Medically Reviewed by Michael Dansinger, MD on December 08, 2021 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 women who haven’t ever been diagnosed with diabetes. There are two classes of gestational diabetes. Women 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. Women with gestational diabetes usually don’t have symptoms or may chalk them up to pregnancy. Most find out that they have it during a routine screening. 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. You’re more likely to get gestational diabetes if you: 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, meaning you’ll get a blood glucose test 3 hours after you drink a 100-gram glucose drink. Your doctor can also test you by having you fast for 12 hours, then giving you a 75-gram glucose drink and a 2-hour blood glucose test. 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. 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: 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. The American Diabetes Association recommends these targets for pregnant women who test their blood sugar: Take these simple steps to stay healthy: 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:
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 the right prenatal care: Not only can your doctor screen you for this condition; they can 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. You can lower your risk before you get pregnant by:
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, they may need to get glucose through an IV until it comes back up to normal. Gestational diabetes raises the chance that you will have a baby who is 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. 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 every 3 years. To lower your risk: 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. If you have gestational diabetes, the chances of having problems with the pregnancy can be reduced by controlling your blood sugar (glucose) levels. You'll also need to be more closely monitored during pregnancy and labour to check if treatment is working and for any problems. You'll be given a testing kit that you can use to check your blood sugar (glucose) level. This involves using a finger-pricking device and putting a drop of blood on a testing strip. You'll be advised: If you take insulin and have problems with low blood sugar (hypoglycaemia) or your blood sugar is not stable, your care team might offer you a continuous glucose monitor (CGM). This is a small sensor you wear on your skin that sends data wirelessly to a receiver or a mobile phone, so you can see your blood sugar level at any time. Diabetes UK has more information about checking your blood sugar levels Making changes to your diet can help control your blood sugar levels. You should be referred to a dietitian, who can give you advice about your diet and how to plan healthy meals. You may be advised to: It's also important to be aware of foods to avoid during pregnancy, such as certain types of fish and cheese. Diabetes UK has more information about diet and lifestyle with gestational diabetes Physical activity lowers your blood glucose level, so regular exercise can be an effective way to manage gestational diabetes. You'll be advised about safe ways to exercise during pregnancy. Find out more about exercise in pregnancy. A common recommendation is to aim for at least 150 minutes (2 hours and 30 minutes) of moderate-intensity activity a week, plus strength exercises on 2 or more days a week. You may be given medicine if your blood sugar levels are still not stable 1 to 2 weeks after changing your diet and exercising regularly, or if your blood sugar level is very high when you're first diagnosed. This may be tablets – usually metformin – or insulin injections. Your blood sugar levels can increase as your pregnancy progresses, so even if they improve at first, you may need to take medicine later in pregnancy. You can usually stop taking these medicines after you give birth. TabletsMetformin is taken as a tablet up to 3 times a day, usually with or after meals. Side effects of metformin can include:
Occasionally a different tablet called glibenclamide may be prescribed. InsulinInsulin may be recommended if:
You inject insulin using an insulin pen. This is a device that helps you inject safely and take the right dose. Using an insulin pen does not usually hurt. The needles are very small, as you only inject a small amount just under your skin. You'll be shown where to inject and how to use your pen. Depending on the type of insulin you're prescribed, you may need to take it before meals, at bedtime, or on waking. You will be told how much insulin to take. Blood sugar levels usually increase as pregnancy progresses, so your insulin dose may need to be increased over time. Insulin can cause your blood sugar to fall too low (hypoglycaemia). Symptoms of low blood sugar include feeling shaky, sweaty or hungry, turning paler than usual, or finding it difficult to concentrate. If this happens, test your blood sugar, and treat it straight away if it's low. Find out how to treat low blood sugar. You'll be given information about hypoglycaemia if you're prescribed insulin. Find out more from Diabetes UK about types of insulin and how to take it Gestational diabetes can increase the risk of your baby developing problems, such as growing larger than usual. Because of this, you'll be offered extra antenatal appointments so your baby can be monitored. Appointments you should be offered include:
The ideal time to give birth if you have gestational diabetes is usually around weeks 38 to 40. If your blood sugar is within normal levels and there are no concerns about your or your baby's health, you may be able to wait for labour to start naturally. However, you'll usually be offered induction of labour or a caesarean section if you have not given birth by 40 weeks and 6 days. Earlier delivery may be recommended if there are concerns about your or your baby's health, or if your blood sugar levels have not been well controlled. You should give birth at a hospital where specially trained health care professionals are available to provide appropriate care for your baby. When you go into hospital to give birth, take your blood sugar testing kit with you, plus any medicines you're taking. Usually you should keep testing your blood sugar and taking your medicines until you're in established labour or you're told to stop eating before a caesarean section. During labour and delivery, your blood sugar will be monitored and kept under control. You may need to have insulin given to you through a drip, to control your blood sugar levels. You can usually see, hold and feed your baby soon after you've given birth. It's important to feed your baby as soon as possible after birth (within 30 minutes) and then at frequent intervals (every 2-3 hours) until your baby's blood sugar levels are stable. Your baby's blood sugar level will be tested starting 2 to 4 hours after birth. If it's low, your baby may need to be temporarily fed through a tube or a drip. If your baby is unwell or needs close monitoring, they may be looked after in a specialist neonatal unit. Any medicines you were taking to control your blood sugar will usually be stopped after you give birth. You'll usually be advised to keep checking your blood sugar for 1 or 2 days after you give birth. If you're both well, you and your baby will normally be able to go home after 24 hours. You should have a blood test to check for diabetes 6 to 13 weeks after giving birth. This is because a small number of women with gestational diabetes continue to have raised blood sugar after pregnancy. If the result is normal, you'll usually be advised to have an annual test for diabetes. This is because you're at an increased risk of developing type 2 diabetes – a lifelong type of diabetes – if you've had gestational diabetes.
This video gives advice about gestational diabetes and Kimberly talks about her pregnancy after being diagnosed.
Page last reviewed: 06 August 2019 |