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Gestational diabetes develops during pregnancy in people who didn’t have a diabetes diagnosis before becoming pregnant. Pregnancy can make it harder for your body to use insulin and keep your blood glucose levels in a healthy range.
Gestational diabetes, formally known as gestational diabetes mellitus, is common and treatable. You can reduce the risk of complications for you and your baby by managing your blood sugar level. You may need to check your blood glucose, adjust your eating plan, stay physically active and take medication.
Most people with gestational diabetes can have a healthy pregnancy and baby with appropriate care and monitoring. Your OB/GYN may manage your gestational diabetes or coordinate your care with specialists through the Wendy Novak Diabetes Institute Perinatal Program and Norton Children’s Maternal-Fetal Medicine. The program brings together diabetes educators, clinical dietitians and maternal-fetal medicine specialists to support diabetes management during pregnancy.
Gestational diabetes develops during pregnancy in people who did not have diabetes before pregnancy.
During pregnancy, hormonal changes can cause your body to become more resistant to insulin. Insulin helps move glucose from your blood into your cells, where it can be used for energy. As pregnancy progresses, your body may need to produce more insulin to keep your blood glucose levels in a healthy range.
If your pancreas cannot produce enough additional insulin to overcome this increased insulin resistance, blood glucose levels can rise. This can lead to gestational diabetes.
Gestational diabetes is different from diabetes that was present before pregnancy. Type 1 or Type 2 diabetes diagnosed before pregnancy is called pregestational diabetes.
Some people who are diagnosed with diabetes early in pregnancy actually may have had Type 1 or Type 2 diabetes that was not previously diagnosed. Your healthcare provider can determine which type of diabetes you have and recommend the appropriate care.
The exact reason some people develop gestational diabetes is not completely understood. Pregnancy itself causes changes that increase insulin resistance, particularly as pregnancy progresses.
The placenta produces hormones that help support your baby’s growth. These hormones also can interfere with the way insulin works in your body. Your pancreas normally responds by making more insulin.
For some people, the pancreas cannot make enough additional insulin to overcome the increased insulin resistance. Blood glucose then rises, resulting in gestational diabetes.
Gestational diabetes is not caused by too much sugar or by a lack of exercise. It can develop in people who eat a healthy diet and are physically active.
Gestational diabetes can develop in anyone during pregnancy, including people without obvious risk factors.
You may have a higher risk if you:
Your healthcare provider may recommend earlier testing if you have risk factors for gestational diabetes.
Having one or more risk factors does not mean you will develop gestational diabetes. Likewise, gestational diabetes can occur even when you have no known risk factors.
Gestational diabetes often does not cause noticeable symptoms. This is one reason routine screening during pregnancy is important.
Some people may notice increased thirst or more frequent urination, but these symptoms also can occur during a normal pregnancy. Testing is the only way to determine whether you have gestational diabetes.
If you have been told that your glucose screening result was abnormal, an abnormal screening result does not necessarily mean you have gestational diabetes. Your provider may recommend an additional test to determine whether you meet the criteria for diagnosis.
Most pregnant patients are screened for gestational diabetes between 24 and 28 weeks of pregnancy.
Screening commonly begins with a glucose challenge test. You drink a liquid containing a measured amount of glucose, and your blood glucose is checked after a specified amount of time.
If your screening result is higher than the expected range, your provider may recommend an oral glucose tolerance test. This longer test involves additional blood glucose measurements and can determine whether you have gestational diabetes.
People with certain risk factors may be tested earlier in pregnancy. If blood glucose is significantly elevated early in pregnancy, your provider may evaluate you for previously undiagnosed Type 1 or Type 2 diabetes rather than gestational diabetes.
Your OB/GYN will explain which test you need and what the results mean for your pregnancy.
The goal of treatment is to keep your blood glucose in the range recommended by your healthcare team while supporting healthy growth and development of your baby.
Your treatment plan may include:
You may need to check your blood glucose at home at specific times during the day. Your care team will tell you when to check and what your individual blood glucose goals are.
Keeping a record of your results can help your care team determine whether your treatment plan is working and whether adjustments are needed.
A clinical dietitian or diabetes educator can help you develop a meal plan that supports your nutritional needs during pregnancy while helping manage blood glucose.
You generally do not need to eliminate carbohydrates or follow a highly restrictive diet. Instead, your care team can help you understand how different foods, portions and meal timing affect your blood glucose.
Physical activity can help your body use insulin more effectively and can help manage blood glucose. Your OB/GYN can recommend activities that are appropriate for your pregnancy and health.
Learning how to monitor blood glucose, plan meals and recognize changes in your blood glucose can make managing gestational diabetes easier.
The Wendy Novak Diabetes Institute Perinatal Program provides gestational diabetes education, blood glucose monitoring support, nutrition counseling and insulin education.
If nutrition and physical activity do not keep your blood glucose within your recommended range, your provider may recommend medication.
Some people with gestational diabetes need insulin during pregnancy. Pregnancy-related insulin resistance can make medication necessary even when you are following your treatment plan carefully.
Your care team will determine which medication is appropriate for you and how to use it safely during pregnancy.
Depending on your blood glucose control and other factors, your pregnancy may require additional monitoring. Your care team may monitor your baby’s growth and your health more closely as pregnancy progresses.
The Wendy Novak Diabetes Institute Perinatal Program, the first of its kind in Louisville and Southern Indiana, provides specialized support for managing diabetes before, during and after pregnancy. Integrated within the Norton Children’s Perinatal Center, our program brings together a team with diabetes expertise, specializing in complex pregnancies. This includes maternal-fetal medicine specialists, diabetes educators and clinical dietitians, working collaboratively to develop a personalized care plan that addresses your unique needs and ensures the best possible health for both you and your baby.
We also collaborate with endocrinologists and primary care providers when needed to ensure seamless care and support. Our services include prepregnancy counseling, pregnancy monitoring and postpartum care, providing a full spectrum of care designed to help you thrive throughout your pregnancy.
Care through the program may include:
Your OB/GYN can coordinate care with the Wendy Novak Diabetes Institute Perinatal Program based on your individual needs.
Wendy Novak Diabetes Institute is part of Norton Healthcare and Norton Children’s.
If you have gestational diabetes, your OB/GYN may manage your care or coordinate care through Norton Children’s Maternal-Fetal Medicine and the Wendy Novak Diabetes Institute Perinatal Program.
Maternal-fetal medicine specialists, sometimes called MFM specialists, are OB/GYNs with additional training in managing high-risk and complex pregnancies. If gestational diabetes requires additional monitoring or your pregnancy has other complications, your OB/GYN may refer you to an MFM specialist.
An MFM specialist can help assess how gestational diabetes is affecting your pregnancy and determine whether you need additional monitoring or treatment. Depending on your individual needs, this may include monitoring your baby’s growth, assessing your health and blood glucose control, and coordinating care with your OB/GYN and other members of your care team.
You continue seeing your regular OB/GYN while receiving specialized care from an MFM specialist.
When gestational diabetes is not well controlled, higher blood glucose can increase the risk of certain pregnancy and delivery complications.
Potential complications include:
Having gestational diabetes does not mean you will experience these complications. Your care team will monitor your pregnancy and recommend treatment to help reduce your risks.
Higher blood glucose levels during pregnancy can cause your baby to grow larger than expected. This is sometimes called fetal macrosomia.
A larger baby can make labor and delivery more difficult and can increase the risk of birth complications.
After birth, some babies born to mothers with gestational diabetes have low blood glucose and may need additional monitoring. Your baby’s care team will monitor blood glucose when appropriate and provide treatment if needed.
The good news is that managing your blood glucose during pregnancy can help reduce these risks.
For many people, blood glucose returns to a normal range after delivery because the pregnancy-related changes that caused insulin resistance resolve.
However, having gestational diabetes increases your future risk of developing Type 2 diabetes. It also increases the likelihood of developing gestational diabetes in a future pregnancy.
Follow-up blood glucose testing after pregnancy is important even if your blood glucose returns to normal. Your healthcare provider can tell you when you should be tested and how often you should continue diabetes screening.
If you are considering another pregnancy, talk with your OB/GYN or primary care provider before becoming pregnant.
If you have gestational diabetes, you may receive care from your OB/GYN along with specialists who can help you manage blood glucose and support your pregnancy.
Norton Women’s Care and the Wendy Novak Diabetes Institute Perinatal Program bring together specialists with experience managing diabetes during pregnancy. The multidisciplinary team includes maternal-fetal medicine specialists, diabetes educators and clinical dietitians.
Your care may include:
Norton Children’s Maternal-Fetal Medicine specialists can provide specialized care for pregnancies affected by diabetes while coordinating with your regular OB/GYN.
Gestational diabetes is diabetes that develops during pregnancy in someone who did not have diagnosed diabetes before pregnancy. It occurs when pregnancy-related insulin resistance causes blood glucose to rise.
Pregnancy hormones increase insulin resistance. If the pancreas cannot produce enough additional insulin to compensate, blood glucose rises, and gestational diabetes can develop.
Gestational diabetes can increase the risk of excessive fetal growth, delivery complications and low blood glucose in the newborn. Good blood glucose management can help reduce these risks.
Having gestational diabetes also increases your risk of developing Type 2 diabetes in the future. The American Diabetes Association notes that about 50% of women who have had gestational diabetes go on to develop Type 2 diabetes. Lifestyle changes and regular follow-up can help reduce your risk.
No. Gestational diabetes is different from Type 2 diabetes. However, having gestational diabetes increases your future risk of developing Type 2 diabetes.
Your nutritional needs during pregnancy are individual. A clinical dietitian or diabetes educator can help you develop a meal plan that supports your pregnancy and helps manage blood glucose.
Not everyone with gestational diabetes needs insulin. If nutrition, physical activity and other recommended measures do not adequately control blood glucose, your provider may recommend insulin.
Most patients are screened between 24 and 28 weeks of pregnancy. Some patients with risk factors may be tested earlier.
Yes. Having gestational diabetes increases your risk of developing Type 2 diabetes later in life. Follow-up testing and healthy lifestyle habits can help you monitor and reduce your risk.
Yes. Having gestational diabetes increases the chance of developing it during a future pregnancy, but it does not mean you will.