Cedars-Sinai Blog

Gestational Diabetes: What You Need to Know

Unlike other types of diabetes, gestational diabetes usually goes away soon after delivery.

Gestational diabetes is when a woman without diabetes develops high blood sugar levels during pregnancy.

Why? Like so many things in pregnancy, it comes down to hormones.

Insulin is a hormone that keeps blood sugar (aka glucose) at healthy levels.

During pregnancy, higher levels of other hormones can interfere with your body's sensitivity to insulin, resulting in elevated blood sugar.

Unlike other types of diabetes, gestational diabetes usually goes away on its own and soon after delivery blood sugar levels return to normal, says Dr. Tania Esakoff, clinical director of the Prenatal Diagnosis Center.

"There is no need for gestational diabetes to take away from the joys of pregnancy."

If gestational diabetes goes away on its own, why is it a problem?

The problem with having too much sugar in your blood is that it bypasses the placenta and goes straight to the unborn baby.

Will the baby be OK?

Most women who get gestational diabetes do well as long as it is adequately managed.

"However, there can be complications for the baby like low blood sugar at birth, breathing issues, low levels of calcium, and jaundice," says Dr. Esakoff.

High blood sugar levels can also lead to an excessive buildup of amniotic fluid, macrosomia (which is when the baby is much larger than normal), or in rare cases, a stillbirth. Other risks include early delivery, high blood pressure, or preeclampsia.

Most of these complications can be prevented. The key is to get your blood sugar levels under control as soon as you're diagnosed.

How is it diagnosed?

While most women with gestational diabetes have no obvious symptoms, some experience extreme hunger, thirst, or fatigue. Since these symptoms are also common during typical pregnancies, Dr. Esakoff says it's essential to get proper screening.

"We have patients who take care of themselves, are in excellent shape, watch their diet, and they still get it," says Dr. Esakoff. “So you should definitely get tested around 24-28 weeks."

Tests include a 1-hour glucose tolerance test, and if it's positive, a follow-up 3-hour test to confirm the diagnosis.

What's the best way to manage it?

Unless your doctor has restricted exercising, keeping active is important. It keeps you and the baby healthy and it minimizes weight gain—women who are overweight or obese are more likely to develop gestational diabetes.

Dr. Esakoff also recommends consulting a diabetic nurse educator, dietitian, or doctor to find a way of eating that works for you.

"Controlling gestational diabetes is about finding a correct balance of protein, fats, and carbs," she explains. "A lot of patients assume if they cut carbs, things will be better, but you do need carbs when you're pregnant."

Some women also need medication or insulin injections.

Who's at risk?

Any woman can develop gestational diabetes when she's pregnant, but you're at higher risk if you:

  • Are overweight or obese
  • Have a family history of diabetes
  • Had gestational diabetes in a past pregnancy
  • Are over 25
  • Are African-American, American Indian, Asian-American, Hispanic or Latina, or Pacific Islander
  • Are prediabetic
  • Have high blood pressure

Will gestational diabetes go away?

For most women, yes, but half the women who test positive for gestational diabetes have an increased chance of developing type 2 diabetes later in life.

All women with gestational diabetes should be screened at 6 weeks postpartum to determine if they actually have diabetes outside of pregnancy.

"Once a woman has had gestational diabetes, she has to be mindful about diet and exercise for the rest of her life," says Dr. Esakoff.

But that can also be a silver lining.

"Better eating habits will give mom a healthier heart, more energy, and improved self-esteem. That benefits her and the whole family," says Dr. Esakoff.

"There is no need for gestational diabetes to take away from the joys of pregnancy."