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Pregnancy is a time of significant hormonal and physical changes. For some women, these changes can affect how the body uses insulin, leading to gestational diabetes - a temporary but serious condition that requires careful monitoring and management.

Although most women go on to have healthy pregnancies and healthy babies, understanding what gestational diabetes is, why it happens, and how it can affect both mother and baby is an important part of prenatal care.

What is gestational diabetes?

Gestational diabetes is a type of diabetes that develops during pregnancy when the body cannot produce enough insulin to meet increased demands. As pregnancy progresses, hormone levels rise and the placenta produces hormones that help the baby grow. These same hormones can reduce the body’s ability to respond to insulin effectively. This is called insulin resistance1.

When the body can’t produce enough insulin to overcome this resistance, blood glucose levels rise above the normal range. This is what leads to gestational diabetes mellitus1. The condition can be diagnosed at any stage of pregnancy, but most commonly occurs between weeks 24 and 28 of pregnancy, which is why glucose tolerance tests are routinely offered during this time1,2.

Key points to remember:

  • Gestational diabetes differs from type 1 or type 2 diabetes - it develops during pregnancy and is usually resolved after giving birth1.
  • Not all women experience symptoms, so screening tests play a crucial role in detection1,3.
  • Good blood sugar control throughout pregnancy reduces risks for both mother and baby1,4.

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Causes and risk factors for gestational diabetes

The exact cause of gestational diabetes isn’t fully understood, but hormonal changes that affect how much insulin your body can produce during pregnancy play a central role. This hormonal shift can lead to higher blood glucose levels, particularly in women who already have some degree of insulin resistance or have been living with diabetes1.

Certain factors can increase the risk of developing gestational diabetes:

  • Age - Women over 40 have a higher risk.
  • Body weight - Having overweight or obesity can make the body less responsive to insulin.
  • Weight loss surgery - If you’ve had a gastric bypass or other weight loss surgery.
  • Previous pregnancy - Women who’ve experienced gestational diabetes before are at greater risk in future pregnancies.
  • Child’s birth weight - You previously had a baby who weighed 4.5kg (10lb) or more at birth.
  • Family history - A family history of type 2 diabetes increases the likelihood of developing gestational diabetes.
  • Ethnicity - If you are of south Asian, Black, African-Caribbean or Middle Eastern origin1,5.

While these factors raise the chances of developing gestational diabetes, many women who don’t fit into any of these categories can still be affected1. This is why universal glucose challenge tests are offered during pregnancy1,2.

Symptoms and how gestational diabetes is diagnosed

Many women with gestational diabetes don’t experience any obvious diabetes symptoms. For this reason, routine blood tests are crucial3.

If symptoms do appear, they may include:

  • Increased thirst
  • Frequent urination
  • Fatigue or low energy
  • Blurred vision
  • Genital itching or thrush1,3

Glucose testing during pregnancy

  • Glucose challenge test: A preliminary screening in which you drink a sugary solution and provide a blood sample an hour later to check your blood glucose levels.
  • Oral glucose tolerance test (OGTT): If the first test shows high blood sugar levels, this follow-up test involves drinking a more concentrated sugary drink and providing additional blood samples at set intervals2.

If your blood glucose level exceeds the normal blood sugar range, a diagnosis of gestational diabetes is made2.

Health risks for mother and child

Gestational diabetes can increase the risk of complications if not well controlled. However, with early diagnosis, close monitoring, and proper management, many of these risks can be significantly reduced1.

Risks for pregnant mothers
  • High blood pressure and preeclampsia: Women with gestational diabetes are at a higher risk of these pregnancy complications1.
  • Caesarean section (C-section): High blood sugar can cause the baby to grow larger than average (macrosomia), making vaginal delivery more difficult1,6.
  • Future diabetes: Women who’ve had gestational diabetes have a higher risk of developing type 2 diabetes later in life1.
Risks for babies
  • High birth weight: Babies born to mothers with poorly controlled blood glucose levels may be larger, which can complicate delivery1,6.
  • Premature birth: Gestational diabetes may increase the likelihood of early labour1,6
  • Low blood sugar after birth: The baby’s insulin levels may remain high, leading to neonatal hypoglycaemia1,6.
  • Jaundice: Babies born with gestational diabetes exposure may be more likely to develop jaundice shortly after birth1,6.
  • Long-term risks: Children born to mothers with gestational diabetes face a higher risk of obesity and type 2 diabetes in later life6.

Managing gestational diabetes

The good news is that most women can manage gestational diabetes effectively and have a healthy pregnancy with the right combination of self-care, monitoring, and medical support4.

Lifestyle changes and self-care

For many women, managing gestational diabetes begins with daily lifestyle adjustments, including:

  • Balanced diet:
    •  Prioritise whole grains, lean proteins, healthy fats, and fibre-rich vegetables.
    • Limit sugary drinks, desserts, and refined carbohydrates.
    • Eat smaller, more frequent meals to stabilise blood sugar levels7.
    • Follow a specialist diabetes cookbook for guidance.
  • Physical activity:
    • Regular exercise such as walking, swimming, or prenatal yoga improves insulin sensitivity.
    • Being physically active can help keep blood glucose levels in the normal range1,4.
  • Weight management:
    • Maintaining a healthy weight during pregnancy can help reduce complications.
    • Losing extra weight before a future pregnancy can lower your risk of developing gestational diabetes again7.
  • Blood glucose monitoring:
    • Use a glucose meter to check your blood sugar levels regularly.
    • Monitoring typically happens before and after meals to track blood glucose ranges accurately4.
Medical management

If lifestyle changes aren’t enough to control blood sugar:

  • Insulin injections:
    • Insulin is the standard diabetes treatment as it helps bring blood glucose levels back into a healthy range, and is safe for both mother and baby4.
  • Other medications:
    • In some cases, oral medications such as metformin may be prescribed, though insulin remains the most common option4.
Ongoing monitoring and prenatal care
  • Regular antenatal appointments to track both maternal and baby’s health.
  • Adjustments to diet, insulin doses, or physical activity as needed1.

How to help prevent gestational diabetes

Not all cases of gestational diabetes can be prevented, but maintaining healthy habits before and during pregnancy can reduce the likelihood of developing the condition5.

Helpful strategies include:

  • Achieving and maintaining a healthy BMI before pregnancy1,5.
  • Incorporating regular physical activity into daily life1,5.
  • Choosing a balanced diet that includes whole grains, lean proteins, and vegetables7.
  • Reducing intake of sugary drinks and processed foods7.
  • Attending regular prenatal appointments and following medical advice closely1,5.

Life after gestational diabetes

Although gestational diabetes is usually resolved after birth, its impact can last beyond pregnancy. Women who’ve experienced the condition have an increased risk of developing type 2 diabetes in the future, and their children may face a higher likelihood of obesity or blood sugar regulation problems later in life1,6.

Postpartum care for mothers

  • Blood test 6-13 weeks after delivery to check blood glucose levels1,4.
  • Ongoing screening every 1-3 years to catch early signs of diabetes1.
  • Continuing healthy eating and regular exercise to maintain blood sugar control1.
  • Maintaining healthy weight to lower future risks1.

Supporting your baby’s health

  • Monitoring the baby’s blood sugar level immediately after birth.
  • Fostering healthy family habits, including nutritious meals and active play, to reduce long-term risk factors6.

Looking forward: empowering mothers with knowledge

Gestational diabetes can feel overwhelming at first, but with the right information, support, and care, most women go on to have healthy pregnancies and healthy babies.

Most importantly, staying engaged in postpartum care and maintaining healthy habits such as dietary changes beyond pregnancy can protect you and your child from future health problems. With proper management, gestational diabetes is not just a medical condition - it can also be a powerful opportunity to adopt lasting lifestyle changes for the whole family.

FAQs

How is gestational diabetes treated?

Gestational diabetes is treated through a combination of diet, exercise, and sometimes medication or insulin. A balanced, diabetes-friendly diet with smaller, frequent meals helps control blood sugar levels. Regular physical activity also aids in managing blood sugar. Monitoring blood sugar at home is essential, and if lifestyle changes aren't enough, insulin or medication may be prescribed. Regular doctor visits ensure the health of both mother and baby.

Can you prevent gestational diabetes?

While you can’t always prevent gestational diabetes, there are steps you can take to lower your risk. Maintaining a healthy weight before pregnancy, eating a balanced diet with whole grains, lean proteins, and plenty of vegetables, and staying physically active can help. If you're planning a pregnancy or are already pregnant, it's important to monitor your health with regular check-ups and follow your doctor’s advice to manage blood sugar levels effectively.

Does gestational diabetes go away after birth?

Yes, gestational diabetes typically goes away after childbirth. Once the baby is born, blood sugar levels usually return to normal. However, women who have had gestational diabetes are at higher risk of developing type 2 diabetes later in life. It’s important to have regular follow-up check-ups and monitor blood sugar levels after delivery to ensure they stay within a healthy range.

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References
  1. NHS, 2023. Gestational diabetes. Available at: https://www.nhs.uk/conditions/gestational-diabetes/ (Accessed 28 October 2025).
  2. Diabetes UK, 2023. Gestational diabetes tests. Available at: https://www.diabetes.org.uk/about-diabetes/gestational-diabetes/test (Accessed 28 October 2025).
  3. Diabetes UK, 2023. Gestational diabetes symptoms. Available at: https://www.diabetes.org.uk/about-diabetes/gestational-diabetes/symptoms (Accessed 28 October 2025).
  4. Diabetes UK, 2023. Treatments for gestational diabetes. Available at: https://www.diabetes.org.uk/about-diabetes/gestational-diabetes/treatments (Accessed 28 October 2025).
  5. Diabetes UK, 2023. Causes of gestational diabetes. Available at: https://www.diabetes.org.uk/about-diabetes/gestational-diabetes/causes (Accessed 28 October 2025).
  6. Diabetes UK, 2023. Complications of gestational diabetes. Available at: https://www.diabetes.org.uk/about-diabetes/gestational-diabetes/complications (Accessed 28 October 2025).
  7. Diabetes UK, 2023. What can I eat with gestational diabetes? Available at: https://www.diabetes.org.uk/living-with-diabetes/eating/gestational-diabetes (Accessed 28 October 2025)