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When diabetes is diagnosed for the first time during pregnancy, it is known as gestational diabetes. Gestational diabetes occurs in about 1 in 10 pregnancies in the US, and it usually resolves after the baby is born, though there are risks if it isn’t treated.
All women are screened for diabetes between 24 and 28 weeks of pregnancy, and high-risk women may be screened sooner. Here’s how to know your risk for gestational diabetes and how to treat it if you’re diagnosed.
What causes gestational diabetes?
While scientists aren’t exactly sure what causes gestational diabetes, it’s believed that the hormonal fluctuations during pregnancy can make it harder for the body to use insulin effectively.
Insulin is a hormone that regulates your blood sugar. If insulin isn’t working properly in your body — due to hormonal fluctuations during pregnancy — then it can lead to gestational diabetes. This is similar to what causes type 2 diabetes, where insulin is produced, but not used properly.
Most cases of gestational diabetes occur later in pregnancy, which is why women are screened between 24 and 28 weeks. That’s when the placenta is producing more hormones, including human placental lactogen (HPL), which may interfere with insulin use.
Any pregnant woman can develop gestational diabetes, but certain risk factors increase the likelihood, such as:
- Weight. The risk for gestational diabetes increases with body weight. A 2007 study published in the journal Diabetes Care found that overweight women were more than twice as likely as women with a healthy BMI to develop gestational diabetes, while severely obese women were more than eight times as likely.
- Age. A 2020 study published in the journal Diabetes Research and Clinical Practice found that the risk for gestational diabetes increases with age from 25 to 40 — with those aged 35 to 40 at the highest risk.
- Medical history. Having polycystic ovarian syndrome (PCOS), a hormonal imbalance, can increase your risk for gestational diabetes by up to four times. In addition, if you’ve had gestational diabetes in a previous pregnancy, you have a 66% chance of having it in future pregnancies.
- Family history of diabetes. “Women with a family history of diabetes are more at risk for getting it during pregnancy,” says Lisa DeFazio, a registered dietitian and nutritionist. Women who are 30 or older and have a family history of diabetes are three times more likely to have gestational diabetes. For more information, read about the link between diabetes and genetics.
Risks of gestational diabetes
Those with gestational diabetes can have healthy pregnancies and healthy babies, especially when they are treating their condition under the guidance of their doctor. However, there are still risks.
“Gestational diabetes puts the mom and baby at increased risk for pregnancy complications,” says Sherry A. Ross, MD, an OB/GYN and author.
The risks for babies born to someone with gestational diabetes include:
- High birth weight. “The baby is at risk for being much larger than normal,” Ross says. This can increase risk for birth complications like shoulder dystocia, and babies may also have difficulty regulating their own blood sugars, and could need attention in the neonatal intensive care unit (NICU).
- Increased risk for premature delivery. Most babies whose mothers have gestational diabetes are delivered full-term, between 39 and 40 weeks, but there is an increased risk for premature delivery. Premature delivery can come with health complications for the baby, such as an increased risk for having trouble regulating body temperature or experiencing digestive problems.
- Increased risk for stillbirth. Women with gestational diabetes are up to five times more likely to have a baby that is stillborn, or born dead after 20 weeks of pregnancy.
Treatment for gestational diabetes
Overall, most cases of gestational diabetes resolve once the baby is born, and your hormone levels return to normal.
“When the umbilical cord is cut, the diabetes goes away,” DeFazio says. “Pregnancy hormones cause it, so when the baby is born, mom is no longer pregnant and not producing the pregnancy hormones.”
However, it’s important to control your gestational diabetes during pregnancy in order to reduce the risk of health complications. Ross recommends the following lifestyle changes:
- Work with a dietitian. “A visit to a dietitian is important to help give you guidelines to create a low carbohydrate and high protein diet to control blood sugars,” Ross says. Learn more about why it’s so important for people with diabetes to limit their carb intake.
- Exercise regularly. Moderate exercise, like brisk walking, can help control your blood sugar levels. Ross recommends creating a daily exercise routine with your doctor.
- Check your blood sugars. Ross says a doctor will also teach you how to monitor blood glucose levels first thing in the morning and two hours after eating meals. Read our guide for more information on how to check your blood sugar.
Ross says about 15% of women with gestational diabetes may also need medication for treatment, such as insulin therapy or metformin.
Regular exercise and healthy eating can reduce that risk, but those who had a previous gestational diabetes diagnosis should continue to have their blood sugars checked every 1 to 3 years.
“Identifying early risk factors for adult onset diabetes, such as gestational diabetes, can be an early call to action to start changing your eating patterns, exercise regimen, and other harmful lifestyle habits,” says Ross.
Gestational diabetes occurs in about 1 out of 10 pregnancies in the US. But with early recognition and consistent treatment measures — like eating a healthy diet and exercising regularly — you can manage gestational diabetes and reduce your risk for health complications.