Gestational diabetes

What is gestational diabetes?

Gestational diabetes is a condition in which there’s too much sugar in the blood. 

When you eat, your body breaks down sugar and starches from food into glucose to use for energy. Your pancreas makes a hormone called insulin that helps your body keep the right amount of glucose in your blood. When you have diabetes, your body doesn’t make enough insulin or it can’t use insulin properly, so you end up with too much sugar in your blood. This can cause serious health problems, such as heart disease, kidney failure and blindness. 

Pregnant people are usually tested for gestational diabetes between 24 and 28 weeks of pregnancy. Most of the time it can be controlled and treated during pregnancy. If it’s not treated, gestational diabetes can cause problems for you and your baby. It usually goes away after your baby’s born. Once you’ve had gestational diabetes, you have a higher risk of being diagnosed with diabetes later in life.

Who is at risk for gestational diabetes?

In the United States, 6 out of every 100 pregnant people develop gestational diabetes. You’re more likely to have gestational diabetes if you:

• Are older than 25.
• Are overweight or obese and not physically active.
• Have had gestational diabetes or a baby with macrosomia in a past pregnancy.
• Have high blood pressure or you’ve had heart disease.
• Have polycystic ovarian syndrome (also called polycystic ovary syndrome or PCOS). This is a hormone problem that can affect reproductive and overall health.
• Have prediabetes. This means your blood glucose levels are higher than normal but not high enough to be diagnosed with diabetes.
• Have a parent, brother or sister who has diabetes.
• Are a member of a racial or ethnic group that has a higher prevalence of diabetes that isn’t entirely explained by race or ethnicity, such as Black, American Indian or Alaska Native, Asian, Hispanic/Latino or Pacific Islander

Racism and risk of gestational diabetes

Being a person of color is not a cause for having gestational diabetes.

Researchers aren’t exactly sure why people in these groups are more likely to have gestational diabetes, but they have noticed some patterns in studies about gestational diabetes. For example, many people of color experience chronic stress and lack access to fresh and healthy food. These factors are known as social determinants of health. They are the conditions in which you are born, grow, work, and live. In many cases, the social determinants of health are related to racism.

Racism and unequal living conditions affect health and well-being and increases the risk of pregnancy complications, including gestational diabetes. Racism refers to the false belief that certain groups of people are born with qualities that make them better than other groups of people.

Racism isn’t limited to personal attacks such as ethnic slurs, bullying, or physical assault. In a racist culture, one group of people has more power than other groups. People in the dominant racial or ethnic group make important decisions that affect everyone’s lives. For example, they have a lot of control over the way that schools, health care, housing, laws and law enforcement work. This control means that people in the dominant group are more likely to:

• Have better education and job opportunities
• Live in safer environmental conditions
• Be shown in a positive light by media, such as television shows, movies, and news programs.
• Be treated with respect by law enforcement
• Have better access to health care

In contrast, people from racial or ethnic minority groups who live in a racist culture are more likely to:

• Experience chronic stress
• Live in an unsafe neighborhood
• Live in areas that have higher amounts of environmental toxins, such as air, water, and soil pollution
• Go to a low-performing school
• Have limited access to healthy foods
• Have little or no access to health insurance and quality medical care
• Have less access to well-paying jobs

March of Dimes recognizes that racism and its effects are factors in the health disparities in pregnancy outcomes and babies’ health. We must work together to bring fair, just and full access to health care for all moms and babies.

Can gestational diabetes increase your risk for problems during pregnancy?

Yes. If not treated, gestational diabetes can increase your risk for pregnancy complications and procedures, including: 

• Macrosomia. This means your baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth. Babies who weigh this much are more likely to be hurt during labor and birth, and can cause damage to his or her mother during delivery.
• Shoulder dystocia or other birth injuries (also called birth trauma). Complications for birthing parents caused by shoulder dystocia include postpartum hemorrhage (heavy bleeding). For babies, the most common injuries are fractures to the collarbone and arm and damage to the brachial plexus nerves. These nerves go from the spinal cord in the neck down the arm. They provide feeling and movement in the shoulder, arm and hand.
• High blood pressure and preeclampsia. High blood pressure (also called hypertension) is when the force of blood against the walls of the blood vessels is too high. It can stress your heart and cause problems during pregnancy. Preeclampsia is when a pregnant person has high blood pressure and signs that some of their organs, such as the kidneys and liver, may not be working properly.
• Perinatal depression. This is depression that happens during pregnancy or in the first year after having a baby (also called postpartum depression). Depression is a medical condition that causes feelings of sadness and a loss of interest in things you like to do. It can affect how you think, feel, and act and can interfere with your daily life.
• Preterm birth. This is birth before 37 weeks of pregnancy. Most women who have gestational diabetes have a full-term pregnancy that lasts between 39 and 40 weeks. However, if there are complications, your health care provider may need to induce labor before your due date. This means your provider will give you medicine or break your water (amniotic sac) to make your labor begin. 
• Stillbirth. This is the death of a baby after 20 weeks of pregnancy.
• Cesarean birth (also called c-section). This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. You may need to have a c-section if you have complications during pregnancy, or if your baby is very large (also known as macrosomia). Most people who have gestational diabetes can have a vaginal birth. But they’re more likely to have a c-section than people who don’t have gestational diabetes.

Gestational diabetes also can cause health complications for your baby after birth, including:

• Breathing problems, including respiratory distress syndrome. This can happen when babies don’t have enough surfactant in their lungs. Surfactant is a protein that keeps the small air sacs in the lungs from collapsing.
• Jaundice. This is a medical condition in which the baby’s liver isn’t fully developed or isn’t working well. A jaundiced baby’s eyes and skin look yellow. 
• Low blood sugar (also called hypoglycemia)
• Obesity later in life
• Diabetes later in life

How do you know if you have gestational diabetes?

Your health care provider tests you for gestational diabetes with a prenatal test called a glucose tolerance test. If your provider thinks you’re at risk, you may get the test earlier.

If the glucose screening test comes back positive, you’ll have another test called a glucose tolerance test. After this test, your doctor will be able to tell whether you have gestational diabetes. 

How is gestational diabetes treated?

If you have gestational diabetes, your prenatal care provider will want to see you more often at prenatal care checkups so they can monitor you and your baby closely to help prevent problems. You’ll probably have tests to make sure you and your baby are doing well. These include a nonstress test and a biophysical profile. The nonstress test checks your baby’s heart rate. The biophysical profile is a nonstress test with an ultrasound.

Your provider also may ask you to do kick counts (also called fetal movement counts). This is way for you to keep track of how often you can feel your baby move. Here are two ways to do kick counts:

1. Every day, time how long it takes for your baby to move 10 times. If it takes longer than 2 hours, tell your provider.
2. See how many movements you feel in 1 hour. Do this 3 times each week. If the number changes, tell your provider.

If you have gestational diabetes, your provider tells you how often to check your blood sugar, what your levels should be and how to manage them during pregnancy. Blood sugar is affected by pregnancy, what you eat and drink, and how much physical activity you get. You may need to eat differently and be more active. You also may need to take insulin shots or other medicines. 

Treatment for gestational diabetes can help reduce your risk for pregnancy complications. Your provider begins treatment with monitoring your blood sugar levels, healthy eating, and physical activity. If this doesn’t do enough to control your blood sugar, you may need medicine. Insulin is the most common medicine for gestational diabetes. It’s safe to take during pregnancy.  

Here’s what you can do to help manage gestational diabetes:

• Go to all your prenatal care checkups, even if you’re feeling fine.
• Follow your provider’s directions about how often to check your blood sugar. Your provider shows you how to check your blood sugar on your own. They tell you how often to check it and what to do if it’s too high. Keep a log that includes your blood sugar level every time you check it. Share it with your provider at each checkup. Most parents can check their blood sugar four times each day: once after fasting (first thing in the morning before you’ve eaten) and again after each meal.
• Eat healthy foods. Talk to your provider about the right kinds of foods to eat to help control your blood sugar.
• Do something active every day. Try to get 30 minutes of moderate-intensity activity at least 5 days each week. Talk to your provider about activities that are safe during pregnancy, like walking.
• If you take medicine for diabetes, take it exactly as your provider tells you to. If you take insulin, your provider teaches you how to give yourself insulin shots. Tell your provider about any medicine you take, even if it’s medicine for other health conditions. Some medicines can be harmful during pregnancy, so your provider may need to change them to ones that are safer for you and your baby. Don’t start or stop taking any medicine during pregnancy without talking to your provider first.
• Check your weight gain during pregnancy. Gaining too much weight or gaining weight too fast can make it harder to manage your blood sugar. Talk to your provider about the right amount of weight to gain during pregnancy. 

If you have gestational diabetes, how can you help prevent getting diabetes later in life?

For most people, gestational diabetes goes away after giving birth. But having it makes you more likely to develop type 2 diabetes later in life. Type 2 diabetes is the most common kind of diabetes.

Here’s what you can do to help reduce your risk of developing type 2 diabetes after pregnancy:

• Get tested for diabetes 4 to 12 weeks after your baby is born. If the test is normal, get tested again every 1 to 3 years.
• Get to and stay at a healthy weight.
• Talk to your provider about medicine that may help prevent type 2 diabetes. 

Last reviewed: March 2022