What Is Gestational Diabetes?

Pregnant woman eating salad.

Gestational diabetes is diabetes that happens only during pregnancy. Normally, as food is digested, it turns into sugar (glucose) that goes into your bloodstream. Your body makes a substance called insulin that helps your cells use this blood sugar for energy. Changes that occur in your body during pregnancy may cause your blood sugar to be too high. This can be risky for both you and your baby. You can take steps to control your blood sugar and reduce these risks.

Managing gestational diabetes

Managing gestational diabetes means controlling your blood sugar while you are pregnant. Your healthcare team will help you put together a plan to do this. This plan will include:

  • Eating right. Eating the right foods is the main way to control your blood sugar. You need to eat a variety of foods from each of the food groups each day. To help you with the changes that may be needed in your diet, you will likely work with a registered dietitian. This is an expert on food and nutrition. The dietitian can help you understand how specific foods affect your blood sugar. He or she can also teach you the skills you need to plan healthy, balanced meals.

  • Getting exercise. Your body uses more blood sugar when you exercise. Your healthcare team can decide on the best kind of exercise for you, and the best times for you to exercise.

  • Checking your blood sugar. You will most likely check your blood sugar at home 2 or more times a day. Your healthcare team will teach you how to do this. They will also discuss your blood sugar goals with you. Your blood sugar may also be tested every week or so in the lab. If your blood sugar stays too high, you may need to take insulin shots during your pregnancy.

Risks to your baby

If you don’t control your blood sugar, your baby is more likely to have these problems:

  • Your baby may grow too large. If your blood sugar stays too high, your baby may grow too large (macrosomia) to be delivered vaginally. Shoulder dystocia is one complication that may occur during delivery. This is when the baby's shoulder is stuck behind the pubic bone. If this occurs, the arms and shoulders could be injured. This may result in lasting (permanent) arm damage. The baby can also have low oxygen levels (hypoxia) and acidemia if the dystocia can't be fixed. Hypoxia can lead to cerebral palsy. In rare cases, it can lead to death.

  • Your baby’s organs may not be fully developed before birth. If you have diabetes, your baby may need to be delivered early. This may be because of problems with the pregnancy. Or it may be because of possible risks to you or your baby. If your baby is delivered early, his or her lungs may not work well. This is called respiratory distress syndrome (RDS). Your baby's liver also may not work correctly. And your baby may have yellowing of the skin and eyes (jaundice) after birth.

  • Your baby’s blood sugar may be low after birth. If your blood sugar is too high, your baby makes extra insulin. The baby will keep making extra insulin right after birth. He or she may need to be treated for low blood sugar.

  • Your baby could be stillborn. This is very rare. But your baby could die before birth if your blood sugar stays high for too long.

Risks to you

If you don’t control your blood sugar, you are more likely to have these problems:

  • High blood pressure. High blood sugar makes you more likely to have high blood pressure during your pregnancy (preeclampsia). This is a danger to your health that could lead to early delivery for your baby.

  • Infections. High blood sugar makes you more likely to have bladder, kidney, and vaginal infections.

  • Trouble breathing. You may be uncomfortable or short of breath. High blood sugar can cause too much fluid around the baby (polyhydramnios). Your abdomen gets big and pushes on your lungs.

  • Prolonged labor. Your delivery may be harder, and recovery may take longer. If your blood sugar stays too high, your baby may grow too large. A large baby might cause injury to you during birth. Or the baby may have to be delivered by cesarean section (C-section). This means making a cut (incision) in your abdomen and uterus. Needing a C-section is one of the most common risks of gestational diabetes.

Reduce your future risk for type 2 diabetes

Women who have gestational diabetes are at higher risk of developing type 2 diabetes. To help reduce your risk, lose weight if you’re overweight. Be as active as you can. Eat more fruits and vegetables and fewer processed foods. And have your healthcare provider screen you regularly for diabetes. You will also be at increased risk of having gestational diabetes with your next pregnancy.

Who gets gestational diabetes?

Gestational diabetes is more likely in women who:

  • Are overweight

  • Have a family history of diabetes

  • Have had a baby who weighed more than 9 pounds at birth

  • Have had a baby who died before birth

  • Have had gestational diabetes in the past

  • Are Latina, African American, American Indian, South or East Asian, or Pacific Islander