Gestational Diabetes

What is gestational diabetes?

Gestational diabetes (GDM) is a type of diabetes that develops during pregnancy, usually in the second or third trimester. GDM causes your blood sugar level to rise too high. This can harm you and your unborn baby. Blood sugar levels go back to normal for most women after they give birth.

What causes gestational diabetes?

No one knows for sure what causes GDM. It is believed that the hormones made by the placenta cause insulin resistance. Your body uses insulin to take sugar out of your blood and use it for energy. Insulin resistance means your pancreas makes insulin, but your body cannot use it. As the placenta grows, more of these hormones are produced, which further blocks insulin.

What increases my risk for gestational diabetes?

  • You do not get enough exercise.

  • You have a close family member with diabetes.

  • You have a history of high blood sugar, high blood pressure, or high cholesterol.

  • You weigh more than your healthcare provider wants before and during pregnancy.

  • You gave birth to a large baby.

  • You have glycosuria (sugar in your urine) or polycystic ovary syndrome (PCOS).

  • You are of African American, Latino, Native American, Asian American, or Pacific Islander heritage.

What are the signs and symptoms of gestational diabetes?

  • More thirst than usual

  • More urination than usual

  • Blurred vision

  • More fatigue (tired) than usual

  • Frequent bladder, vaginal, or skin infections

  • More weight gain than your healthcare provider suggests during your pregnancy

  • Nausea or vomiting

How is gestational diabetes diagnosed?

  • Blood glucose test: A sample of your blood is tested for the amount of sugar it contains.

  • Fasting plasma glucose test: After you have fasted for 8 hours, your blood sugar level is tested.

  • Oral glucose tolerance test: After you have fasted for 8 hours, your blood sugar level is tested. You are then given a glucose drink. Your blood sugar level is checked at 1 hour after you drink the glucose and again at 2 hours after. Healthcare providers look at how much your blood sugar level increases from the first check.

How is gestational diabetes controlled?

The goal is to keep your blood sugar level as close to normal, as safely as possible. A nutrition and exercise plan will be set up for you.

  • Insulin: Insulin may be given if your diabetes cannot be controlled by nutrition and exercise alone, or if your diabetes gets worse. You may also need to have screening tests for diabetes after you have your baby.

  • Nutrition: Talk to a dietitian about the best meal plan for you. Eat 3 small meals and 3 snacks every day. Wait at least 2 hours between all meals and snacks. Limit carbohydrates (such as bread, cereal, and fruit). Too much carbohydrate in 1 meal or snack can cause your blood sugar to rise to a very high level. Eat foods that are a good source of fiber, such as vegetables and legumes (beans and lentils).



  • Exercise: Ask your healthcare provider what type and amount of physical activity is right for you. Exercise helps keep your blood sugar level steady, decreases your risk of heart disease, and can help you lose weight. Non-weight bearing exercise may be more comfortable and safer for you. This type of exercise may also be safer for your unborn baby. When you walk, wear flat shoes with cushioned soles.

  • Quit smoking: If you smoke, it is never too late to quit. Smoking is dangerous for you and for your baby. Smoking also worsens the problems that can occur with diabetes. Ask your healthcare provider for information about quitting if you need help to stop smoking.

How do I check my blood sugar levels?

  • Ask your healthcare provider when and how often to check your blood sugar levels during the day. You may need to check at least 3 times each day. Your healthcare provider will teach you how to use a glucose monitor. This is a small device that tells how much sugar is in your blood. The monitor uses a small drop of blood.



  • Ask what your blood sugar levels should be before and after you eat. Your healthcare provider may suggest that your blood sugar level should be below 95 mg/dL before you eat. The level may need to be below 140 mg/dL 1 hour after you eat or below 120 mg/dL 2 hours after you eat. Record your blood sugar results each time you check them. Take the record with you to follow-up visits. Your healthcare provider may use the record to make changes to your food, medicine, or exercise schedules.

What are the risks of gestational diabetes?

  • Gestational diabetes increases your risk of premature (early) labor or a caesarean (C-section) delivery. You are at higher risk of bladder or vaginal infections. You may develop GDM with future pregnancies or diabetes later in life.

  • Gestational diabetes increases the risk that your baby will weigh more than 8½ pounds at birth. He may also have hypoglycemia (low blood sugar) after birth. He may have twitching of the hands and feet, or cramping muscles caused by low calcium and magnesium levels. He is at an increased risk of newborn jaundice (yellowing of the skin).

When should I contact my healthcare provider?

  • You think your baby is not moving as much as usual.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • Your blood sugar level is below 70 mg/dL or above 250 mg/dL and does not improve with treatment.

  • Your breath has a fruity, sweet smell.

  • Your heartbeat is fast and weak, or your breathing is fast and shallow.

  • You are more sleepy than usual or become confused.

  • You have an upset stomach and are vomiting.

  • You are urinating more often than usual.

  • You have a headache or are dizzy.

  • You have blurred or double vision.

  • You have more hunger or thirst than usual.

  • You have cold, clammy sweating.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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