What to Know About Gestational Diabetes: Risk Factors, Symptoms, and Causes

If you have been diagnosed with GD, you probably have a lot of questions. In this article, we will discuss what GD is, the risk factors associated with it, the symptoms, the screening, and how it can (and can’t) be treated.

By Halle Tecco, MBA, MPH

Gestational diabetes (GD), also known as gestational diabetes mellitus (GDM), is a type of diabetes that only occurs during pregnancy. [1] It affects up to 10% of all pregnancies in the United States, making it one of the most common complications of pregnancy. [2] GD is characterized by high blood sugar levels that develop during pregnancy and usually resolves after delivery. While GD can be managed, if left untreated, GD can cause serious health problems for both the mother and baby. [1-2]

What causes gestational diabetes?

Gestational diabetes develops when your body is unable to produce enough insulin during pregnancy. [1-4] Insulin is a hormone produced by the pancreas that helps your cells use sugar for energy. During pregnancy, the body undergoes hormonal changes and weight gain, which can sometimes reduce the effectiveness of insulin in the cells, resulting in insulin resistance. [1-4] This resistance increases the body's need for insulin.

While all pregnant people experience some degree of insulin resistance during the later stages of pregnancy, some people have insulin resistance even before becoming pregnant. [1-4] Those who begin their pregnancy with a heightened need for insulin may be at a greater risk of developing gestational diabetes. Genetics may also play a role, as those with a family history of diabetes are at a higher risk of developing GD. [2]

What are the risk factors for GD?

There are many risk factors that can increase your chances of developing GD. These include [1-3]:

• Being overweight or having obesity 
• A family history of type 2 diabetes 
• Low physical activity 
• Being over 25 years of age 
• Having PCOS, a hormonal disorder that affects the ovaries 
• Having pre-diabetes 
• Having high-blood pressure 
• A history of gestational diabetes during a previous pregnancy 
• Being African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander 

While GD usually goes away after you give birth, it can increase your risk for type 2 diabetes. [2] 

How do I know if I have gestational diabetes? 

For most people, gestational diabetes does not present any noticeable symptoms. Some have mild symptoms, such as increased thirst or frequent urination, but those may be written off as pregnancy symptoms! [1]

To find out if you have GD, your healthcare provider will typically screen you between 24-28 weeks of pregnancy. [1] However, if you have risk factors, such as a family history of diabetes or being overweight, your provider may recommend earlier screening.

Screening for gestational diabetes

There are two types of screening tests for GD, and both involve a sugary drink that tastes like a sweet gas-station slushie (some of the flavors include orange, fruit punch, or lime).

The glucose challenge test is usually the first test conducted, and it starts with drinking a bottle of the sugary drink described above. An hour later, they draw your blood to measure your blood glucose level. If your blood glucose is too high (over 140), you may need to return for an Oral Glucose Tolerance Test (OGTT) while fasting. [1]

If your provider wants you to come back for the OGTT (or if it’s your first test), it means you’ll need to fast for at least eight hours before the test. They will start with a blood draw, then have you drink the glucose tolerance drink (yum!). After that, your blood will be drawn every hour for two to three hours. If high blood glucose levels are found two or more times, it’s generally a diagnosis of gestational diabetes. Your healthcare provider will explain the results of your OGTT and recommend the necessary steps to manage your condition. [1]

Since many women with GD don’t experience any noticeable symptoms, it's essential to attend all prenatal appointments and undergo regular testing to ensure you and your baby stay healthy throughout pregnancy.

What are the symptoms of gestational diabetes?

GD usually has no symptoms, which is why it is important to get tested during pregnancy. [1] However, some women may experience the following symptoms due to blood sugar levels being too high [4]:

• Increased thirst
• Frequent urination
• Fatigue
• Dry mouth
• Blurred eyesight
• Genital itching or thrush

Some of these symptoms are also symptoms of pregnancy, another reason the best way to diagnose GD is through screening with your provider. 

Does gestational diabetes go away?

For most people, GD will resolve soon after delivery. [1] The main goal of treating GD is to keep blood sugar levels within a healthy range to prevent complications for both the mother and the baby. Treatment for GD really means managing GD, and may involve some of the following [2]: 

Blood sugar monitoring

Women with GD will need to check their blood sugar levels regularly, usually several times a day. This can be done using a glucose meter, also called a glucometer.

Healthy foods

A healthy diet and regular exercise can help control blood sugar levels. Those with GD should work with a healthcare provider or registered dietitian to develop a meal plan that is tailored to their individual needs. 

Exercise

Physical activity can also help lower blood sugar levels, but you should talk to your healthcare provider before starting any exercise program.

If those management techniques aren’t enough to keep your blood glucose levels in range, you may need medication (insulin) to help control blood sugar levels. If this is the case, your provider will show you how to give yourself insulin shots, which are safe for you and the baby. [1]

Can you prevent gestational diabetes?

​​While there is no guaranteed way to prevent gestational diabetes, there are steps that you can take to reduce your risk of developing the condition during pregnancy.

Maintaining a healthy weight before getting pregnant and staying physically active throughout pregnancy can help to reduce the risk of gestational diabetes. [2] However, if you are already pregnant it is not advised to lose weight, as you need to gain some weight for your baby to be healthy. [1]

It is critically important to attend all prenatal appointments and undergo regular blood sugar level testing as recommended by your healthcare provider. Early detection and prompt treatment of gestational diabetes can help to reduce the risk of complications for both you and your baby.

Can myo-inositol help prevent GD?

Some studies have suggested that myo-inositol, a type of sugar found in certain foods and dietary supplements, may help to reduce the risk of developing gestational diabetes. A Cochrane meta-analysis of seven randomized controlled trials concluded that “myo‐inositol during pregnancy may reduce the incidence of gestational diabetes, hypertensive disorders of pregnancy and preterm birth”. [5]

However, more research is needed to confirm these findings and to determine the optimal dose and timing of myo-inositol supplementation during pregnancy. It is important to speak with your healthcare provider before taking any new supplements. They can provide personalized guidance on the safety and effectiveness of different interventions for preventing gestational diabetes and help you make informed decisions about your care.

Can prenatal vitamins help prevent GD?

While prenatal vitamins are essential for a healthy pregnancy, there is no evidence to suggest that they can prevent gestational diabetes. However, taking prenatal vitamins containing folate acid, DHA, and other key nutrients can help to support your baby's growth and development and reduce the risk of certain birth defects.

Summing it up

Gestational diabetes is a common complication of pregnancy that can cause serious health problems for both the mother and baby. The causes of GD are related to the body’s hormonal changes and weight gain during pregnancy, which increase the need for insulin. There are many risk factors associated with GD, including being overweight, having a family history of type 2 diabetes, and low physical activity. GD usually has no symptoms, which is why it is important to get tested during pregnancy. 

Gestational diabetes self-care and management

Blood sugar monitoring, healthy foods, and regular exercise can help control blood sugar levels. If those management techniques aren’t enough to keep blood glucose levels in range, medication (insulin) may be required. Although there is no guaranteed way to prevent GD, there are steps that can be taken to reduce the risk of developing the condition, such as maintaining a healthy weight, staying physically active, and following a healthy diet. It's important to attend all prenatal appointments and undergo regular testing to ensure you and your baby stay healthy throughout pregnancy. We wish you all the best for your pregnancy!

References:

1. “Gestational Diabetes.” National Institutes of Health. URL. Accessed May 2023.
2. “Gestational Diabetes.” Centers for Disease Control and Prevention. URL. Accessed May 2023.
3. “Gestational Diabetes.” March of Dimes. URL. Accessed May 2023.
4. “Overview: Gestational Diabetes.” National Health Service. URL. Accessed May 2023.
5. Motuhifonua SK, Lin L, Alsweiler J, Crawford TJ, Crowther CA. Antenatal dietary supplementation with myo‐inositol for preventing gestational diabetes. Cochrane Database of Systematic Reviews 2023, Issue 2. Art. No.: CD011507. DOI: 10.1002/14651858.CD011507.pub3. Accessed 26 April 2023. URL