Gestational diabetes is a condition in which blood sugar (glucose) levels increase during pregnancy, usually developing in the second or third trimester and usually resolving after the baby is born.
It occurs when the body is unable to produce enough insulin, a hormone that regulates blood sugar—to meet the increased demands of pregnancy.
If not managed properly, gestational diabetes can lead to health complications for both mother and baby during pregnancy and after delivery. However, early detection and effective treatment can reduce these risks to a great extent.
Who is at risk of gestational diabetes?
- Any pregnant woman can develop gestational diabetes, but certain factors can increase your risk. You’re more likely to have the condition if:
- You’re over 40 years old
- Your body mass index (BMI) is over 30 – you can check this using the BMI healthy weight calculator
- you’ve previously given birth to a baby weighing 4.5 kilograms (10 pounds) or more
- You’ve had gestational diabetes in a previous pregnancy
- Your parent or sibling has diabetes
- you’re of South Asian, Black, African-Caribbean, or Middle Eastern origin (even if you were born in the UK)
- You’ve had a gastric bypass or other weight-loss surgery
- If any of these risk factors apply to you, you should be offered a screening test for gestational diabetes during your pregnancy.
Symptoms of Gestational Diabetes
Gestational diabetes often doesn’t cause noticeable symptoms. In most cases, it’s detected through routine blood sugar testing during pregnancy screening.
However, if blood sugar levels become very high (a condition called hyperglycaemia), some women may experience:
- Increased thirst
- Frequent urination
- Dry mouth
- Tiredness
- Blurred vision
- Genital itching or recurrent thrush
It’s important to note that many of these symptoms are also common in pregnancy and don’t always indicate gestational diabetes. If you’re concerned about any symptoms, talk to your midwife or doctor for reassurance and guidance.
How Gestational Diabetes Can Affect Your Pregnancy
Most women with gestational diabetes go on to have healthy pregnancies and babies. However, the condition can increase the risk of certain complications, including:
- A larger-than-average baby – This can make labour more difficult and raise the chances of needing an induced labour or a caesarean section.
- Polyhydramnios – Excess amniotic fluid around the baby, which can lead to premature labour or complications during delivery.
- Premature birth – Going into labour before 37 weeks of pregnancy.
- Pre-eclampsia – A condition causing high blood pressure during pregnancy, which can lead to serious complications if untreated.
- Newborn health issues – Your baby may have low blood sugar (hypoglycaemia) or develop jaundice (yellowing of the skin and eyes) after birth, sometimes requiring hospital care.
- Stillbirth – Though rare, there is a slightly increased risk of losing the baby before birth.
Additionally, having gestational diabetes increases your risk of developing type 2 diabetes later in life. Regular monitoring and a healthy lifestyle can help reduce this risk.
Screening for Gestational Diabetes
At your first antenatal (booking) appointment—usually between 8 and 12 weeks of pregnancy—your midwife or doctor will ask questions to assess whether you’re at a higher risk of developing gestational diabetes.
If you have one or more risk factors, you’ll be offered a screening test known as an oral glucose tolerance test (OGTT).
The OGTT takes about two hours and is usually performed between 24 and 28 weeks of pregnancy. If you’ve had gestational diabetes in a previous pregnancy, you may be offered the test earlier, shortly after your booking appointment, and again between 24 and 28 weeks if the initial result is normal.
Here’s how the OGTT works:
- You’ll have a blood test in the morning, after fasting for 8 to 10 hours (usually you can drink water, but check with your hospital).
- You’ll then drink a glucose solution.
- After resting for 2 hours, a second blood sample is taken to measure how your body processes the sugar.
This test helps determine whether your body is producing enough insulin to manage blood sugar levels during pregnancy.
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Treatments for Gestational Diabetes
Managing gestational diabetes effectively can significantly reduce the risk of complications during pregnancy and birth. The main goal is to keep your blood sugar levels within a healthy range.
You’ll be given a blood sugar testing kit to regularly monitor your glucose levels and track how well your treatment is working.
Lifestyle Changes
In many cases, blood sugar levels can be managed through diet and physical activity:
- Eat a healthy, balanced diet tailored to your needs.
- Engage in gentle exercise, such as walking, swimming, or prenatal yoga. Always check with your midwife or doctor before starting any new physical activity.
Medication
If lifestyle changes alone aren’t enough to control your blood sugar, you may need to take medication. This could include:
- Tablets (such as metformin)
- Insulin injections, if tablets aren’t effective or suitable
Monitoring and Birth Planning
You’ll be more closely monitored throughout your pregnancy to detect any potential issues early. This may involve extra scans and check-ups.
If you have gestational diabetes, it’s generally recommended to give birth before 41 weeks. If labour hasn’t started naturally by then, your care team may suggest inducing labour or performing a caesarean section.
In some cases, earlier delivery might be advised—especially if there are concerns about your health, your baby’s health, or if your blood sugar levels have not been well controlled.
Long-Term Effects of Gestational Diabetes
Gestational diabetes usually disappears after your baby is born. However, having it increases your risk of developing certain health conditions in the future, including:
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Gestational diabetes in future pregnancies
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Type 2 diabetes, a lifelong condition
To monitor your health, you should have a blood test for diabetes 6 to 13 weeks after giving birth. If the result is normal, this test should be repeated every year.
Be sure to contact your GP if you experience symptoms of high blood sugar, such as:
- Increased thirst
- Frequent urination
- Dry mouth
Don’t wait until your next scheduled test—even if you feel fine. Many people with diabetes have no obvious symptoms.
You’ll also receive advice on how to lower your risk of developing type 2 diabetes, including:
- Maintaining a healthy weight
- Eating a balanced diet
- Staying physically active
Research also suggests that children born to mothers with gestational diabetes may have a higher risk of developing obesity or diabetes later in life.
Planning a future pregnancy
If you’ve had gestational diabetes before and you’re planning a second pregnancy, it’s important to get tested for diabetes beforehand. Your GP can arrange the necessary tests.
If you’re found to have diabetes, you’ll be referred to a diabetes pre-conception clinic. These clinics help you manage your condition and make sure your blood sugar is well-controlled before you get pregnant.
If your pregnancy is unplanned, contact your GP as soon as possible and tell them you’ve previously had gestational diabetes.
If the initial check shows you don’t have diabetes, you’ll still be offered early screening for gestational diabetes in your next pregnancy, usually soon after your first midwife appointment. If that test is normal, another check will be done between 24 and 28 weeks.
In some cases, your midwife or doctor may advise you to monitor your blood sugar levels at home, using a finger-prick device, in the same way as you controlled your blood sugar during your previous pregnancy.
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