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Diabetes and Pregnancy

What is Gestational Diabetes?

Three pregnant women sitting in a doctors office reading and attending to children
Gestational diabetes is diabetes that is found for the first time when a woman is pregnant.

Gestational (jes-TAY-shun-ul) diabetes is diabetes that is found for the first time when a woman is pregnant. Out of every 100 pregnant women in the United States, three to eight get gestational diabetes. Diabetes means that your blood glucose (also called blood sugar) is too high. Your body uses glucose for energy. But too much glucose in your blood can be harmful. When you are pregnant, too much glucose is not good for your baby.

What Causes Gestational Diabetes?

Changing hormones and weight gain are part of a healthy pregnancy. But both changes make it hard for your body to keep up with its need for a hormone called insulin. When that happens, your body doesn't get the energy it needs from the food you eat.

What is My Risk of Gestational Diabetes?

To learn your risk for gestational diabetes, check each item that applies to you. Talk with your doctor about your risk at your first prenatal visit.

  • I have a parent, brother, or sister with diabetes.
  • I am African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander.
  • I am 25 years old or older.
  • I am overweight.
  • I have had gestational diabetes before, or I have given birth to at least one baby weighing more than 9 pounds.
  • I have been told that I have "pre-diabetes," a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes. Other names for it are "impaired glucose tolerance" and "impaired fasting glucose."

If you checked any of these risk factors, ask your health care team about testing for gestational diabetes.

  • You are at high risk if you are very overweight, have had gestational diabetes before, have a strong family history of diabetes, or have glucose in your urine.

  • You are at average risk if you checked one or more of the risk factors.

  • You are at low risk if you did not check any of the risk factors.

When Will I be Checked for Gestational Diabetes?

Your doctor will decide when you need to be checked for diabetes depending on your risk factors.

  • If you are at high risk, your blood glucose level may be checked at your first prenatal visit. If your test results are normal, you will be checked again sometime between weeks 24 and 28 of your pregnancy.

  • If you have an average risk for gestational diabetes, you will be tested sometime between weeks 24 and 28 of pregnancy.

  • If you are at low risk, your doctor may decide that you do not need to be checked.

How is Gestational Diabetes Diagnosed?

Your health care team will check your blood glucose level. Depending on your risk and your test results, you may have one or more of the following tests.

Fasting blood glucose or random blood glucose test

Your doctor may check your blood glucose level using a test called a fasting blood glucose test. Before this test, your doctor will ask you to fast, which means having nothing to eat or drink except water for at least 8 hours. Or your doctor may check your blood glucose at any time during the day. This is called a random blood glucose test.

These tests can find gestational diabetes in some women, but other tests are needed to be sure diabetes is not missed.
A doctor drawing blood from a patient to check blood glucose levels.
Your health care provider will check your blood glucose level to see if you have gestational diabetes.

Screening glucose challenge test

For this test, you will drink a sugary beverage and have your blood glucose level checked an hour later. This test can be done at any time of the day. If the results are above normal, you may need further tests.

Oral glucose tolerance test

If you have this test, your health care provider will give you special instructions to follow. For at least 3 days before the test, you should eat normally. Then you will fast for at least 8 hours before the test.

The health care team will check your blood glucose level before the test. Then you will drink a sugary beverage. The staff will check your blood glucose levels 1 hour, 2 hours, and 3 hours later. If your levels are above normal at least twice during the test, you have gestational diabetes.

Above-normal results for the oral glucose tolerance test
Fasting 95 or higher
At 1 hour
180 or higher
At 2 hours
155 or higher
At 3 hours 140 or higher
Note: Some labs use other numbers for this test.
*These numbers are for a test using a drink with 100 grams of glucose.

How Will Gestational Diabetes Affect My Baby?

Untreated or uncontrolled gestational diabetes can mean problems for your baby, such as

  • being born very large and with extra fat; this can make delivery difficult and more dangerous for your baby
  • low blood glucose right after birth
  • breathing problems

If you have gestational diabetes, your health care team may recommend some extra tests to check on your baby, such as

  • an ultrasound exam, to see how your baby is growing
  • "kick counts" to check your baby's activity (the time between the baby's movements) or special "stress" tests

Working closely with your health care team will help you give birth to a healthy baby.

Both you and your baby are at increased risk for type 2 diabetes for the rest of your lives.

How Will Gestational Diabetes Affect Me?

Often, women with gestational diabetes have no symptoms. However, gestational diabetes may

  • increase your risk of high blood pressure during pregnancy
  • increase your risk of a large baby and the need for cesarean section at delivery

The good news is your gestational diabetes will probably go away after your baby is born. However, you will be more likely to get type 2 diabetes later in your life. (See the information on how to lower your chances of getting type 2 diabetes.) You may also get gestational diabetes again if you get pregnant again.

Some women wonder whether breastfeeding is OK after they have had gestational diabetes. Breastfeeding is recommended for most babies, including those whose mothers had gestational diabetes.

Gestational diabetes is serious, even if you have no symptoms. Taking care of yourself helps keep your baby healthy.

How is Gestational Diabetes Treated?

Treating gestational diabetes means taking steps to keep your blood glucose levels in a target range. You will learn how to control your blood glucose using

  • a meal plan
  • physical activity
  • insulin (if needed)
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