When a woman develops diabetes during her pregnancy, it’s called gestational diabetes. 

Gestational diabetes is typically symptomless, but that doesn’t mean it’s harmless. You might need an earlier delivery, and the condition can also affect the baby. Some lifestyle tweaks – like exercise and diet – may help you get your blood sugar under control. 

Get answers to nine common questions about gestational diabetes from OB-GYN Karen Carlson, MD. Plus, find out how your OB-GYN can help you manage this condition.

1. Why does gestational diabetes happen?

Pregnancy hormones from the growing placenta cause gestational diabetes. These hormones make the mother’s insulin less effective. If the mother can’t produce enough insulin to overcome these changes, gestational diabetes develops. 

2. Can gestational diabetes be prevented?

“You can’t completely prevent gestational diabetes,” says Dr. Carlson. “But lifestyle interventions can reduce your risk by about 20%.”

Reduce your risk of gestational diabetes:

• Get regular exercise
• Keep your weight at a healthy level
• Stop smoking

Some women can do everything right and still develop gestational diabetes, largely because of the hormones secreted by the placenta.

3. How is gestational diabetes diagnosed? 

The glucose challenge is a standard test for gestational diabetes. You’ll drink a sugary liquid. Then your provider will check your blood sugar once or several times to see how your body responds to the sugar intake
If your blood sugar is too high after the glucose challenge, you might get additional tests, or you may be diagnosed with gestational diabetes right away. Women without risk factors can expect to get tested at the end of the second or early in the third trimester.

4. Who is at higher risk for gestational diabetes?

Women who are high risk may be tested earlier in pregnancy and then again at 24 to 28 weeks. “Some women may be tested and diagnosed as early as their first prenatal visit,” says Dr. Carlson.

Risk factors for gestational diabetes:

• Obesity
• Previous pregnancy with gestational diabetes
• Strong family history of diabetes
• A history of having a large baby
• Later age at conception
• Polycystic ovarian syndrome

5. How does gestational diabetes affect the baby? 

Women with gestational diabetes or who had diabetes before pregnancy have an increased risk of having a large baby. “Frequently, these large babies have a normal head size but broader shoulders and larger chest and abdominal measurements,” explains Dr. Carlson. 

This can make delivery more difficult, with a higher risk of injury to both mother and fetus. Also, the baby may be at risk of having low blood sugars after birth. 

Symptoms of low blood sugar in the newborn:

• Fussy or jittery baby
• Seizures
• Breathing problems 

Excess insulin in the newborn may also be associated with jaundice and imbalances of calcium and magnesium.

6. Are gestational diabetes and preeclampsia related? 

Yes. Women with diabetes are more likely to have high blood pressure during pregnancy. 

Preeclampsia may cause high blood pressure, protein in the urine, and swelling in the fingers and toes. Your OB-GYN can help you manage preeclampsia, but it needs to be monitored closely.

7. Gestational diabetes diet: What can I eat?

“Eat a low carbohydrate diet to help control blood sugars,” says Dr. Carlson. “Avoid sugary foods, sugary drinks and simple carbohydrates.” These foods will cause your blood sugar to spike.

The best foods to eat:

• Lean proteins: chicken, eggs, fish
• Nonstarchy vegetables: salad greens, broccoli, green beans
• Healthy fats: avocados, olive oil, nuts
• Complex carbohydrates: beans, brown rice, whole wheat bread

8. How is gestational diabetes treated?

“The first treatment for gestational diabetes is a low carbohydrate diet and regular exercise,” says Dr. Carlson. If that doesn’t control your blood sugar levels, you may need oral medications or insulin. Your OB-GYN can help you manage this condition, taking into account your medical history and how your baby is developing.

When to deliver depends on each patient:

• Uncontrolled diabetes: Delivery may be recommended at 34 to 37 weeks
• Well-controlled diabetes: Many women can go to 39 to 40 weeks before induction is recommended

Because of the risk of stillbirth with suboptimal glucose control, delivery may be recommended earlier than 39 weeks in some women. 

9. Will gestational diabetes go away?

“Most often, once delivery occurs, and the placental hormones decrease, gestational diabetes does resolve on its own,” says Dr. Carlson. However, half of all women with gestational diabetes develop Type 2 diabetes later in life. It’s important to get tested regularly by your primary care provider after pregnancy. 

Still have questions? Call 800.922.0000 to make an appointment with an OB-GYN to get your concerns checked out.