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Overview

What Is Gestational Diabetes?

Gestational diabetes is high blood glucose that develops during pregnancy in someone who did not already have diabetes. It usually happens when pregnancy hormones increase insulin resistance and the body cannot make enough insulin to keep blood glucose in the usual range. Gestational diabetes often improves after delivery, but it can increase the parent’s future risk of type 2 diabetes and affect the baby’s health. This is why routine testing and pregnancy care are important.

How It's Diagnosed

How Gestational Diabetes Is Diagnosed

Many people with gestational diabetes have no noticeable symptoms. For this reason, clinicians commonly screen during pregnancy, usually between 24 and 28 weeks, or earlier when a person has a higher risk. Testing for gestational diabetes during pregnancy can identify high blood glucose before it causes noticeable problems.

Glucose challenge and tolerance tests

A gestational diabetes test may begin with a glucose challenge, in which you drink a sweet glucose solution and have your blood glucose measured after a set period. If that result is outside the expected range, an oral glucose tolerance test may involve drinking another solution and having blood samples taken over several hours. The care team interprets the results using pregnancy-specific thresholds, which can differ by region and protocol, and explains whether repeat or follow-up testing is needed.

Causes

What Causes Gestational Diabetes?

During pregnancy, hormones made by the placenta can make the body’s cells less responsive to insulin, a change called insulin resistance. The pancreas normally responds by making more insulin, but it may not produce enough additional insulin to keep blood glucose in the target range. This biological process is the main reason gestational diabetes can develop.

Risk Factors

Risk Factors for Gestational Diabetes

  • Previous gestational diabetes increases the likelihood of developing it again in a later pregnancy.
  • A family history of type 2 diabetes is associated with higher risk.
  • Prediabetes or insulin resistance before pregnancy can raise the chance of high blood glucose during pregnancy.
  • Polycystic ovary syndrome is associated with increased risk.
  • Overweight or obesity before pregnancy may increase the likelihood of gestational diabetes.
  • Having a previous baby weighing more than 9 pounds or 4.1 kilograms is a risk factor.
  • Some racial or ethnic backgrounds are associated with higher population risk.

These factors change the likelihood of gestational diabetes but do not predict it with certainty. People without known risk factors can still develop pregnancy diabetes, which is why routine screening is recommended.

Complications

Gestational Diabetes Complications

FOR THE PREGNANT PERSON

Possible complications include high blood pressure, preeclampsia, and a greater chance of cesarean birth. Gestational diabetes also increases the future risk of type 2 diabetes, so ongoing follow-up after pregnancy matters.

FOR THE BABY

The baby may grow larger than expected, which can increase birth injury risk and affect delivery planning. Newborns may also have low blood glucose or breathing problems after birth, and gestational diabetes may be linked with later metabolic risk.

Individual risk depends on blood glucose control and other pregnancy factors. The maternity team monitors the pregnancy and baby to identify concerns early, and appropriate management can lower the risk of complications.

Treatment & Management

Gestational Diabetes Treatment and Management

  • Meet with a registered dietitian or diabetes educator to create an individualized gestational diabetes diet plan.
  • Choose balanced meals and snacks with appropriate portions of carbohydrate, protein, fiber, and healthy fats.
  • Check blood glucose at the times recommended by the care team and record the results.
  • Use pregnancy-safe physical activity when the obstetric team approves it.
  • Attend additional prenatal visits and fetal growth monitoring when recommended.

Medication options

If blood glucose remains above the recommended target despite nutrition and activity changes, insulin is commonly used during pregnancy. The clinician will explain how to use it and whether another medicine is appropriate for your situation. Do not start, stop, or change diabetes medicine without medical guidance.

Prevention & Screening

Gestational Diabetes Prevention and Screening

Gestational diabetes cannot always be prevented. Preconception counseling, appropriate weight management before pregnancy, balanced nutrition, and approved physical activity may reduce risk for some people. Ask a clinician for individualized advice, especially if you have had gestational diabetes before or have another risk factor.

  • Most pregnant people are screened between 24 and 28 weeks of pregnancy.
  • People with higher risk may be tested at the first prenatal visit and again later if the initial result is normal.
  • Anyone who had gestational diabetes should receive postpartum diabetes testing and ongoing follow-up.

Outlook and Prognosis

Outlook and Prognosis for Gestational Diabetes

Blood glucose often returns to the usual range after delivery, so gestational diabetes may resolve once pregnancy ends. However, having it raises the chance of developing type 2 diabetes later, even when glucose normalizes after birth. Follow-up testing helps identify ongoing or future blood glucose problems early.

Next Steps After Diagnosis

Next Steps After a Gestational Diabetes Diagnosis

Contact your care team

Know when to ask for help

Contact your maternity or diabetes team about persistently high or low readings, difficulty eating or checking glucose, or questions about medicines. Seek prompt pregnancy advice for reduced fetal movement or any urgent pregnancy concern.

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Tests & Procedure

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Symptoms

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