
- Get 40% of your daily calories from carbs and 20% from protein. Most of the carbs should be complex, high-fiber carbs, with fat being between 25% and 40%.
- Aim for 20-35 grams of fiber a day. Foods such as whole-grain breads, cereals, and pasta; brown or wild rice; oatmeal; and vegetables and fruits will help get you there.
- Limit your total fat to less than 40% of your daily calories. Saturated fat should be less than 10% of all the calories you eat.
- Eat a variety of foods to make sure you get enough vitamins and minerals. You may need to take a supplement to cover your bases. Ask your doctor if they think you should take one.
Exercise throughout your pregnancy. You can exercise when you have gestational diabetes as long as your doctor says it’s OK. Being active is a good way to help manage your blood sugar. Staying fit during pregnancy is also good for your posture and can curb some common problems, like backaches and fatigue.
- Get active as soon as possible. Aim for 30 minutes of moderate activity most days of the week. Running, walking, swimming, and biking are good options. If you are not active now, start slowly and build up to 30 minutes a day.
- Was there a workout that you were doing before you found out you were pregnant? Do you have an activity that you love? Check with your doctor to see if you can keep it up, if you should make some changes, or if it's better to try something else.
- Exercise can lower your blood sugar. So when you work out, always have a form of quick sugar with you, such as glucose tablets or hard candy.
Get the right prenatal care: Your doctor can check to see if you have gestational diabetes and offer advice on food, activity, and weight loss. They can also point you to other health professionals, like nutritionists, that can help.
If you have morning sickness, eat small snacks. Nibble on crackers, cereal, or pretzels before you get out of bed. As you go through your day, have small meals often and avoid fatty, fried, and greasy foods.
If you take insulin, make sure you've got a plan to deal with low blood sugar. Throwing up can make your glucose level drop. Talk to your doctor if you're not sure what to do.
Gestational Diabetes Prevention
You can lower your risk before you get pregnant by:
- Eating a healthy diet
- Staying active
- Losing extra weight
Will Gestational Diabetes Affect My Baby?
Your baby will probably be healthy if you and your doctor manage your blood sugar while you have gestational diabetes.
Right after you give birth, doctors will check your newborn's blood sugar level. If it’s low, your baby may need to get glucose through an IV until it comes back up to normal.
Gestational diabetes raises the chance that your baby will be larger than normal. It's also linked to jaundice, in which the skin looks yellowish. Jaundice generally fades quickly with treatment.
Although your child will be more likely than other kids to get type 2 diabetes later on, a healthy lifestyle (including a good diet and lots of physical activity) can cut that risk.
Will I Get Type 2 Diabetes?
Because you had gestational diabetes, you have a greater chance of having type 2 diabetes. But it won’t definitely happen, and you can take action to prevent that.
Your blood sugar levels will likely return to normal about 6 weeks after childbirth. (Your doctor will check on that.) If it does, you should get follow-up tests at least every 3 years; your doctor may recommend yearly testing.
To lower your risk:
- Try to keep your weight in a healthy range. Not sure what that is? Ask your doctor.
- Eat a good diet that includes lots of vegetables, whole grains, fruits, and lean protein.
- Make exercise a habit.
If you plan to have another baby, keep in mind that you are more likely to get gestational diabetes again. Ask your doctor if there are any lifestyle changes that would help you avoid that.