Gestational Diabetes: What Are the Symptoms, Signs and Treatment?

Everyone gets tested for gestational diabetes during pregnancy, but what is it exactly? And how will you know if you have it? We have answers to your biggest questions about gestational diabetes symptoms, causes and treatments, including these:

What is gestational diabetes?

“Gestational Diabetes Mellitus, often referred to as gestational diabetes or just GDM, is a type of diabetes that occurs during a pregnancy when a woman clearly did not have type 1 or type 2 diabetes prior to becoming pregnant,” says Laura Hieronymus, doctor of nursing practice and VP of health care programs at the American Diabetes Association.

Just like regular, non-pregnancy-related diabetes, gestational diabetes is a condition that causes blood sugar to become abnormally high. With diabetes, the body doesn’t use sugar (a.k.a. glucose) for energy the way it should, so blood sugar isn’t at a normal level. “Gestational” specifically means that it’s happening because you’re pregnant.

The good news is that gestational diabetes can be managed with proper treatment, but it’s important to know whether or not you have gestational diabetes, so you can watch your blood sugar closely and prevent health problems for you and complications for your baby.

And while it’s important to know the risk factors for gestational diabetes, you should also know that it’s standard practice to get screened for gestational diabetes during every pregnancy between 24 and 28 weeks (even if it’s your second or third pregnancy and you didn’t develop gestational diabetes previously). These tests are the glucose challenge test and the glucose tolerance test. (If you're prepping for these tests, here are tips on what to eat before a gestational diabetes test.)

What causes gestational diabetes?

According to the American Diabetes Association, the exact causes of gestational diabetes are unknown. However, certain pregnancy hormones that can block the production of insulin could be the culprit, or, according to Dr. Yvonne Bohn of Providence Saint John’s Health Center in Santa Monica, California, excessive weight gain during early pregnancy is another possible cause.

“Your body’s ability to metabolize glucose is impaired if you have increased weight,” Bohn says. “Also, the placenta releases a hormone called hPL (human placental lactogen)…which basically can impair the body’s ability to uptake glucose. That’s what’s called insulin resistance.”

Insulin is a hormone that helps control your blood sugar; it moves the glucose from your blood to be used as energy.

In order to keep your blood sugar levels where they need to be during your pregnancy, your body (specifically your pancreas) tries to make more insulin. If it can’t, though, you end up with gestational diabetes.

How does gestational diabetes affect the baby?

Your baby should be just fine as long as your gestational diabetes gets diagnosed and treated. Without treatment, gestational diabetes could lead to:

• High birth weight (health risks start at 9 pounds, 15 ounces, known as fetal macrosomia)

• Premature birth

• Higher risk of c-section

• Higher risk of injury to the baby’s shoulders during birth (due to larger size)

• Very low blood glucose levels

• Breathing problems

• Higher risk for obesity and type 2 diabetes in the future

The risks to your baby’s health are caused by the extra blood sugar that crosses the placenta from parent to baby if your high glucose levels aren’t treated with insulin, Hieronymus says.

What is prediabetes, and does it have any effect on pregnancy?

“Prediabetes is when blood glucose (blood sugar) levels are higher than normal but not yet high enough to be diagnosed as diabetes,” Hieronymus says. Having prediabetes means you’re at higher risk for developing type 2 diabetes as well as other health conditions, and if you’re diagnosed with prediabetes early on in your pregnancy, you’re at a higher risk of later developing gestational diabetes. A prediabetes diagnosis early on in pregnancy typically results from a fasting glucose of 110 mg/dL or an A1C of 5.9%, Hieronymus says. If you receive a diagnosis of prediabetes during pregnancy, your doctor will want to monitor your blood sugar often, and you should be vigilant about your own sugar and carb intake.

What are the symptoms of gestational diabetes?

There are no true gestational diabetes symptoms, Bohn says. The only real sign of gestational diabetes is testing positive for it, which is why the tests are so important.

There are some signs that can be associated with gestational diabetes, so you should tell your doctor if you notice any of these:

• Excess thirst or dry mouth

• Frequent urination

• Nausea (this could be hard to decipher from regular morning sickness but if it lasts longer than expected or somehow feels different, let your healthcare provider know)

• Fatigue

• Frequent infections, like yeast infections, UTIs and skin infections

• Blurred vision

“However, these symptoms are also common in any[one] who is pregnant, so may be missed if [you] blame them on pregnancy,” Hieronymus says. “Be sure to discuss these symptoms with your pregnancy health care provider, especially if they have increased.”

What are the risk factors for gestational diabetes?

While any pregnancy can result in gestational diabetes, there are some factors that can put you at a higher risk of developing the condition. You’re at higher risk for gestational diabetes if you:

• Are of advanced maternal age (over 35 years old)

• Have prediabetes

• Have a BMI of 30 or higher prior to becoming pregnant

• Have polycystic ovary syndrome (PCOS)

• Have a family history of type 2 diabetes

• Are Black, Native American, Latinx, Asian or Pacific Islander

What is the treatment for gestational diabetes?

“Because untreated GDM is unhealthy for a woman and her baby, it is essential to start treatment quickly,” Hieronymus says. But keep in mind that if you’re diagnosed with gestational diabetes, it’s not the end of the world. Your doctor will want to monitor you and your baby more often throughout your pregnancy and will likely refer you to a dietician who can help design a meal plan that keeps your blood sugar in check.

“The treatment always includes an individualized meal plan and regular moderate physical activity and will likely include daily self-monitoring of blood glucose (blood sugar),” Hieronymus says. You’ll get instructions on how to monitor your blood sugar, and you’ll have to check it multiple times a day after meals to make sure it’s at a healthy level.

“This will educate you on what foods you’re eating that are triggering your sugars,” Bohn says. “[People] with signs of gestational diabetes need to eat more protein and vegetables and fewer carbs.”

In addition to healthy eating, exercise can help. General guidance for gestational diabetes treatment is both aerobic and resistance exercise for 30 minutes a day at least three days a week unless you have a condition that restricts physical activity.

Talk with your doctor about what kind of exercise might be right for you and your pregnancy—walking, swimming and prenatal yoga are all forms of pregnancy exercises that can be effective yet gentle on your body.

Does gestational diabetes go away?

Yes. The good news is gestational diabetes does go away soon after the baby is born. “For a lot of women with gestational diabetes, their blood sugars return to normal really quickly after they deliver,” Bohn explains. “The exception would be if you really have type 2 diabetes, and it’s not just due to pregnancy. Then, the (issues around) regulating your blood sugars would stick around after delivery.”

If you have GDM, you’ll want to continue exercising, eating healthfully and getting regular check-ups after pregnancy. “We know that type 2 diabetes occurs more frequently in women after they have had GDM,” Hieronymus says. So you should stay vigilant. “We recommend getting a checkup around 6 weeks to 2 months postpartum to see what blood sugars are doing,” Bohn says.

It’s a good idea to get tested every few years after you’ve had your baby, too, since you’re at a higher risk for developing type 2 diabetes.

Knowing these gestational diabetes signs, symptoms and treatments can help you manage this condition if you’re diagnosed and still have a healthy pregnancy and baby.

Sources:

• American Diabetes Association: Gestational Diabetes: https://www.diabetes.org/diabetes/gestational-diabetes

• Laura Hieronymus: DNP, MSEd, RN, MLDE, BC-ADM, CDCES, FADCES: https://events.diabetes.org/speakers/125/view

• Dr. Yvonne Bohn: OBGYN: https://www.providence.org/doctors/obstetrics-and-gynecology/ca/santa-monica/yvonne-bohn-1417058587

• American Diabetes Association: Insulin Resistance https://diabetes.org/health-wellness/insulin-resistance

• Center for Disease Control and Prevention (CDC): Gestational Diabetes and Pregnancy: https://www.cdc.gov/pregnancy/diabetes-gestational.html

• Mayo Clinic: Gestational Diabetes: https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339

• National Library of Medicine: Exercise guidelines for gestational diabetes mellitus: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515443