Understanding Gestational Diabetes
A guide for you and your baby's health
Your partner in care
What is Gestational Diabetes?
Gestational diabetes (also called GDM) is high blood sugar that starts during pregnancy.
It happens when your body can't make enough insulin to handle the changes of pregnancy.
Insulin is a hormone that helps sugar from your food move into your cells for energy. Think of it as a key that unlocks your cells.
Good news: With the right care, most women with GDM have healthy pregnancies and healthy babies.
How Common is This?
About 6 to 7 out of every 100 pregnant women develop gestational diabetes.
You're not alone. Thousands of women manage this condition successfully every year.
Having GDM doesn't mean you did anything wrong. It's a normal response some bodies have to pregnancy hormones.
Why Does Blood Sugar Matter?
Your blood sugar affects your baby's growth and development.
When your blood sugar is high, your baby's blood sugar goes up too. This can cause your baby to grow larger than normal.
What Happens in Normal Pregnancy?
During pregnancy, your body naturally becomes more resistant to insulin. This is normal.
Your pancreas (the organ that makes insulin) usually makes 30% more insulin to keep up.
Sometimes, your pancreas can't make enough extra insulin. That's when gestational diabetes develops.
Insulin resistance means your cells don't respond to insulin as well as they used to. Your body needs more insulin to do the same job.
What's Happening in Your Body?
In gestational diabetes, two things happen:
- Your body becomes more resistant to insulin (the lock gets harder to open)
- Your pancreas can't make enough insulin to compensate (not enough keys)
The result is higher blood sugar levels.
Who's More Likely to Get GDM?
Some women have higher chances of developing gestational diabetes:
- Family history of diabetes
- Previously had a large baby (over 9 pounds)
- Age over 25
- Higher body weight before pregnancy
- Hispanic, African American, Native American, Asian, or Pacific Islander background
Important: More than half of women with GDM have none of these risk factors. That's why your doctor screens everyone.
How Will I Know If I Have It?
Your doctor will screen you between 24 and 28 weeks of pregnancy.
Step 1: Screening Test
You drink a sweet drink and have your blood sugar checked one hour later.
Step 2: Diagnostic Test (if needed)
If your screening test is high, you'll have a longer test. You drink another sweet drink and have your blood checked four times over three hours.
Two or more high readings confirm gestational diabetes.
How Does GDM Affect My Baby?
When your blood sugar is high, extra sugar crosses to your baby.
Your baby's pancreas makes extra insulin to handle this sugar. This extra insulin acts like a growth hormone.
This can cause your baby to grow larger than normal. We call this macrosomia (a large baby).
Why We Monitor Baby's Size
A larger baby can face some challenges:
- The delivery may be more difficult
- Higher chance of needing a C-section
- After birth, baby might have low blood sugar for a short time
- Baby might need a little extra help with breathing or jaundice
The good news: When we control your blood sugar, we can prevent most of these problems. That's why monitoring is so important.
What Happens After Diagnosis?
Your care team will work with you to create a plan. Here's what to expect:
- Diet changes: A nutritionist will help you plan healthy meals
- Blood sugar checks: You'll check your blood sugar at home
- More visits: We'll see you more often to monitor you and baby
- Ultrasounds: We'll check your baby's growth
- Medication if needed: Some women need insulin or other medication
You're not doing this alone. Your entire care team is here to support you.
What Should I Eat?
Food is your first tool for controlling blood sugar. Here's the plan:
The Pattern
Three small meals plus three snacks throughout the day. This keeps your blood sugar steady.
The Foods
Choose foods that release energy slowly:
- Whole grains (oatmeal, barley, whole grain bread)
- Beans and legumes
- Vegetables
- Lean proteins
- Healthy fats
Limit foods that spike blood sugar quickly, like white bread, white rice, potatoes, and sugary drinks.
Smart Food Choices
Some foods raise blood sugar faster than others. We call this the glycemic index.
Lower Glycemic Foods (Better Choices)
- Barley, oats, and beans
- Whole grain specialty breads
- Most vegetables
- Nuts and seeds
Higher Glycemic Foods (Limit These)
- White potatoes and white rice
- White bread and crackers
- Sugary cereals
A dietitian will give you a personalized meal plan based on your needs.
Checking Your Blood Sugar at Home
You'll check your blood sugar several times a day using a small device called a glucose meter.
When to Check
- First thing in the morning (fasting)
- Two hours after each meal
Your Target Numbers
- Fasting: Less than 95 mg/dL
- Two hours after meals: Less than 120 mg/dL
A Newer Option: Continuous Glucose Monitoring
Some women may use a Continuous Glucose Monitor (CGM) instead of or along with fingerstick testing.
What is a CGM? It's a small sensor that you wear on your arm or belly. It checks your blood sugar automatically every few minutes, 24 hours a day.
How Does a CGM Work?
The Sensor
A tiny sensor sits just under your skin. You wear it for 10-14 days, then replace it with a new one.
The Data
The sensor sends your blood sugar readings to your phone or a separate device. You can see your numbers anytime without pricking your finger.
The Alerts
The CGM can alert you when your blood sugar is too high or too low, even while you're sleeping.
You can shower, exercise, and sleep normally while wearing a CGM. It's designed to stay on through your daily activities.
CGM vs. Traditional Monitoring
Fingerstick Testing
- 4-7 tests per day
- Shows one moment in time
- Requires finger pricks
- You manually record results
- Covered by most insurance
Continuous Monitoring (CGM)
- 288+ readings per day
- Shows trends over time
- No finger pricks needed
- Automatic data tracking
- May require insurance approval
Your doctor will help you decide which monitoring method is best for you. Both methods work well for managing gestational diabetes.
Benefits of Using a CGM
CGM can make managing GDM easier in several ways:
- See patterns: You can see how different foods affect your blood sugar
- Catch problems early: Alerts warn you before your sugar gets too high or low
- Less pain: No more multiple finger pricks each day
- Better sleep: The device monitors you at night so you don't have to wake up to test
- Share data: Your doctor can review your patterns between visits
- More information: See how stress, sleep, and exercise affect your levels
Studies show that CGM can help women with GDM keep their blood sugar in a healthy range more consistently.
Is CGM Right for You?
CGM might be a good option if:
- Your blood sugar is hard to control with diet alone
- You're on insulin
- You want more detailed information about your blood sugar patterns
- You have trouble remembering to check with fingersticks
- You want to reduce finger pricks
Talk to Your Doctor
Ask your healthcare team if CGM is covered by your insurance and if it's recommended for your situation.
Cost: Some insurance plans cover CGM for gestational diabetes. Your doctor's office can help check your coverage.
If You Need Medication
About one in three women with GDM needs medication to help control blood sugar.
This doesn't mean you failed. It just means your body needs extra help during pregnancy.
Insulin
Insulin is the most common medication. It's safe for your baby because it doesn't cross the placenta.
Pills
Some women can use diabetes pills instead of insulin. Your doctor will discuss what's best for you.
Medication is a tool, just like diet and exercise. It helps keep you and your baby healthy.
What Can I Do to Help?
You have power over your blood sugar. Here's how:
Stay Active
Movement helps your body use insulin better. Try for 30 minutes of activity most days:
- Walking
- Swimming
- Prenatal yoga
- Light strength training
Follow Your Meal Plan
Eating the right foods at the right times makes a big difference.
Check Your Blood Sugar
Regular monitoring helps you see what's working.
How We Watch Your Baby
We'll monitor your baby more closely to make sure everything is going well.
Ultrasounds
We'll check your baby's growth with ultrasound exams. This helps us see if baby is growing too large.
Kick Counts
You'll track your baby's movements each day. This tells us baby is doing well.
Non-Stress Tests
Later in pregnancy, we might monitor your baby's heart rate. This is painless and takes about 20 minutes.
When and How Will I Deliver?
Your delivery plan depends on how well your blood sugar is controlled and how your baby is growing.
Timing
If your blood sugar is well controlled, you can usually go to your due date. If not, we might deliver a little early (around 39 weeks).
Method
Most women with GDM can have a vaginal delivery. A C-section is only needed if:
- Your baby is very large
- You have other medical reasons
We'll make these decisions together based on what's best for you and your baby.
What Happens During Labor?
During labor, we'll monitor you and your baby closely:
- We'll check your blood sugar every hour
- You'll have an IV with fluids
- We'll continuously monitor baby's heart rate
- If you're on insulin, we'll adjust it during labor
Labor usually proceeds normally. We just watch a little more carefully.
After Delivery
Most of the time, gestational diabetes goes away right after delivery.
For You
- Your blood sugar usually returns to normal immediately
- You can usually stop checking your blood sugar right away
- If you were on insulin, you'll stop it after delivery
- If you were using a CGM, you can remove the sensor
For Your Baby
- We'll check baby's blood sugar after birth
- Most babies do just fine
- Some babies need a little extra help regulating their blood sugar at first
Your Follow-Up Care
Even though GDM usually goes away, we need to check your blood sugar again at 6 to 12 weeks after delivery.
This test makes sure your blood sugar has returned to normal.
Important Long-Term Information
Women who have had gestational diabetes have a higher chance of developing type 2 diabetes later in life.
Your risk is about 50% over the next 5 to 10 years.
But here's the good news: You can lower this risk significantly through healthy lifestyle choices.
Protecting Your Future Health
You can cut your risk of developing type 2 diabetes in half by:
- Maintaining a healthy weight: Even losing 5-10% of your body weight helps
- Staying active: 150 minutes of activity per week
- Eating well: Continue the healthy eating habits you learned
- Regular check-ups: Have your blood sugar checked every 1-3 years
If you plan another pregnancy, talk to your doctor before trying to conceive.
If You Get Pregnant Again
If you had gestational diabetes before, there's a 30-50% chance you'll have it again in a future pregnancy.
Before Getting Pregnant
- See your doctor for a pre-pregnancy visit
- Check your blood sugar to make sure it's normal
- Reach a healthy weight if possible
- Start taking folic acid
During Pregnancy
We'll test you earlier and monitor you more closely. But you'll know what to expect this time.
Questions to Ask Your Care Team
- What are my target blood sugar numbers?
- Should I use fingerstick testing or a CGM?
- If using CGM, is it covered by my insurance?
- How often should I check my blood sugar?
- What foods should I focus on?
- What foods should I avoid?
- How much can I exercise?
- When will we check my baby's growth?
- When do you think I'll deliver?
- What happens if my blood sugar stays high?
- Who can I call if I have questions between visits?
You're Not Alone
Managing GDM is a team effort. Your care team includes:
- Your OB doctor: Oversees your pregnancy
- Maternal-fetal medicine specialist: Expert in high-risk pregnancies
- Diabetes educator: Teaches you how to manage your blood sugar
- Dietitian: Creates your personalized meal plan
- Nurses: Available to answer questions
We're all working together with one goal: a healthy pregnancy and a healthy baby.
Remember These Key Points
1. GDM is common and manageable. About 6-7% of pregnant women have it.
2. You have monitoring options. Both fingerstick and CGM work well for tracking blood sugar.
3. You can control it. Diet, activity, and monitoring make the biggest difference.
4. It usually goes away after delivery. But follow-up is important.
5. You can prevent future diabetes. Healthy choices now protect your future.
6. We're partners in your care. Your team is here to support you every step.
You've Got This
Being diagnosed with gestational diabetes can feel overwhelming at first. That's completely normal.
But thousands of women successfully manage GDM every year and have healthy babies.
With the right care, monitoring, and support, you will too.
Your health matters. Your baby's health matters. We're here to help you both thrive.
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