What You Need to Know About Gestational Diabetes
Medical Reviewer(s): Melissa Walsh, MD
Gestational diabetes is a common complication of pregnancy that can affect your health and your baby’s health. In the United States, gestational diabetes affects about 8% of pregnancies (CDC). The good news is that eating healthy and exercising can help reduce your risk. And, if you find out you have gestational diabetes early, your healthcare provider can help you manage it so that you and your baby stay healthy. That is why it is important for you to know if you are at-risk and to know how to identify the signs of gestational diabetes.
What Is Gestational Diabetes?
Gestational diabetes, which is sometimes called gestational diabetes mellitus or GDM, is a type of diabetes that can develop during pregnancy. It is different from Type 1diabetes, which typically develops in children, and Type 2 diabetes, which typically develops in adults, because gestational diabetes only develops during pregnancy.
When you are pregnant, your body goes through many changes, including hormone changes. One of the hormones that can change is insulin, which is the hormone that helps your body process sugar and keep your blood sugar level healthy. When your insulin is not working the way it should, the sugar stays in your blood, and that can make you sick. This is called gestational diabetes.
Gestational diabetes usually starts around the middle of your pregnancy. Your healthcare provider will most likely test you for gestational diabetes when you are somewhere between 24 and 28 weeks pregnant. But if you are at high risk, your provider may test you earlier.
Gestational diabetes usually stops being an issue after you have your baby. But it can lead to other health problems that can affect your pregnancy and it can cause other health issues for you and your baby after you give birth. This is one reason why postnatal care, which is healthcare for you and your baby in the weeks and months after childbirth, is so important.
Who Is at Risk of Developing Gestational Diabetes?
Anyone who is pregnant can develop gestational diabetes, but some people are more at risk than others. You may be at higher risk if:
- You are 35 years old or older
- You had gestational diabetes in a past pregnancy or you have prediabetes, meaning your blood sugar levels are high, but not high enough to be called diabetes
- Someone in your immediate family, like a parent or sibling, has diabetes
- You were overweight or obese before you got pregnant (talk to a healthcare provider who can help you understand if your pre-pregnancy weight was healthy)
- You are not physically active, meaning you do not exercise for at least 150 minutes every week
- You had a big baby (more than 9 pounds) before
- You have a condition called polycystic ovary syndrome, or PCOS
- You have high blood pressure (hypertension)
- You have a heart condition or someone in your family has had heart disease
- You have hypertriglyceridemia (higher-than-normal level of a type of fat in your blood), low levels of high-density lipoprotein, HDL (sometimes called “good cholesterol”), or another issue with your insulin levels
In addition to the health issues listed above, there are also social factors, such as ethnicity and income level, that can increase your risk. If you are Asian or Indigenous, or if you live in a low-income area, you are more likely to get gestational diabetes. This is because you are more likely to be stressed on a daily basis, more likely to have trouble getting medical care, and are more likely to be treated unfairly by healthcare providers and health systems.
What Are the Signs of Gestational Diabetes?
Many people with gestational diabetes do not have symptoms, which is why testing is so important. But some signs you might notice include:
- Feeling much thirstier than usual
- Needing to pee more often than usual
- Feeling really tired or weak all the time
- Feeling sick to your stomach
- Having trouble seeing clearly (blurry vision)
If you have any of these symptoms, contact your healthcare provider. Do not wait until your next appointment. Seeing your healthcare provider right away and getting treatment early can help keep you and your baby healthy and safe. When you see your healthcare provider, they will give you a test for gestational diabetes and provide advice to help you either prevent gestational diabetes from developing or to help you manage gestational diabetes, if you test positive.
What Happens During a Test for Gestational Diabetes?
Your healthcare provider will typically test you for diabetes when you are between 24 and 28 weeks pregnant. If you are at higher risk, they may test you earlier, possibly during your first visit.
The first test takes about one hour. For this test, you will drink a sugary drink and then have a blood sample taken to measure your blood sugar level. If this test comes back positive, you will then complete a three-hour test to confirm that you have gestational diabetes. For the second test, you will need to fast, meaning you cannot eat or drink anything (besides water) for at least eight hours before you have your blood drawn. After the first blood test, you will drink a sugary drink and then have your blood drawn three more times—after one hour, after two hours, and then after three hours.
If you have any of the risk factors listed earlier in this blog, and you test positive in the one-hour test but negative in the three-hour test, your healthcare provider may give you instructions on how you can change your lifestyle (eating healthy, exercising more) to reduce your risk of developing gestational diabetes.
What Can Happen if Gestational Diabetes Is Not Treated?
If it’s not treated, gestational diabetes can cause serious health issues for you and your baby.
For example, you might:
- Develop high blood pressure or preeclampsia, a serious blood pressure condition
- Go into preterm labor, which is labor that starts before you are 37 weeks, and cause your baby to be born preterm
- Have issues during labor and delivery, which can lead to needing a C-section surgery to give birth or can create a fistula that can cause you to leak urine or feces
- Bleed heavily after giving birth, which is called postpartum hemorrhage
Also, your baby may:
- Be bigger than normal, which can make delivery harder
- Be born too early
- Have trouble breathing once it is born
- Have low blood sugar once it is born
- May be stillborn
Babies who are born too early and those who have trouble breathing or have low blood sugar often require extra support through a neonatal intensive care unit (NICU).
In addition to these immediate problems, you and your baby are also at higher risk of developing diabetes later in life, if you have gestational diabetes.
Dangers of Missing Symptoms of Gestational Diabetes: Example Studies
Sarah Was Thirsty and Peeing All the Time
Story: At 20 weeks, Sarah, a first-time mom whose sister and mother both have diabetes, was always thirsty and had to pee nearly every hour. She thought this was a normal part of pregnancy. But, at her 24-week appointment, her doctor tested her blood sugar and found she had mild gestational diabetes. Sarah worked with her doctor and a dietitian to make a plan to eat healthier, exercise more, and check her blood sugar every day from home until she had her baby.
Lesson: Being extra thirsty and peeing more are common in pregnancy, but they can also indicate gestational diabetes. Tracking how often you drink and use the bathroom and sharing this information with your healthcare provider can help your provider decide how best to care for you. In some cases, your healthcare provider may decide you need to take a gestational diabetes test earlier than normally recommended.
Claudia Felt Sick and Tired
Story: At 16 weeks pregnant, 40-year-old Claudia was still feeling sick and tired all the time. She wasn’t happy, but she thought it was just normal morning sickness and did not think she needed to do anything differently. When she finally went to see her doctor more than a month later, she was tested and diagnosed with severe gestational diabetes. Her doctor gave her medicine and connected her with a dietitian who would create a meal plan for her.
Lesson: Feeling sick and tired are common during pregnancy, but they can also be signs of gestational diabetes. Regularly tracking your symptoms and sharing this information with your healthcare provider can help your provider decide how best to care for you. In some cases, your healthcare provider may decide you need to take a gestational diabetes test earlier than normally recommended.
Can Gestational Diabetes Be Prevented?
You cannot always prevent gestational diabetes, but you can lower your risk. Here are some tips:
- Eat a healthy, balanced diet
- Get regular exercise (like walking, swimming, or yoga) for at least 150 minutes every week
- Go to all your antenatal checkups
- Talk to your doctor if you have any of the risk factors listed in this blog
If you already have gestational diabetes, your healthcare provider can help you manage it and prevent it from causing more health issues for you and your baby.
How Can BobiHealth Help?
Glucose screening is essential, and getting screened early is particularly important if you have any risk factors. But, monitoring your health at home can improve your chances of preventing or identifying gestational diabetes early. It is important that you understand your own risk level and know how to identify signs and symptoms of gestational diabetes, so you can connect with your healthcare provider and share this information as needed, including during scheduled visits and between visits.
Digital monitoring tools, like BobiHealth, can help you monitor and track your symptoms. And, while other pregnancy apps focus on kick counts and weight gain, BobiHealth tracks this information and so much more. For instance, our app allows you to:
- Track your blood glucose levels and get an alert if your levels may be off
- Log symptoms like thirst, tiredness, or sickness that could be a sign of gestational diabetes or another health issue
- Create custom reminders, such as reminders to test your blood sugar or to take your insulin
- Share your health information with your healthcare provider in real-time so they can better understand your needs
This tool is useful for all pregnant people, but it is particularly helpful for anyone who is not able to see their healthcare provider easily. For instance, if you cannot take time off work or find transportation to see your healthcare provider between your scheduled appointments, you can still stay on top of your health and you can still share information with your healthcare provider from home.
When you identify a health issue and seek care quickly, sharing specific examples of your symptoms, your healthcare provider is better able to help you manage the issue and prevent more complications.
Take Care of Yourself and Your Baby
Gestational diabetes is one of the most common complications of pregnancy, and it can lead to serious health issues for labor, delivery, and beyond. Eating healthy and exercising can help reduce your risk. If you develop gestational diabetes, your healthcare provider can help you manage. The sooner you identify the issue, the better—the better care your healthcare provider can offer and the better chance you and your baby have to stay healthy. That is why it is important for you to be able to identify the signs of gestational diabetes and contact your healthcare provider to discuss any concerns.
Download the BobiHealth app today to start tracking your symptoms and taking charge of your pregnancy health.
Useful Terms
Here are definitions of a few terms we used in this blog. It may be helpful to read these definitions so you know what they mean if your healthcare provider uses these words with you.
Cesarean section (C-section): A cesarean section, or C-section, is a surgery that involves a doctor cutting into a pregnant person’s belly to deliver the baby. Read our blog, Are C-Sections Avoidable? What You Need to Know, to learn more.
Diabetes: Diabetes is a health condition that occurs when your body does not process sugar the right way. When your body doesn’t process sugar correctly, the sugar can stay in your blood and make you sick.
Gestational diabetes: Diabetes is a health condition that occurs when your body does not process sugar the right way, which can make you sick. When this happens during pregnancy, it is called gestational diabetes.
High blood pressure, hypertension: High blood pressure, also known as hypertension, happens when your blood pushes too hard against the walls of your blood vessels. This can happen if the blood vessels get tighter or less flexible, and this can lead to severe health issues, like a heart attack or a stroke.
Neonatal intensive care units (NICUs): NICUs, also known as intensive care nurseries, are special areas in a hospital or birthing center that provide extra care for newborns with serious health conditions. Read our blog, NICU101: How Healthy Pregnancies Support Healthy Babies, to learn more.
Obstetric fistula: An obstetric fistula is an abnormal opening between the reproductive tract and urinary tract or rectum. This opening can happen if you have a difficult and long labor and it can cause you to leak either urine or feces.
Polycystic ovary syndrome (PCOS): PCOS is a common health condition that can affect anyone with ovaries. It is caused by a hormonal imbalance and can affect your periods—you may have irregular and heavy periods or your periods may stop.
Postnatal or postpartum care. Postnatal care, which is sometimes called postpartum care, is healthcare for you and your baby in the weeks and months after childbirth. You may have heard this called well-mama and well-baby visits, because these visits take place not because you or your baby feel sick, but so your healthcare provider can make sure you and your baby do not have any health issues that you might not notice.
Postpartum hemorrhage: Postpartum hemorrhage is when a person bleeds extremely heavily after giving birth. The rapid loss of a large amount of blood can cause your blood pressure can drop, which can then lead to more health issues and even cause death, if untreated.
Prediabetes: If you have higher-than-normal blood sugar levels, but the levels are not high enough for your healthcare provider to diagnose you with diabetes, you have prediabetes. Prediabetes is a warning sign that you are at risk of developing diabetes.
Preeclampsia: Preeclampsia is a health condition that can happen during pregnancy and up to 6 weeks postpartum. Preeclampsia happens when your blood pressure is too high and can lead to dangerous complications. Read our blog, What You Need to Know About Preeclampsia, to learn more.
Preterm labor: Preterm labor is labor that takes place earlier than it should, usually before the 37th week of pregnancy. Read our blog, Avoid Having Your Baby Too Early: Your Guide to Preterm Labor and Birth, to learn more.
