Gestational diabetes overview

Overview

Gestational diabetes is a type of diabetes that some women get during pregnancy. It means your blood sugar (glucose) levels become higher than normal. It usually goes away after the baby is born, but it needs careful management during pregnancy to keep you and your baby healthy.

Yes, gestational diabetes is fairly common. It affects about 1 in 20 pregnant women in the UK, though rates vary around the world.

It can affect any pregnant woman, but it is more likely in those who are overweight, have a family history of diabetes, are over 25, or have had gestational diabetes before. It also affects women from certain ethnic backgrounds, such as South Asian, Black, or Hispanic, more often.

Symptoms

Common symptoms

• Many women with gestational diabetes have no noticeable symptoms.
• Some may feel more thirsty than usual.
• Some may need to pee more often.
• Feeling unusually tired.

Causes

Main causes

• During pregnancy, the placenta produces hormones that can make your body less responsive to insulin (a hormone that controls blood sugar).
• If the pancreas cannot make enough extra insulin to overcome this, blood sugar rises.

Risk factors

• Being overweight or obese before pregnancy.
• Having a family history of type 2 diabetes.
• Being over 25 years old.
• Having had gestational diabetes in a previous pregnancy.
• Having given birth to a large baby (over 4 kg or 9 lb) before.
• Having polycystic ovary syndrome (PCOS).
• Being of South Asian, Black, or Hispanic ethnicity.

When to see a doctor

See a doctor urgently if:

• If you are pregnant and have symptoms like excessive thirst, frequent urination, or unexplained weight loss.
• If you have been diagnosed with gestational diabetes and your blood sugar readings are consistently high despite your best efforts.

Book a routine appointment if:

• All pregnant women are offered screening for gestational diabetes around 24 to 28 weeks of pregnancy. Attend all your antenatal appointments.
• If you have risk factors, your doctor may suggest testing earlier.

Diagnosis

Gestational diabetes is diagnosed with a blood test, usually the oral glucose tolerance test (OGTT). You will be asked to drink a sugary drink, and then your blood sugar is measured after a fixed time.

Tests that may be done

• Oral glucose tolerance test (OGTT) – you fast overnight, have a blood test, then drink a glucose drink, followed by another blood test 2 hours later.
• Some places may use a simpler test called a glucose challenge test (GCT) first.

What to expect at your appointment

The test is safe and takes about 2 to 3 hours. You may feel a bit dizzy or nauseous from the sweet drink. Your doctor or midwife will explain the results and what they mean for you and your baby.

Treatment

The main goal is to keep your blood sugar levels within a healthy range. Many women can manage this with diet and exercise alone. Some may need medication or insulin injections.

Self-care at home

• Eat a healthy, balanced diet with plenty of vegetables, whole grains, and lean protein. Avoid sugary snacks and drinks.
• Be physically active – regular walking, swimming, or pregnancy-safe exercises help control blood sugar.
• Monitor your blood sugar levels at home as advised by your healthcare team.
• Keep all your prenatal appointments.

Medical treatments

If diet and exercise are not enough, your doctor may prescribe medication such as metformin tablets, or insulin injections. These treatments are safe during pregnancy and help keep blood sugar under control. Your healthcare team will decide the best option for you and teach you how to use them.

When is surgery considered?

Surgery is not used to treat gestational diabetes. However, if your baby becomes very large, your doctor may discuss induction of labour or a planned caesarean section to reduce the risk of birth complications.

Living with this condition

Living with gestational diabetes means checking your blood sugar several times a day, planning meals, and staying active. It can feel overwhelming at first, but your healthcare team will support you. Most women find it gets easier with routine.

Lifestyle tips

• Eat small, frequent meals to keep blood sugar steady.
• Include fibre-rich foods like oats, lentils, and vegetables.
• Stay hydrated with water.
• Aim for 30 minutes of moderate activity most days, if your pregnancy allows.

Diet and exercise

Work with a dietitian or diabetes educator to create a meal plan that suits you. Include carbohydrates like wholemeal bread or brown rice, but control portions. Exercise helps your body use insulin better. Always talk to your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Being diagnosed with gestational diabetes can cause stress, anxiety, or worry about you and your baby's health. It's important to talk about your feelings with your partner, family, or healthcare team. If you feel very low, ask for support from a mental health professional. Remember, you are not alone, and asking for help is a strength.

Prevention

You cannot always prevent gestational diabetes, but maintaining a healthy weight before pregnancy, eating well, and staying active can lower your risk. If you have had it before, planning with your doctor before your next pregnancy can help.

Screening programmes

Screening for gestational diabetes is a routine part of antenatal care. If you have risk factors, your doctor may offer testing earlier in pregnancy. Early detection helps manage the condition better.

Complications

If left untreated

• Your baby may grow larger than average (macrosomia), which can make delivery difficult.
• Increased risk of preterm birth (baby born early).
• Your baby may have low blood sugar after birth (neonatal hypoglycemia).
• Higher chance of developing high blood pressure or preeclampsia during pregnancy.
• Slightly higher risk of stillbirth (rare with proper care).

Long-term outlook

With proper management, most women with gestational diabetes have a healthy pregnancy and baby. After delivery, blood sugar usually returns to normal. However, you will have a higher risk of developing type 2 diabetes later in life, so it is important to maintain a healthy lifestyle and get tested regularly. Your healthcare team will help you plan follow-up care.

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