Gestational Diabetes Management Guide

What Is Gestational Diabetes?

Gestational diabetes is a type of diabetes that is first diagnosed during pregnancy. It happens when your blood sugar, also called blood glucose, is higher than normal and your body is not using insulin as well as it should.¹

During pregnancy, the placenta makes hormones that help your baby grow. Some of these hormones make it harder for insulin to work. This is called insulin resistance³. If your pancreas cannot keep up by making enough insulin, your blood sugar rises and you may develop gestational diabetes.

Gestational diabetes usually appears between 24 and 28 weeks of pregnancy and often goes away after your baby is born. Even though it is temporary in many cases, it still matters. Managing gestational diabetes helps lower the risk of complications for you and your baby, both now and in the future.

You are not alone if you have been diagnosed. An estimated 8 to 10 percent of pregnant people in the United States and roughly 14 to 17 percent worldwide develop gestational diabetes.

Managing gestational diabetes usually includes:

A structured eating plan
Safe, regular physical activity
Checking your blood sugar at home (interpret your OGTT lab results with our gestational diabetes calculator)
Medication such as insulin, if needed

These tools, along with this gestational diabetes meal plan, can help you keep blood sugar in a healthy range.

Symptoms

Gestational diabetes can be sneaky. Many people have no noticeable symptoms at all, which is why routine screening is so important.⁴

When symptoms do appear, they may include:

Increased thirst
Needing to urinate more often
Feeling more tired than usual
Blurry vision
Increased hunger

The challenge is that pregnancy itself can cause tiredness, frequent urination, and hunger. That makes it hard to tell what is normal pregnancy and what might be related to gestational diabetes.

Screening tests are the most reliable way to find gestational diabetes. For most pregnancies, your provider will offer a glucose challenge test between 24 and 28 weeks.² You drink a sweet glucose drink, then have your blood drawn an hour later. A blood sugar level of 190 mg per deciliter or higher usually means gestational diabetes, while below 140 mg per deciliter is typically considered normal, although exact cutoffs can vary by clinic (source).

When To See A Doctor

Contact your healthcare provider if you:

Notice extreme thirst that does not improve when you drink
Need to urinate very frequently, especially at night
Have sudden changes in vision
Feel unusually tired, shaky, or unwell after eating
Had gestational diabetes in a previous pregnancy
Have risk factors such as being overweight before pregnancy or having a close relative with diabetes

You should also follow your provider’s routine schedule for gestational diabetes screening:²

At your first prenatal visit if you are considered high risk
Between 24 and 28 weeks of pregnancy for almost everyone else

If you already have a diagnosis and you notice consistently high readings on your meter, call your care team. They may adjust your food plan, your activity, or your medications.

Causes

You do not cause gestational diabetes by something you did or did not do. It develops because of changes that happen naturally during pregnancy.

Here is what is going on inside your body:

The placenta makes hormones that support your baby’s growth.
Some of these hormones interfere with the way insulin works.
Your body becomes more resistant to insulin, so blood sugar rises.
Your pancreas tries to make more insulin to keep blood sugar normal.
If your pancreas cannot keep up, gestational diabetes develops.

This process is called pregnancy related insulin resistance and is considered the main cause of gestational diabetes.¹

In some cases, gestational diabetes is the first sign that you may have had type 2 diabetes, or even type 1 diabetes, before pregnancy. If blood sugar does not return to normal after delivery, your provider may diagnose ongoing diabetes and recommend continued treatment.

Risk Factors

Anyone can develop gestational diabetes, but your risk is higher if you:

Were overweight or obese before pregnancy
Have a parent or sibling with type 2 diabetes
Had gestational diabetes in a past pregnancy
Previously delivered a baby with a high birth weight
Are over age 45
Had prediabetes before pregnancy
Belong to a population with higher diabetes rates in your region
Have limited access to prenatal care

Having risk factors does not mean you will definitely develop gestational diabetes. It simply means your provider may watch you more closely and may test you earlier in pregnancy.³

Complications

Gestational diabetes is treatable. With a good management plan and regular follow up, you can greatly lower the chances of complications. Without good control, high blood sugar can affect both you and your baby.

Complications That Can Affect Your Baby

If blood sugar stays high during pregnancy, your baby may be at risk for:

High birth weight
Extra sugar in your blood crosses the placenta, and your baby’s body makes more insulin to use it. This can lead to a larger baby, which can make vaginal delivery harder and increase the chance of needing a cesarean birth (source).
Preterm birth
Uncontrolled gestational diabetes can raise the risk of early delivery.
Low blood sugar after birth
Babies who make extra insulin in the womb may have low blood sugar shortly after delivery and may need monitoring and treatment.
Breathing problems
Babies born early or with exposure to high blood sugar may have more breathing difficulties.
Longer term risks
Children exposed to gestational diabetes may have a higher chance of obesity and type 2 diabetes later in life.

Keeping your blood sugar close to target is one of the most powerful ways you can protect your baby’s health now and in the years to come.

Complications That Can Affect You

For you, unmanaged gestational diabetes can lead to:

Higher chance of cesarean birth
A very large baby or other complications can increase the likelihood of needing a C-section.
Pregnancy related high blood pressure
Gestational diabetes can occur along with high blood pressure or preeclampsia, which needs close monitoring.
More frequent prenatal visits and tests
You will likely see your care team more often, and they may order additional ultrasounds or monitoring to track your baby’s growth.
Higher risk of type 2 diabetes later
After a pregnancy affected by gestational diabetes, your long term risk of type 2 diabetes is higher. Some estimates suggest that many people with a history of gestational diabetes develop type 2 diabetes within 5 to 10 years, which is why regular blood sugar checks after pregnancy are important.
Recurrence in future pregnancies
You are more likely to develop gestational diabetes again in another pregnancy (American Diabetes Association).

The good news is that a structured care plan, including nutrition, movement, and medication if needed, can greatly reduce these risks. Many parents with gestational diabetes go on to have healthy pregnancies and healthy babies.

Gestational Diabetes Prevention

There is no guaranteed way to prevent gestational diabetes (source). Some risk factors, like age or family history, are out of your control. However, healthy habits before and during pregnancy can reduce your risk and can also support better outcomes if you are already diagnosed.

Here are practical steps you can take:

Move your body regularly
Aim for at least 30 minutes of moderate activity on most days, with your provider’s approval. Examples include:
- Brisk walking
- Prenatal yoga
- Swimming or water aerobics
- Stationary cycling
  Regular movement helps your body use insulin more effectively and can lower your risk of gestational diabetes and type 2 diabetes later.
Focus on a balanced eating pattern
A general healthy pattern for blood sugar includes:
- Plenty of vegetablesHigh fiber foods like beans, lentils, and whole grainsLean protein, such as poultry, fish, tofu, or eggsHealthy fats such as avocado, nuts, and olive oilFewer sugary drinks and dessertsSmaller portions of refined carbohydrates, such as white bread or pastries
If you have already been diagnosed, following a structured gestational diabetes meal plan and rotating easy gestational diabetes recipes can help keep your blood sugar more stable.
Plan nourishing snacks
Instead of going long stretches without eating, try small, frequent meals and snacks, especially if you feel nauseated. Pair carbohydrates with protein or fat, for example:
- Apple slices with peanut butter
- Greek yogurt with berries
- Whole grain crackers with cheese or hummus
You can find more ideas in curated gestational diabetes snacks that are designed with blood sugar in mind.
Reach and maintain a healthy weight before pregnancy, if possible
If you are planning pregnancy, your provider can help you set realistic goals. Even modest weight loss before conception, if recommended, can lower your risk of gestational diabetes.
Attend all prenatal visits and screenings
Early detection makes a big difference. Screening at the right time and regular follow up allow your care team to step in quickly if your blood sugar starts to rise.²
Continue healthy habits after delivery
After your baby is born, your provider will usually check your blood sugar 6 to 12 weeks postpartum, and then every few years. Staying active, following a balanced eating pattern, and practicing gestational diabetes self-care can help reduce your long term risk of type 2 diabetes.

If you already have gestational diabetes, these same steps, plus any medications your team recommends, form the backbone of your treatment plan.

FAQs

Most often, diagnosis starts with a glucose challenge test between 24 and 28 weeks. You drink a sweet liquid and your blood sugar is checked one hour later. If your level is higher than a certain cutoff, your provider may order a longer glucose tolerance test to confirm the diagnosis. Some people at high risk are tested earlier in pregnancy (Mayo Clinic).

Tools like a gestational diabetes calculator can sometimes help you understand how your readings fit into your overall management plan, but they never replace lab tests and guidance from your care team.

In many cases, blood sugar returns to normal soon after delivery. Your provider will usually test your blood sugar before you leave the hospital or at a visit 6 to 12 weeks postpartum. If your levels are still high, you may be diagnosed with prediabetes or type 2 diabetes and need ongoing care (Mayo Clinic, Cleveland Clinic).

Even if your numbers return to normal, your lifetime risk of type 2 diabetes is higher, so regular screening is important.

Not everyone with gestational diabetes needs insulin. Many people can manage their blood sugar with food choices, physical activity, and careful monitoring. If these steps are not enough to meet your target levels, your provider may recommend insulin injections. Some providers also use certain oral medications, although insulin is still the standard in many cases and more research is needed on pills in pregnancy (Mayo Clinic).

Your team will work with you to choose the safest option for you and your baby.

Your provider will give you a schedule, which often includes:

Fasting blood sugar first thing in the morning
Checks one or two hours after meals
Occasionally, checks before meals or at bedtime

These readings help your team see patterns and adjust your plan. Keeping a log, either on paper or in a digital app, makes it easier to spot what is working for you.

Yes. With a supportive care team, regular monitoring, and a practical plan for meals, snacks, and movement, many people with gestational diabetes have healthy pregnancies and healthy babies. You do not have to do everything perfectly. Focus on steady, realistic steps that fit into your daily life, use structured tools like gestational diabetes recipes, and lean on your healthcare team whenever you need guidance.

Clinical References & Methodology

American Diabetes Association (ADA)
Gestational Diabetes: Causes & Treatment. View source Back to content ↑
Agency for Healthcare Research and Quality (AHRQ)
Screening and Diagnosing Gestational Diabetes Mellitus (Evidence Report). View source Back to content ↑
Peer-Reviewed Clinical Review
A Comprehensive Review of Gestational Diabetes Mellitus (GDM). PubMed Central (PMC). View source Back to content ↑
Johns Hopkins Medicine
Gestational Diabetes Mellitus (GDM): Symptoms & Treatment. View source Back to content ↑