Usually, gestational diabetes goes away after you deliver your baby, but it does raise your risk of developing type 2 diabetes later in life. We consulted some experts to find out more about this condition and how you can effectively manage it while you anticipate the birth of your baby.
Causes of Gestational Diabetes
When you become pregnant, your body begins producing hormones to support your pregnancy, and you gradually put on weight. As a result, your body needs extra insulin, a hormone produced in your pancreas, to be able to use the glucose in your food for energy. But pregnant people usually develop some insulin resistance—that is, their cells don’t use insulin as effectively as they usually would, which means they need even more insulin. Some people are able to produce the necessary insulin to overcome this resistance, but others can’t produce enough to meet the demand. As a result, they may develop gestational diabetes. It’s important to note that some folks already have diabetes before they get pregnant, but that’s considered pre-existing diabetes, not gestational diabetes.
Risk Factors for Developing Gestational Diabetes
The Centers for Disease Control and Prevention (CDC) estimates that somewhere between 2% and 10% of pregnancies are affected by gestational diabetes. “It’s very common,” notes Amy Banulis, MD, an OB/GYN for Kaiser Permanente in Falls Church, Virginia. “This is something that I talk to all of my patients about.” But certain factors can raise your risk for developing this condition. You’re at greater risk if you:
Are overweight Are over age 25 Had gestational diabetes during an earlier pregnancy Gave birth to a baby who weighed more than nine pounds Have a family history of type 2 diabetes Have polycystic ovary syndrome (PCOS)
Additionally, people who are African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or a Pacific Islander are at greater risk.
Symptoms of Gestational Diabetes
Unlike some other conditions that develop during pregnancy, gestational diabetes can be silent. That is, sometimes there aren’t any symptoms at all. When symptoms are present, they’re often mild, like increased thirst or the urge to urinate more often—both of which aren’t unusual during pregnancy anyway.
How Is Gestational Diabetes Diagnosed?
Testing for gestational diabetes typically occurs between weeks 24 and 28 of pregnancy. Don’t miss this appointment, because it’s vital to be screened, notes Dr. Banulis. “We can only identify people with risk factors about 50% of the time, so even my young, healthy, physically active, normal body weight patients need to be screened, because there is still a chance of having gestational diabetes,” she says. That said, your doctor might suggest a test as early as your first prenatal visit. “If there are risk factors of concern, you will have blood sugar testing early in your pregnancy,” adds Monte Swarup, MD, an OB/GYN and founder of HPV information site HPV HUB.
Glucose Challenge Test
The first step is the blood glucose screening test, or glucose challenge test, that all pregnant people receive between 24 and 28 weeks. You will have to drink a super-sweet beverage containing glucose. An hour later, a nurse will draw a blood sample to measure your blood glucose level. If your blood glucose level is below 140, you’re in the clear. But if it hits or exceeds the 140 mark, your doctor will likely recommend a second test.
Glucose Tolerance Test
That second screening is called a glucose tolerance test (GTT). The glucose tolerance is a more comprehensive—and longer—test than the glucose challenge test. First, you’ll need to fast for eight hours beforehand. Then you’ll drink another one of those extra-sugary drinks, but this time, you’ll undergo multiple blood draws over the course of three hours in order to determine if a diagnosis should be made.
Risks Associated With Gestational Diabetes
Gestational diabetes is associated with some potential risks to you and your baby. Here’s a look at what you need to know.
Risks for the Birthing Parent
Having gestational diabetes increases your risk for developing type 2 diabetes later in life. In fact, the CDC estimates that 50% of people who have gestational diabetes eventually develop type 2 diabetes. Other possible complications that can occur during labor and childbirth include:
Greater risk of needing a C-section Severe tears to the vagina or perineum during a vaginal birth Preeclampsia Hypoglycemia
Risks for Baby
Your gestational diabetes can also pose some risk to your baby. Your baby is more likely to:
Weigh nine pounds or more, which can make delivery more challenging Be born early and experience breathing difficulties Have low blood sugar, or hypoglycemia Develop type 2 diabetes later life.
There’s also an increased risk for stillbirth with babies born to people with gestational diabetes.
Treatment for Gestational Diabetes
You might not necessarily need to see your doctor in person more often, says Dr. Banulis. But you will have to carefully monitor your blood sugar levels for the remainder of your pregnancy—and a nurse may contact you weekly to make sure you’re staying on track. For many pregnant people with gestational diabetes, a healthy diet and regular exercise can keep their blood sugar levels under control. But others may need medication, which is typically a series of insulin injections—or in some cases, oral medication. If you have trouble managing your blood sugar levels, you may need to speak to your physician about making adjustments. The earlier you can get control, the better your outcomes, according to a recent study for JAMA Network Open. While you may no longer need to track your blood sugar levels on a daily basis and take any medication after delivery, don’t forget that you are still at elevated risk for developing type 2 diabetes later on. “It’s recommended that you have your blood tested six to 12 weeks after giving birth,” says Dr. Swarup. Depending on the results, your doctor may encourage you to undergo regular screenings afterward. Dr. Banulis usually requests that her patients undergo a follow-up glucose challenge test during their first postpartum visit, about four to eight weeks after delivery. “If that’s normal, and for the vast majority of women, it will be, we then recommend lifetime annual screenings,” she says. According to the CDC, people who had gestational diabetes should remind their doctors to check their blood sugar levels every one to three years.
Can You Prevent Gestational Diabetes?
You can’t change certain risk factors, like your family history, but you can try to reduce your chances of developing gestational diabetes. However, it may take a little advance planning. The CDC suggests losing some weight before you conceive if you’re already overweight, as well as logging regular physical activity. Research suggests that 30 minutes of walking, swimming, or cycling three or four days a week may be enough to have a positive impact on your blood sugar levels. Changing your diet may help, too—but only if you’re already overweight or obese. According to Dr. Banulis, those healthy habits may help you even after you deliver your baby, too.
Coping Strategies
Coping with a new diagnosis during pregnancy can be challenging. But learning about the best ways to manage your blood sugar levels and then diligently incorporating these tactics into your life may give you a better sense of control over the situation. Some key steps to take:
Eat a healthy diet. Eat regularly to avoid big dips and spikes in your blood sugar levels. Check and record your blood sugar levels as recommended. Take your insulin or other prescribed medications as needed. Exercise regularly as recommended by your healthcare provider.
You might find other coping strategies that help you manage. Consider these strategies:
Keep a journal. Some pregnant people like to track their food intake, their physical activity, and their blood sugar levels in a journal so they can get a better sense of how their body is responding. Talk it out. Find a trusted friend or a counselor in whom you can confide about your feelings.Don’t blame yourself. You didn’t bring this diagnosis upon yourself. Find a support network. An online or in-person support group can be a great way to share your concerns, collect some useful ideas, and maybe even make a few new friends.
A Word From Verywell
Many people who develop gestational diabetes are able to successfully manage their condition and go on to deliver perfectly healthy babies. You can be one of them, too. Talk to your healthcare provider about any concerns or questions that you have. No question is too small, especially since you’re grappling with some changes to your daily routine as you work to stay on top of your blood sugar levels and prepare for the birth of your baby.
