Gestational Diabetes: Symptoms, Management, and What to Expect During Pregnancy
Gestational diabetes is a temporary form of diabetes that develops during pregnancy, usually in the second or third trimester. With proper management, most people have healthy pregnancies and babies, and the condition typically resolves after delivery.
Gestational diabetes is a temporary form of diabetes caused by pregnancy-related hormonal changes that make it harder for your body to use insulin. It is usually diagnosed with a glucose screening test between 24 and 28 weeks of pregnancy, and can be managed with diet, exercise, and sometimes medication. Most cases resolve after delivery, but people who have gestational diabetes have a higher risk of developing type 2 diabetes later in life.
Overview
Gestational diabetes is a form of diabetes that develops for the first time during pregnancy, usually in the second or third trimester (weeks 24 to 40). It occurs when hormonal changes from the placenta make it harder for your body to use insulin, a hormone that helps turn food into energy, leading to higher-than-normal blood sugar levels. According to the Centers for Disease Control and Prevention (CDC), gestational diabetes affects 6% to 9% of pregnancies in the United States each year. With proper care, most people with gestational diabetes have healthy pregnancies and babies, and the condition almost always resolves after delivery.
Signs & Symptoms
Most people with gestational diabetes have no obvious symptoms, which is why routine screening is critical. Some may experience mild signs that overlap with normal pregnancy changes, including increased thirst and frequent urination, unusual fatigue, blurred vision, nausea, and recurring urinary tract or yeast infections. Never skip your routine screening test, even if you feel perfectly healthy, as symptoms are often absent or too mild to notice without testing.
Causes & Risk Factors
Gestational diabetes is linked to placental hormones that block insulin action, making it harder for your body to regulate blood sugar. You are at higher risk if you have any of the following:
- A pre-pregnancy body mass index (BMI) of 30 or higher
- Family history of type 2 diabetes
- Previous prediabetes or gestational diabetes
- History of delivering a baby weighing 9 pounds (4.1 kilograms) or more
- Polycystic ovary syndrome (PCOS)
- Age over 25 during pregnancy
- Racial/ethnic background including Black, Hispanic/Latino, Native American, Asian American, or Pacific Islander communities
Diagnosis
Gestational diabetes is diagnosed with a two-part glucose test, usually done between 24 and 28 weeks of pregnancy. Those with high risk factors may be tested earlier.
| Test Name | What It Involves | Timing |
|---|---|---|
| Glucose Challenge Test (Screening Test) | You drink a sugary glucose drink, and your blood sugar is checked 1 hour later. No fasting is required. | 24-28 weeks of pregnancy (earlier if high risk) |
| Oral Glucose Tolerance Test (OGTT, Diagnostic Test) | If your screening test result is high, you will fast for 8 hours, then drink a higher-concentration glucose drink. Your blood sugar is checked multiple times over 2-3 hours to confirm a diagnosis. | After an abnormal screening test |
Treatment & Management
The goal of treatment is to keep your blood sugar levels in a target range to protect your health and your baby’s health. Most people can manage gestational diabetes with lifestyle changes, but some may need medication. Your healthcare team (including your obstetrician, diabetes educator, and dietitian) will work with you to create a personalized plan.
- Blood sugar monitoring: You will likely need to check your blood sugar 4 or more times a day, using a small finger-prick test, to make sure it stays in your target range.
- Healthy eating: A registered dietitian can help you create a meal plan that balances carbohydrates, protein, and fat to keep blood sugar stable. This often includes eating smaller, more frequent meals, and choosing high-fiber, low-sugar foods.
- Regular physical activity: Moderate exercise, such as walking, swimming, or prenatal yoga, for 30 minutes most days of the week can help lower blood sugar. Always check with your provider before starting a new exercise routine.
- Medication if needed: If lifestyle changes are not enough to control your blood sugar, your provider may prescribe insulin (the safest option during pregnancy) or sometimes oral medications like metformin or glyburide.
- Extra fetal monitoring: Your provider may recommend extra ultrasounds and fetal movement tracking to make sure your baby is growing at a healthy rate.
Living With It
A diagnosis of gestational diabetes can feel overwhelming, but with consistent care, most people have healthy pregnancies and babies. After delivery, your blood sugar will be checked 6 to 12 weeks postpartum to make sure it has returned to normal. Most people’s blood sugar levels go back to normal after birth, but having gestational diabetes increases your risk of developing type 2 diabetes later in life: about 50% of people with gestational diabetes develop type 2 diabetes within 5 to 10 years. To lower this risk, maintain a healthy weight, eat a balanced diet, stay active, and get your blood sugar tested regularly after pregnancy. Unmanaged gestational diabetes can lead to serious complications for both you and your baby, including preterm birth, high birth weight, birth injuries, low blood sugar in the baby after birth, and increased risk of the child developing type 2 diabetes later in life. For the pregnant person, it raises the risk of high blood pressure, preeclampsia, and future type 2 diabetes.
Medical Review Team
WellAlly Medical Editorial Team
This content is not a replacement for professional medical advice.
Recovery & management timeline
Before 24 weeks of pregnancy
Pre-Screening (High-Risk Individuals)
If you have risk factors for gestational diabetes, discuss early screening with your provider, and adopt healthy lifestyle habits like balanced eating and regular moderate exercise before and during early pregnancy.
24-28 weeks of pregnancy
Screening & Diagnosis
Attend your routine glucose screening test. If results are abnormal, complete the follow-up oral glucose tolerance test to confirm a diagnosis.
After diagnosis until delivery
Active Management During Pregnancy
Follow your personalized care plan: monitor blood sugar daily, eat a balanced diet, exercise regularly, attend all prenatal appointments, and take medication if prescribed.
6-12 weeks after delivery
Postpartum Follow-Up
Get a glucose tolerance test to check if your blood sugar has returned to normal. Discuss long-term type 2 diabetes risk reduction strategies with your provider.
Every 1-3 years after delivery
Long-Term Monitoring
Get routine blood sugar screenings to catch early signs of type 2 diabetes, and maintain healthy lifestyle habits to lower your long-term risk.
Self-care steps
1Monitor your blood sugar regularly
Check your blood sugar as directed by your provider, usually 4 or more times a day (including fasting and 1-2 hours after meals). Keep a log of your results to share with your care team so they can adjust your treatment plan as needed.
2Follow your personalized meal plan
Work with a registered dietitian to create a meal plan that balances carbohydrates, protein, and fat. Aim for consistent carbohydrate intake at each meal, choose whole grains, lean proteins, and plenty of vegetables, and limit added sugars and refined carbohydrates.
3Stay active with safe pregnancy exercise
Aim for 30 minutes of moderate, low-impact exercise most days of the week, such as brisk walking, swimming, or prenatal yoga. Always check with your provider before starting a new routine, and stop if you feel dizzy, short of breath, or experience cramping.
4Attend all prenatal and follow-up appointments
Keep all scheduled appointments with your obstetrician, diabetes educator, and dietitian. These visits help your team monitor your blood sugar, your baby’s growth, and adjust your care plan as your pregnancy progresses.
5Manage stress and prioritize rest
Pregnancy and managing a new health condition can be tiring. Get enough sleep, practice relaxation techniques like deep breathing or meditation, and ask for help from loved ones to reduce stress, which can help keep your blood sugar stable.
When to seek medical help
Seek urgent medical care right away if you experience any of the following: blood sugar levels consistently above your target range that do not improve with at-home management; severe nausea or vomiting that prevents you from eating or drinking; decreased fetal movement (if you are past 28 weeks); signs of preeclampsia including severe headache, vision changes, swelling in your hands or face, or upper abdominal pain; or symptoms of low blood sugar (hypoglycemia) including shakiness, sweating, confusion, or dizziness that does not improve with fast-acting sugar.
Frequently asked questions
Will I have gestational diabetes in future pregnancies?
Can I breastfeed if I have gestational diabetes?
Will my baby have diabetes after birth?
Do I need to take medication for gestational diabetes?
Sources
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Medical Editorial Team · Last reviewed October 9, 2026. · Read our editorial policy