Causes of Gestational Diabetes
Impact of Placental Hormones on Insulin Function
Dr Martin de Villiers, a physician at Mediclinic Cape Town, explains that in gestational diabetes, the placenta-produced hormone hinders the effective utilization of insulin in the body. This leads to a buildup of glucose in the blood instead of being absorbed by the cells.
It is advisable for women with risk factors such as obesity, advanced maternal age, or a family history of diabetes to undergo early pregnancy blood sugar testing.
Conducting glucose level tests before conceiving is optimal. Seeking a blood test from a healthcare provider when planning pregnancy can assist in devising a strategy for a healthy gestation.
Potential Complications
Gestational diabetes can result in heavier infants, which may lead to birthing complications jeopardizing both the mother and child. Changes in the placenta due to gestational diabetes can impact the supply of nutrients and oxygen to the baby, potentially culminating in stillbirth.
To manage gestational diabetes, a combination of a balanced diet, moderate exercise, and medication, if necessary, is crucial in regulating glucose levels.
Post-Delivery Monitoring
It is essential to screen glucose levels after childbirth to ensure a safe recovery. Regular postnatal tests can indicate whether the body is efficiently processing glucose.
Individuals with a history of gestational diabetes are advised to undergo an annual blood sugar test through a finger-prick method to monitor potential risks of developing Type 2 diabetes.
Gestational diabetes can manifest at any trimester of pregnancy, with a higher occurrence in the second or third trimester.
Early detection and effective management are vital in reducing risks for both mother and baby during and after delivery.
Risk Factors and Symptoms
Risk factors for developing gestational diabetes include age over 40, high body mass index, previous gestational diabetes, family history of diabetes, and specific ethnic backgrounds.
Screening for gestational diabetes is recommended for individuals with these risk factors.
Common symptoms of gestational diabetes include increased thirst, frequent urination, fatigue, blurred vision, and frequent infections.
If you experience any of these symptoms during pregnancy, it is important to consult with your healthcare provider for proper evaluation and management.
Symptoms and Potential Risks
Gestational diabetes typically does not present with symptoms but can lead to hyperglycemia. Symptoms such as increased thirst, frequent urination, and fatigue may occur.
If experiencing any concerns, it is advisable to inform healthcare providers as certain symptoms may be commonplace during pregnancy.
Pregnancy Progress and Monitoring
While most pregnancies with gestational diabetes progress normally, it is important for women to be monitored closely by healthcare providers. Regular check-ups and monitoring of blood sugar levels are crucial to ensure the health of both the mother and the baby. In some cases, medication or insulin therapy may be required to manage blood sugar levels.
There are risks associated with gestational diabetes, including delivery complications such as macrosomia (a baby that is significantly larger than average), premature birth, and an increased likelihood of developing Type 2 diabetes in the future for both the mother and the baby. However, with proper management and care, these risks can be minimized.
Screening and Management
Routine screening for gestational diabetes involves an oral glucose tolerance test (OGTT) to evaluate glucose levels. Lifestyle modifications and medication may be necessary to control blood sugar levels.
Regular monitoring throughout pregnancy aids in promptly identifying and addressing potential issues.
Managing Blood Sugar Levels
Effective management of blood sugar levels is crucial in reducing pregnancy-related complications in gestational diabetes. Regular monitoring, lifestyle adjustments, and medication can assist in controlling glucose levels.
Consulting with healthcare providers regarding physical activities and delivery options is recommended if gestational diabetes is present.
It is important for pregnant women with gestational diabetes to eat a balanced diet that is low in refined carbohydrates and sugar. Including plenty of fruits, vegetables, whole grains, and lean proteins in meals can help maintain stable blood sugar levels.
In addition to dietary changes, regular exercise is also essential for managing blood sugar levels during pregnancy. Walking, swimming, and prenatal yoga are safe and effective forms of physical activity for pregnant women with gestational diabetes.
If medication is prescribed to help control blood sugar levels, it is important to take it as directed by healthcare providers. Monitoring blood sugar levels regularly and following the prescribed treatment plan can help prevent complications for both the mother and baby.
Postpartum care
Gestational diabetes typically resolves after delivery, but the risk of developing Type 2 diabetes in the future persists. Regular diabetes screenings post-birth are crucial.
Discussing lifestyle changes with healthcare providers is important to minimize the risk of diabetes.
It is important for new mothers to continue monitoring their blood sugar levels even after giving birth. By maintaining a healthy diet, staying physically active, and monitoring glucose levels regularly, women can reduce their risk of developing Type 2 diabetes in the future.
Additionally, postpartum check-ups with healthcare providers are essential to assess overall health and well-being, as well as to address any potential complications that may arise.
Pre-pregnancy Preparation
Individuals with a history of gestational diabetes should undergo diabetes screening before getting pregnant to ensure that their condition is well-maintained. Pre-conception clinics can provide support for managing diabetes before conception.
For unplanned pregnancies, it is important to inform healthcare providers about any prior history of gestational diabetes to ensure appropriate monitoring and management.
If initial tests show no signs of diabetes, early pregnancy screening will be offered. An additional test may be conducted at 24 to 28 weeks if the first results are normal. In some cases, midwives or doctors may suggest self-testing of blood sugar levels using a finger-pricking device.
Page last reviewed: 08 December 2022
Next review due: 08 December 2025
Monitoring Blood Sugar Levels
A testing kit will be provided to check blood sugar levels, involving a finger-pricking device and a testing strip.
Guidance will be provided on correctly testing blood sugar levels, frequency of testing, target levels, and how to share results with the care team.
If insulin is used and low blood sugar issues arise, continuous glucose monitoring might be offered by the care team for better monitoring.
Dietary Changes
Diet modifications can aid in controlling blood sugar levels. Referral to a dietitian for guidance on diet and meal planning is recommended.
Patients may be advised to eat regularly, focus on starchy and low GI foods, consume ample fruits and vegetables, avoid sugary items, and opt for lean protein sources like fish.
Being aware of foods to avoid during pregnancy is also important.
It is also important for pregnant women to stay hydrated by drinking plenty of water throughout the day. Additionally, incorporating regular physical activity into their routine can help manage gestational diabetes and support overall health during pregnancy.
Consulting with a healthcare provider before making any significant changes to your diet or exercise routine is essential to ensure the health and safety of both the mother and the baby.
Physical Activity
Engaging in physical activity can assist in managing gestational diabetes by lowering blood glucose levels. A target of 150 minutes of moderate-intensity activity per week and strength exercises on at least 2 days weekly is recommended.
The NHS Diabetes Prevention Programme can provide support for individuals with a history of gestational diabetes.
Medication and Insulin Use
If blood sugar levels remain unstable despite diet and exercise changes, medication may be prescribed. This could be in the form of tablets or insulin injections.
As pregnancy progresses, adjustments in medication may be necessary due to fluctuating blood sugar levels.
Medication Details
Metformin, typically taken up to 3 times daily in tablet form, may be prescribed. Side effects like nausea, stomach cramps, and reduced appetite can occur.
Alternatively, glibenclamide, another tablet, may be recommended in some cases.
Insulin Use
If metformin is unsuitable or ineffective in lowering blood sugar levels, insulin injections may be advised. Insulin administration is done through an insulin pen, and precautions should be taken to prevent hypoglycemia.
Antenatal Monitoring
Gestational diabetes can heighten the risk of fetal complications, necessitating additional antenatal appointments for baby monitoring.
Antenatal checks may include ultrasound scans to assess the baby’s growth and amniotic fluid levels.
In addition to ultrasound scans, antenatal monitoring may also involve fetal heart rate monitoring to ensure the baby’s well-being throughout the pregnancy.
Regular antenatal appointments are essential for managing gestational diabetes and monitoring the health and development of the baby.
Delivery Timing
The optimal time for delivery with gestational diabetes is typically around weeks 38 to 40. If blood sugar levels are stable and there are no health issues, waiting for natural labor onset may be possible.
However, if delivery has not occurred by 40 weeks and 6 days, induction or a caesarean section may be offered. Early delivery may be recommended based on health concerns for the mother or baby.
Postnatal Care
Feeding the baby promptly after birth and at regular intervals until stable blood sugar levels are crucial. The baby’s blood sugar level should be monitored 2 to 4 hours post-birth.
If close monitoring is required, the baby may be cared for in a specialized neonatal unit.
Further Information through Video
For additional insights on gestational diabetes and pregnancy post-diagnosis, a video resource is available.
Page last reviewed: 08 December 2022
Next review due: 08 December 2025
As a specialist in high-risk pregnancies, I often encounter women with gestational diabetes (GD). While GD poses challenges, effective management is attainable.
Below, I address six frequently asked questions regarding GD from my patients.
Common Misconceptions
Contrary to common belief, GD is not solely influenced by dietary choices. Understanding the role of insulin in regulating blood sugar levels is crucial in comprehending GD. Hormonal changes during pregnancy can disrupt insulin function, leading to elevated blood sugar levels characteristic of GD and potential complications.
Many women with GD may feel unjustly blamed or ashamed, but it is essential to recognize that the underlying cause lies with placental hormones affecting insulin balance.
Gestational diabetes (GD) can lead to variations in baby size at birth, with risks of increased fat deposits in certain areas that may complicate delivery. Cesarean section or stillbirth are possible outcomes, prompting consideration for early delivery before the due date to minimize risks.
After birth, babies of mothers with GD may experience low blood sugar, jaundice, or respiratory issues. Close monitoring by pediatricians is essential to address any potential health issues promptly.
In the long term, children born to mothers with GD have a higher likelihood of obesity or type 2 diabetes. Informing the pediatrician about GD history ensures appropriate monitoring for potential health concerns.
Managing Blood Sugar Levels
It is crucial to maintain blood sugar levels within the recommended range throughout pregnancy. Regular monitoring with a glucose meter is essential to achieve this goal.
Diet plays a vital role in GD management, with many individuals successfully controlling blood sugar through diet adjustments and physical activity.
Increased prenatal care visits are necessary for monitoring both maternal and fetal health, often involving consultations with nutritionists to optimize dietary choices and blood sugar control. Adjustments may be made based on monitoring results.
Medical Interventions
When lifestyle changes alone are not enough to manage blood sugar levels during pregnancy, medications may be necessary.
Insulin is the preferred treatment for GD, effectively regulating blood sugar levels. It offers flexibility in dose adjustments based on various factors, including dietary intake.
Insulin use during pregnancy is safe and has minimal side effects. Alternatively, oral medications may be prescribed if insulin injections are not suitable. In some cases, a combination of treatments may be required.
Insulin and Pregnancy
Developing insulin dependence during pregnancy is not a concern with GD since the body still produces its insulin.
While adapting to insulin injections may take time, the need for insulin typically resolves after delivery, as hormonal changes related to pregnancy cease, returning blood sugar levels to normal.
Postpartum Care
GD typically resolves after childbirth.
Pregnancy acts as an indicator for future health, with GD increasing the risk of type 2 diabetes later on. Postpartum blood tests are essential to monitor health, with periodic diabetes screenings recommended post-GD diagnosis.
Reduce the risk of type 2 diabetes post-GD through a healthy lifestyle, including nutritious food choices, exercise, and weight management. Breastfeeding can also help lower the risk of type 2 diabetes for both mother and child.
Educating Yourself
Understanding GD and its management is crucial for proper care.
Managing GD alongside other responsibilities can be challenging. Seek support from healthcare professionals, family, and friends during the GD journey. Expert guidance from various healthcare professionals is valuable in navigating GD.
Rochelle, a former patient, successfully managed her GD through education and adherence to blood sugar management strategies, resulting in a healthy delivery. Remember, you are not alone in your GD journey.
If diagnosed with GD, rest assured that with proper care, a healthy pregnancy is achievable.
Published: July 2024
Last reviewed: July 2024
Copyright 2025 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed to educate the public, offering current information and opinions on women’s health. It is not a statement of the standard of care and does not cover all proper treatments or methods of care. It is not a substitute for medical advice. Read ACOG’s complete disclaimer.
Dr. Alexis C. Gimovsky
Dr. Gimovsky is an obstetrician–gynecologist, maternal–fetal medicine specialist, and associate professor at Warren Alpert Medical School of Brown University. She is a fellow of the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine.