Gestational diabetes: What it is, why it matters, and how to manage it

Now that you’re expecting, you’ll go to many prenatal visits. One thing your ob-gyn will screen you for is gestational diabetes. That’s a type of diabetes that develops or is diagnosed for the first time during pregnancy. Just like with other types of diabetes, it means that too much sugar stays in your blood.

About 6% of pregnant women in the United States develop gestational diabetes, according to the March of Dimes. And if it’s not treated, it can cause problems for you and your baby.

If you do receive a gestational diabetes diagnosis, you should know that there are a lot of effective ways to get it under control. Managing your blood sugar levels is key. Your doctor will develop a plan to help you have a healthy pregnancy.

Ready to learn more about the causes, symptoms, and treatments of gestational diabetes? Read on for answers to common questions.

What exactly is gestational diabetes?

Gestational diabetes develops when your body can’t make enough insulin during pregnancy. Insulin is a hormone your pancreas makes that lets blood glucose (sugar) into your cells. Your cells use glucose as energy.

During pregnancy, higher levels of pregnancy hormones can interfere with insulin, according to the American College of Obstetricians and Gynecologists (ACOG). That can cause your blood sugar levels to rise — and affect your health and your baby’s health.

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How will I know if I have gestational diabetes?

Gestational diabetes usually has no symptoms, according to the Centers for Disease Control and Prevention (CDC). That’s why getting screened by your doctor is so important.

You’ll be given a glucose screening test between 24 and 28 weeks of pregnancy. You’ll drink a sweet liquid that contains glucose, then get your blood drawn. If that screening test shows you may have diabetes, you’ll get a second test to confirm the diagnosis.

However, if you are at higher risk of developing gestational diabetes, your doctor may test you earlier (by 12 weeks), says ob-gyn Maureen Whelihan, M.D.

Anyone can develop gestational diabetes. But certain risk factors increase your chances, according to ACOG. They include:

• Gestational diabetes or a very large baby in a previous pregnancy
• Being overweight or obese
• Having high blood pressure or a history of heart disease
• Having a health problem such as polycystic ovary syndrome (PCOS)

Why is it so important to treat gestational diabetes?

If it's not treated, gestational diabetes can cause complications for both mother and baby. Some possible problems include:

• Your body can pass too much blood sugar to your baby. “Excess sugar in the blood feeds your baby, which can cause them to grow too large for a vaginal birth,” Dr. Whelihan says. A large baby can make labor and delivery difficult. For that reason, women with gestational diabetes are more likely to give birth via caesarean delivery (C-section).
• Moms are more likely to develop high blood pressure or a serious condition called preeclampsia.
• Most women with gestational diabetes are able to have a full-term pregnancy, according to the March of Dimes. But if there are complications, your doctor may need to induce labor early (preterm birth).
• Your baby may experience low blood sugar (hypoglycemia) and/or low calcium (hypocalcemia) right after birth. “This adds stress to the newborn trying to get accustomed to life outside the uterus,” Dr. Whelihan says. The risk of breathing problems is also higher.
• While gestational diabetes often goes away after the baby is born, it can increase your chance of diabetes later in life. About half of all women with gestational diabetes go on to develop type 2 diabetes, according to the CDC.

What’s the best way to manage gestational diabetes?

If you get diagnosed with gestational diabetes, there’s a lot you can do to manage it. The goal of treatment is to keep blood sugar levels under control. Ideally that means getting them to the same level as a pregnant woman without gestational diabetes, according to the American Diabetes Association. Your doctor will recommend these lifestyle changes:

• Check your blood sugar. Your doctor may suggest using a device known as a blood glucose meter to check your blood sugar levels throughout the day. That way, you can make sure your blood sugar levels stay in a healthy range. (A blood glucose meter is a device that takes a drop of blood from your finger to measure your blood sugar.) Your doctor can tell you what your target blood sugar level should be.
• Get active. Exercise is key, Dr. Whelihan says. Regular physical activity that’s moderately intense lowers your blood sugar and makes your body more sensitive to insulin. “Exercise takes the sugar out of the blood so your muscles can use it for energy,” she says. Aim for 30 minutes of moderate-intensity physical activity five days a week. Talk with your provider about which activities are best for you.
• Follow a healthy eating plan. Healthy food choices, portion sizes, and timing are important for keeping your blood sugar levels within your target range. Carbohydrate reduction will be especially important, says Dr. Whelihan. Your doctor or a registered dietitian can help you create a meal plan that works best for you.

If those steps aren’t enough, you might need medication to manage your blood sugar. Your doctor may prescribe insulin, metformin, or another medication.

Additional sources:
Gestational diabetes statistic: March of Dimes
Gestational diabetes basics, risk factors: American College of Obstetricians and Gynecologists
Symptoms, complications: Centers for Disease Control and Prevention
Preterm birth: March of Dimes
Chance of diabetes post-pregnancy: National Institutes of Health
Treatment goals: American Diabetes Association

Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association.