Gestational Diabetes: Understanding Causes, Risks, and Management

Comprehensive guide to gestational diabetes, covering symptoms, causes, risks, diagnosis, treatment and living well during pregnancy.

By Sneha Tete, Integrated MA, Certified Relationship Coach

Created on Oct 3, 2025

Comprehensive guide to gestational diabetes, covering symptoms, causes, risks, diagnosis, treatment and living well during pregnancy.

Gestational Diabetes: What You Need to Know

Gestational diabetes mellitus (GDM) is a type of diabetes that develops in some women during pregnancy. This condition is characterized by high blood sugar levels that can affect the health of both mother and baby if not properly managed. Importantly, gestational diabetes typically arises around the middle of pregnancy and often resolves after delivery, but it can increase the risk of developing type 2 diabetes later in life.

What Is Gestational Diabetes?

Gestational diabetes is a form of diabetes diagnosed for the first time during pregnancy. Unlike other types of diabetes, gestational diabetes is unique to pregnant individuals who did not have diabetes before becoming pregnant. It most commonly develops in the second or third trimester as hormonal changes in the placenta increase insulin resistance, making it more challenging for the body to control blood glucose levels.

Who Is at Risk for Gestational Diabetes?

Several factors can increase a person’s likelihood of developing gestational diabetes during pregnancy. Common risk factors include:

Being overweight or obese before pregnancy
Having a family history of type 2 diabetes
Previously giving birth to a very large baby (over 9 pounds)
Having had gestational diabetes in a previous pregnancy
Being age 25 or older
Belonging to certain ethnic groups (such as African American, Hispanic, American Indian, and Asian American)
Having polycystic ovary syndrome (PCOS) or metabolic syndrome

It’s important to note that gestational diabetes can develop in anyone, even those without known risk factors.

What Causes Gestational Diabetes?

Gestational diabetes is primarily caused by hormonal changes during pregnancy. The placenta produces hormones that help the baby develop but can also block the action of insulin in the mother’s body. This leads to insulin resistance and higher levels of glucose in the blood. In most pregnancies, the pancreas compensates by increasing insulin production. However, if this compensation is insufficient, gestational diabetes occurs.

Other contributing factors include:

Maternal obesity, which increases insulin resistance
Genetic predispositions affecting insulin secretion and glucose metabolism
Older maternal age, as insulin sensitivity often decreases with age

Symptoms of Gestational Diabetes

Most women with gestational diabetes do not experience noticeable symptoms. In rare cases where symptoms occur, they may include:

Increased thirst
Frequent urination
Fatigue
Blurred vision

Typically, gestational diabetes is detected through routine prenatal screening rather than symptom presentation.

How Is Gestational Diabetes Diagnosed?

Screening for gestational diabetes is a standard part of prenatal care. Diagnosis is usually conducted between the 24th and 28th weeks of pregnancy. However, screening may occur earlier for those at higher risk.

The typical diagnostic process involves:

Glucose Challenge Test: The patient drinks a sugary solution, and blood sugar is measured after one hour. If levels are high, a follow-up test is ordered.
Oral Glucose Tolerance Test (OGTT): Conducted after fasting, blood sugar is measured before and at intervals after consuming a sweet solution. Multiple elevated readings confirm gestational diabetes.

Timely diagnosis is crucial as early management can help minimize risks for both mother and baby.

Risks and Possible Complications

Gestational diabetes increases the risk of several complications during and after pregnancy:

For the Baby:
- Macrosomia: Excessive birth weight, raising the risk of birth injuries and complicating delivery
- Premature birth: Increased likelihood of early labor
- Neonatal hypoglycemia: Low blood sugar in the baby after birth
- Respiratory distress syndrome: Breathing difficulties due to immature lungs
- Greater risk of obesity and type 2 diabetes later in life
- Stillbirth (in rare, poorly managed cases)
For the Mother:
- Higher chance of cesarean section
- Increased risk of preeclampsia (high blood pressure with organ system involvement)
- Greater risk of type 2 diabetes in the future
- Postpartum complications (e.g., bleeding, infections)

Managing Gestational Diabetes

Effective management of gestational diabetes is key to a healthy pregnancy and a healthy baby. The main goal is to maintain blood glucose within the target range. Management typically includes the following steps:

Healthy Eating and Nutrition

Balanced diet: Focus on vegetables, fruits, whole grains, and lean proteins
Avoid refined carbs: Minimize white bread, rice, and sweets
Smaller, more frequent meals: Three small-to-moderate meals with 2–3 healthy snacks maintain steadier blood sugar
Include healthy fats and fiber: These help regulate glucose levels
Bedtime snack: Helps prevent nighttime low blood sugar and ketosis

Nutrition counseling with a registered dietitian or certified diabetes educator is recommended to develop a personalized meal plan.

Physical Activity

Moderate exercise—such as walking, swimming, or cycling—most days of the week can help lower blood sugar.
Physical activity also reduces common pregnancy discomforts, such as back pain or swelling, and can improve sleep.
Consult your healthcare provider before starting a new exercise regimen, especially if you have complications or were inactive before pregnancy.
Even everyday activities (housework, gardening) contribute to better glucose control.

Blood Glucose Monitoring

Frequent self-monitoring of blood sugar is essential—typically fasting and after meals.
Keeping a blood sugar log helps the healthcare team adjust your treatment plan as needed.

Medication

If lifestyle changes alone are insufficient to keep blood sugar in the recommended range, medication may be necessary. Medication options include:

Insulin therapy: Considered the standard for gestational diabetes if medication is required. Insulin does not cross the placenta and comes in short- and long-acting forms tailored to your needs.
Oral medications: Metformin is commonly used if insulin injections are not suitable, but it is less favored than insulin in some guidelines. Other tablets (such as glibenclamide) may be considered on a case-by-case basis.

Dosages are individualized and often adjusted as pregnancy progresses. Health professionals provide specific instructions on administration and how to respond to low blood sugar incidents (hypoglycemia).

Follow-Up and Ongoing Care

Regular prenatal visits are crucial to monitor blood glucose, assess fetal growth, and detect complications early.
Additional ultrasounds may be ordered to check the baby’s size and amniotic fluid levels.
Delivery planning may involve earlier induction if the baby is large or other complications are suspected.

After the Baby Is Born

Gestational diabetes usually resolves soon after childbirth. However, both mother and child require follow-up to monitor for ongoing health concerns:

Mothers are advised to have a blood glucose test 6–12 weeks postpartum to check for persistent diabetes.
Even if blood sugar returns to normal, annual monitoring is recommended due to the increased risk of type 2 diabetes in the future.
Babies may require early monitoring for hypoglycemia and other conditions.

Can Gestational Diabetes Be Prevented?

Although gestational diabetes cannot always be prevented, you can lower your risk by adopting healthy habits before and during pregnancy:

Maintain a healthy weight prior to conception
Eat a balanced, nutrient-rich diet
Stay physically active
Manage chronic health conditions (e.g., PCOS, high blood pressure)

Frequently Asked Questions

What happens if gestational diabetes is not treated?

If gestational diabetes goes untreated, high blood sugar levels can lead to serious health complications for both mother and baby, including excessive fetal growth, preterm birth, and higher risk of stillbirth or respiratory issues for the newborn.

Will gestational diabetes continue after pregnancy?

For most women, gestational diabetes goes away after childbirth. However, experiencing gestational diabetes increases your risk of developing type 2 diabetes later in life. Ongoing follow-up and gestational diabetes testing are important.

Can I breastfeed if I have had gestational diabetes?

Yes. In fact, breastfeeding offers significant health benefits for both mother and child and may help lower the baby’s risk of obesity and diabetes in the future.

Will my child develop diabetes because of gestational diabetes?

Having gestational diabetes can slightly raise the risk that your child will develop obesity or type 2 diabetes later in life. Fostering a healthy lifestyle as your child grows can help lower these risks.

What kind of doctor treats gestational diabetes?

You will typically continue care with your obstetrician and may also work with a diabetes specialist (endocrinologist), registered dietitian, or certified diabetes educator as needed for optimal management.

Key Takeaways

Gestational diabetes is a common but manageable pregnancy complication.
Early detection and proactive treatment dramatically reduce health risks.
Healthy eating, physical activity, regular blood sugar checks, and medical guidance are central to successful management.
Long-term follow-up is important for both mother and child.

References

Author

Sneha TeteBeauty & Lifestyle Writer

Sneha is a relationships and lifestyle writer with a strong foundation in applied linguistics and certified training in relationship coaching. She brings over five years of writing experience to thebridalbox, crafting thoughtful, research-driven content that empowers readers to build healthier relationships, boost emotional well-being, and embrace holistic living.

Read full bio of Sneha Tete