Gestational Diabetes: What It Is and How to Manage It for a Healthy Pregnancy

Gestational diabetes is a pregnancy-related condition that affects blood sugar metabolism in pregnant people. Though the development of any health condition during pregnancy can be understandably worrying, gestational diabetes is often manageable with healthy lifestyle changes and close supervision from a healthcare professional. Understanding gestational diabetes, its risks, and how to manage it, is key to a healthier pregnancy for both yourself and the baby.

What Is Gestational Diabetes?

Gestational diabetes is defined as a type of diabetes that only occurs during pregnancy in people who did not have diabetes prior to becoming pregnant. The condition typically manifests around the 6th month of pregnancy when the mother and baby need more insulin than the body is able to provide, which makes it more difficult to manage blood sugar.

About 5–9% of pregnant people in the US will develop gestational diabetes. In most cases, the production of insulin and natural management of blood sugar will return to normal once the baby is born. However, those who have gestational diabetes have a 50% chance of developing type 2 diabetes later in life.

There is no need to worry, however, as people with gestational diabetes are still able to carry healthy babies through a healthy pregnancy when the condition is managed properly. Diet plays a major role in diabetes management, so working with a registered dietitian who specializes in pregnancy can make managing diabetes less daunting.

Why Does Gestational Diabetes Happen?

As the placenta develops during pregnancy, it produces hormones that can make it more difficult for the body to respond to insulin properly, causing the same insulin resistance seen in those with prediabetes and diabetes.

When nutrients go into the blood, sugar rises to provide the body with energy, and insulin is the guide that shows these sugars where to go. When the body becomes insulin resistant, these guides become "lost" and blood sugar remains high, which can pose health risks to the mother and baby.

Furthermore, in some pregnancies, the pancreas has trouble producing enough extra insulin for both the mother and the baby. Both of these mechanisms can result in gestational diabetes. Considering the placenta produces more hormones as it grows in size, this is why the condition is typically seen late in the pregnancy.

Though type 2 diabetes is typically a result of lifestyle, gestational diabetes is a common complication of pregnancy that is hormone-driven. Even if a parent follows all the doctor's recommendations with regard to diet, exercise, and medications, it is still possible to develop the condition by chance.

Who's More Likely to Develop Gestational Diabetes?

ClassificationRisk FactorsPre-existing ConditionsPrediabetes, metabolic syndrome, family history of type 2 diabetes, or polyendocrine metabolic ovarian syndrome (PMOS)Lifestyle HabitsHigh body fat prior to pregnancy; little to no exercise; pro-inflammatory diet high in refined sugar, saturated fat, and processed foodsPrevious Pregnancy ComplicationsPrior gestational diabetes; previous baby weighing 9+ pounds; carrying multiplesAge & EthnicityPregnancy at age 35+; Black, Hispanic, and Indigenous people face higher risk

Signs and Symptoms of Gestational Diabetes to Watch For

Diabetes in pregnancy can be very hard to detect, especially when your body is already undergoing so many changes. Common symptoms to look out for include constant thirst, frequent urination, blurry vision, unusual fatigue, and recurring infections, especially yeast infections. As mentioned, symptoms like fatigue and frequent bathroom breaks are also normal pregnancy symptoms, which makes gestational diabetes even less obvious.

This is why you should be cautious about self-diagnosing and voice any concerns to your doctor. Don't be afraid to get prenatal screenings even if nothing seems obviously wrong.

How Gestational Diabetes Is Diagnosed

Diabetes is typically detected through a glucose challenge test, which tests how effectively your body responds to your current production of insulin. Usually the assessments are done between 6–7 months of pregnancy, though some doctors may test earlier if you are at higher risk.

The test is simple. You're given a sweet glucose beverage to drink and then wait an hour while your body processes the sugar. Your doctor will then test your blood sugar by taking a quick blood sample from the arm. If blood sugar is higher than expected, a second, more comprehensive test will be done to confirm gestational diabetes.

How Gestational Diabetes Can Affect the Baby

Most people who develop gestational diabetes go on to have healthy babies. A high blood sugar level causes the baby to receive more calories than necessary, which results in the baby growing larger than normal. Large babies can cause complications during delivery or make c-sections necessary. Early birth can also result from high blood sugar. As concerning as this sounds, these risks are only an issue with uncontrolled blood sugars.

Effects on the Baby After Birth

Babies born to parents with gestational diabetes may have low blood sugar after being born, but this is swiftly managed by medical staff in the delivery room. Long-term, there is a slight risk the child will develop diabetes or obesity later in life — though instilling healthy diet and exercise habits can help drastically lower these risks.

How Gestational Diabetes Can Affect You

During the pregnancy as well as the years after, there are health risks for the parent that come with uncontrolled gestational diabetes.

During Pregnancy

The high blood sugar that comes with gestational diabetes can inflame the blood vessels and make them stiff, which increases risk of high blood pressure and preeclampsia. With prompt, individualized medical care, the condition is often managed safely.

After Pregnancy

After pregnancy, about 50% of people will develop type 2 diabetes later in life. This is a sizable statistic, but not inevitable by any means. Lifestyle changes, many similar to what you would be advised to implement while experiencing gestational diabetes, can delay the onset or prevent the development of diabetes again down the line.

Managing Gestational Diabetes: What You Can Do

Knowing how to manage and monitor gestational diabetes is the most important piece of information you can receive here, and it can be reasonably achieved through lifestyle changes and, if needed, certain medications.

Monitoring Your Blood Sugar

Blood sugar monitoring involves using a glucose monitor to assess how high your blood sugar climbs after a meal, typically using a tiny amount of blood from a finger prick. It's advised to check your blood sugar first thing in the morning and two hours after eating. Target ranges are under 95 mg/dL before meals, and under 120 mg/dL two hours after eating.

Eating Well for Blood Sugar Control

The most impactful way to manage blood sugars is through a proper diet. A focus on high-fiber foods like vegetables and whole grains along with lean proteins helps slow digestion, which prevents blood sugar spikes after meals.

In addition to what you eat, when and how much you eat are also important. Eating too frequently and eating too large portions can increase blood sugar levels quickly. Spread mindfully portioned meals throughout the day and always balance them with fiber and protein, rather than eating high-carb foods in isolation.

Top Nutrition Coaching connects pregnant people with dietitians who specialize in gestational diabetes, with counseling that is often covered by insurance.

Staying Active During Pregnancy

Physical activity plays a major role in blood sugar control and improving insulin sensitivity. Being moderately active for just 30 minutes most days of the week is enough to make a difference — just make sure this level of movement is cleared with your doctor first. Low-impact activities like walking, swimming, and yoga are great options.

Strength training has also been shown to help lower risk of preeclampsia or needing a c-section and can also help result in smoother labor.

Medication When Needed

It's not always needed, but some people may need insulin or other medications to help manage blood sugar in addition to lifestyle changes. Needing medication doesn't mean you've done anything wrong or have failed — it just means your individual pregnancy requires a little more support. Note that insulin is a naturally occurring hormone, so using it is perfectly safe for you and the baby.

Preventing Gestational Diabetes and Future Type 2 Diabetes

Gestational diabetes can't always be avoided, but maintaining healthy lifestyle choices can still reduce risk. Working with your doctor to screen for these conditions is also recommended.

Before Pregnancy

When trying to conceive, the most ideal situation would be reaching a healthy weight before the pregnancy begins. A portion-controlled diet and regular physical activity can help achieve this.

During Pregnancy

Staying active during pregnancy can help keep weight within healthy parameters, along with healthy eating habits that are balanced and portion-controlled to prevent overeating.

After Delivery

Though gestational diabetes goes away after the baby is born, it's still important to have your doctor test your blood sugar to make sure your insulin metabolism is back to normal. In the years following delivery, it's wise to be tested for diabetes every 1–3 years to assess risk.

If you'd like to be proactive, it's recommended to follow the National Diabetes Prevention Program, which has been proven to reduce type 2 diabetes risk by 58% in those with a history of gestational diabetes.

Working With a Registered Dietitian for Gestational Diabetes

There are registered dietitians who specialize in nutrition during pregnancy and the management of conditions like gestational diabetes. They can take a close and comprehensive look at your pregnancy, blood sugar patterns, cultural food preferences, and overall lifestyle to tailor recommendations that are easy for you as an individual to follow.

Many insurance plans fully cover nutrition counseling for gestational diabetes, and Top Nutrition Coaching can conveniently match you with a dietitian with this expertise. Licensed registered dietitians on the platform consult virtually, which allows you to receive support from home.

Pregnancy is a beautiful period of one's life, but comes with a host of challenges both expected and unexpected. If you find yourself facing gestational diabetes as one of these challenges, you don't have to face it alone. Check your insurance coverage and get matched with a registered dietitian who can help.

Frequently Asked Questions

What is gestational diabetes and how does it differ from other types of diabetes?

Gestational diabetes is a temporary form of high blood sugar that develops during pregnancy in people who didn't already have diabetes.

What causes gestational diabetes and who is at highest risk?

‍Gestational diabetes is caused by pregnancy hormones that block the action of insulin, leading to insulin resistance. You are at highest risk if you are overweight, over 25, have prediabetes or a family history of type 2 diabetes, had gestational diabetes in a previous pregnancy, or have PCOS.

What are the warning signs and symptoms?

Gestational diabetes usually has no obvious symptoms, but some people experience unusual thirst, frequent urination, fatigue, or blurred vision.

How will gestational diabetes affect my baby?

Gestational diabetes can cause the baby to grow larger than normal (macrosomia), increasing the risk of a difficult delivery or a c-section. After birth, babies often experience sudden low blood sugar or breathing difficulties.

Can gestational diabetes be managed with diet and exercise alone?

Most people successfully manage gestational diabetes through diet and exercise alone. However, about a third to half will eventually require medication — such as insulin or metformin — if lifestyle changes are not enough.

How often do I need to check my blood sugar?

You need to check your blood sugar at least four times a day: first thing in the morning and one to two hours after each main meal.

Will gestational diabetes go away after I give birth?

Yes, gestational diabetes usually goes away shortly after birth.

What is my risk of developing type 2 diabetes after gestational diabetes?

People who have had gestational diabetes are approximately 7 to 11 times more likely to develop type 2 diabetes later in life.

What should a gestational diabetes meal plan include?

A gestational diabetes meal plan should stabilize blood sugar by featuring a balance of lean proteins, healthy fats, and complex carbohydrates at every meal. Avoid simple sugars and refined carbs like sodas, white bread, and sweets.