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Gestational Diabetes

Gestational diabetes is a form of diabetes that affects pregnant women. The condition can lead to dangerous complications, including preeclampsia and stillbirth. Controlling your blood sugar throughout your pregnancy will reduce your risk of developing these problems.

Last Modified: September 5, 2023
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What Is Gestational Diabetes?

Gestational diabetes is a type of diabetes that only occurs only in women during pregnancy. It differs from Type 1 and Type 2 diabetes. All three types affect the way your body processes sugars, but each has its own distinct cause.

Type 1 diabetes is an autoimmune condition that causes the body to destroy cells that release insulin, reducing your body’s supply of this key hormone. Type 2 diabetes occurs when the body develops an irregular reaction to insulin.

Gestational diabetes occurs when a woman’s body reacts abnormally to insulin during pregnancy. It shares some symptoms with Type 2 diabetes, and 50% of those diagnosed with gestational diabetes develop Type 2 diabetes.

Causes of Gestational Diabetes

Scientists have not yet pinpointed the precise cause of gestational diabetes, but some hormones, including cortisol, estrogen and placental lactogen, make it difficult for women to respond properly to insulin. This is called the contra-insulin effect.

During pregnancy the placenta, an organ that develops and attaches to the uterine wall, creates the hormones that the woman’s body needs to support the unborn baby. Women usually notice the contra-insulin effect 20 to 24 weeks into their pregnancy.

As a pregnancy progresses, insulin resistance can build, worsening the condition if left untreated.

Risk Factors for Gestational Diabetes

Some women are at higher risk of gestational diabetes than others. Diabetes statistics suggest that you may be more likely to develop this condition if you:

  • Are 25 years old or older
  • Are overweight
  • Are not physically active
  • Have high blood pressure or heart disease
  • Have polycystic ovarian syndrome (PCOS)
  • Have a first-degree relative with Type 1 or Type 2 diabetes
  • Have prediabetes
  • Have had gestational diabetes before
  • Have given birth to a baby that weighed 9 pounds or more
  • Are Asian (particularly South Asian), black, American Indian or Hispanic

Researchers believe minority and ethnic populations may experience higher incidence of gestational diabetes because of significant chronic stress and systemic food deserts, limiting easy access to diverse, healthy produce.

If any of these risk factors apply to you, discuss them with your doctor as soon as possible. You can even bring up any concerns prior to conception if you plan to get pregnant or want to try. Your doctor can provide you with the information and care you need to have a healthy pregnancy.

Symptoms of Gestational Diabetes

Unlike other forms of diabetes, gestational diabetes rarely causes any symptoms. You may not find out you have it until you receive results from routine tests as part of your prenatal care.

You may show signs of hypoglycemia, including shaking, weakness and confusion. You may also develop symptoms that mirror Type 1 and Type 2 diabetes symptoms, including excessive thirst, fatigue and increased hunger.

If you experience any symptoms of gestational diabetes, your blood sugar may be much higher or lower than it should be.

Testing for Gestational Diabetes

OB/GYNs (and midwives) screen all their pregnant patients for gestational diabetes as part of routine prenatal care. They usually schedule screenings between the 24th and 28th weeks of pregnancy.

The first recommended screening is the Glucose Challenge Test, a series of blood tests designed to measure how well your body processes glucose. This test can also be used to test for diabetes when Type 2 diabetes is suspected.

After an initial blood test to measure your fasting blood sugar, technicians give you a syrupy glucose solution to drink. They will then test your blood sugar twice — once an hour for the next two hours.

If your blood sugar readings are higher than normal after drinking the solution, you may have gestational diabetes. Your doctor will then schedule additional tests to confirm the diagnosis before beginning treatment.

Complications of Gestational Diabetes

Uncontrolled gestational diabetes can cause serious complications. Women who do not treat this form of diabetes are at high risk for:

  • Birth injuries. Your baby is at risk for injuries such as shoulder dystocia and you have an increased risk of postpartum hemorrhage when giving birth. These problems can be extremely dangerous for both you and your baby.
  • Preeclampsia. Sometimes dangerously high blood pressure during or shortly after pregnancy characterizes preeclampsia. This condition can lead to many serious health problems, including low levels of blood platelets, poor kidney and liver function, fluid in the lungs and neurological problems like seizures.
  • Cesarean birth (c-section). C-sections are necessary when doctors can’t deliver the baby vaginally in a safe manner. C-sections expose you to risks like muscle damage and infections. It also makes future pregnancies riskier.

Gestational diabetes can put your baby’s health at risk. Treatment is necessary to protect you both from its negative effects.

Potential Complications That Can Impact Babies

Uncontrolled gestational diabetes can also affect your baby’s health. Babies born to mothers with uncontrolled gestational diabetes are at higher risk for:

  • Premature birth. If you develop complications with your pregnancy, your doctor may have to induce labor before 37 weeks. This is not good for your baby’s health and may even put their life at risk.
  • Breathing difficulties. Infants who are born too early may experience respiratory distress syndrome. This condition severely restricts their breathing and may make it hard for them to get enough oxygen.
  • Macrosomia (high birth weight). Babies may be born at exceptionally high weights (over 9 pounds). This puts them at high risk for birth injuries and other complications.
  • Low blood sugar (hypoglycemia). Babies may experience low blood sugar after birth. This happens because of high levels of insulin they developed in response to all the sugar they were exposed to in the womb.
  • Increased risk of obesity and Type 2 diabetes. These babies have a greater chance of becoming obese when they grow up. They are also at greater risk of developing Type 2 diabetes.
  • Stillbirth. These babies may die in the womb or shortly after delivery.

Be sure to follow all your doctor’s recommendations to keep your gestational diabetes under control. Doing so will give your baby the best chance of living a healthy life.

How to Treat Gestational Diabetes

Doctors struggle to treat gestational diabetes consistently and effectively because the causes are so unclear. Researchers constantly develop new tactics, giving doctors increased options for treatment.

For instance, a 2022 study found that gestational diabetes shares many genetic links with Type 2 diabetes and obesity. Scientists know that all three forms of the disease have an association with genes that make it more difficult for your body to produce and release insulin. These findings may guide research into development of future treatment modalities.

For now, women who develop this pregnancy-related condition are usually prescribed a gestational diabetes diet to manage their blood sugar. This is a similar approach to diabetes treatment plans for prediabetes and Type 2; however, your healthcare team should design a diet specifically for you, incorporating all of the nutrients you and your growing baby need.

The goal is to lower blood sugar and keep your levels as stable as possible while still providing you and your baby with a complete and healthy diet. Your doctors will monitor your blood sugar regularly to ensure the diet works for you.

Your doctors may also recommend light exercise as part of your gestational diabetes treatment. Recent studies suggest that exercise is a key part of successful treatment for gestational diabetes. Mothers who exercised while taking insulin for their gestational diabetes experienced significantly better health outcomes than mothers who only took insulin.

Always talk to your doctor before attempting any exercise during pregnancy.

Gestational Diabetes Prevention

Scientists are not sure how to prevent gestational diabetes. Some evidence suggests a healthy diet and regular exercise before pregnancy may make women less likely to develop the condition because it removes or lessens some of the risk factors (obesity, high blood pressure, prediabetes and Type 2 diabetes). But this is unconfirmed and needs further study before it can inform prenatal care.

Women who are already pregnant should not diet or exercise as ways to prevent gestational diabetes without support from their doctor. It’s dangerous for pregnant women to lose weight while carrying a baby to term.

Talk to your doctors — and follow their advice — about any concerns you have or health information you may need during your pregnancy.

Please seek the advice of a medical professional before making health care decisions.