How to Prevent Gestational Diabetes

Gestational diabetes is a type of diabetes that happens during pregnancy. Like other kinds of diabetes, gestational diabetes affects how the body processes glucose or sugar, causing glucose levels to be higher than they should be. Pregnancy hormones can make it harder for insulin to move glucose from your blood into other cells in your body.

According to the Centers for Disease Control, between 2 and 10 percent of pregnancies are affected by gestational diabetes. And it affects pregnant women who haven’t ever been diagnosed with diabetes.

There is some new research on the different causes of gestational diabetes – one recent study looked at the cause being in the pancreas, where insulin is made, versus at the level of the cells in the body and how they’re able to use that insulin. Currently, people with diabetes are treated similarly, but in the future, we may have more information about how to best treat pregnant women based on where the source of the disease originates. 

We know gestational diabetes is caused by the body's inability to process glucose normally. Maintaining a healthy weight, eating a balanced diet low in sugar, and getting regular exercise all help the body keep blood sugar under control. Exercise is especially important because it helps the body be more sensitive to insulin (the hormone that allows cells to use blood sugar for energy). 

Yes, most women will be tested for gestational diabetes. Typically, we test for this between 24- 28 weeks gestation (at the end of the second trimester or beginning of the third trimester). This usually involves drinking a sugary drink with a set amount of glucose in it, then measuring the blood glucose level an hour later to see how the body is able to process that sugar. For women who have risk factors, they may be tested early in pregnancy during the 1st trimester. 

For the initial test, you don’t have to fast. Some people recommend that you don’t eat sugary foods before the test, as it might falsely elevate the result.  I generally recommend folks eat a breakfast of eggs and whole wheat toast without honey or jam. 

 A positive test doesn’t mean you have gestational diabetes, but it does mean we need to do a longer, more comprehensive test is recommended to determine if you have the disease. 

Gestational diabetes typically doesn’t have any symptoms, which is why it’s so important to test for this during routine pregnancy care. Your medical history and whether you have any risk factors may suggest to your doctor that you could have gestational diabetes, but you’ll need to be tested to know for sure. Risk factors include:

• Being overweight or obese
• Family history of type 2 diabetes
• Have previously given birth to a baby who weighed more than nine pounds  
• Have had gestational diabetes in a previous pregnancy 
• Women who are African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander 

There’s a lot you can do a lot to manage your gestational diabetes. Be sure to go to all your prenatal appointments and follow your treatment plan, which includes:

• Checking your blood sugar to make sure your levels stay in a healthy range.
• Eating healthy food in the right amounts at the right times. Follow a healthy eating plan created by your midwife, doctor, or dietitian.
• Consistent, moderate exercise helps your body use insulin better, as long as you do it safely. Before you get started, talk with your healthcare team about what kind of exercise is best for you.
• Monitoring your baby. Your midwife or doctor will check your baby’s growth and development.

If healthy eating and being active aren’t enough to manage your blood sugar, your midwife or doctor may prescribe insulin or other medication to help manage your blood glucose.

• Increased chance of preeclampsia, a condition that causes high blood pressure. If it becomes severe it can be life-threatening for mother and baby. 
• Increased chance of needing a Caesarean delivery
• Higher risk of developing regular diabetes 

Women who have gestational diabetes have about a 50 percent chance of developing Type 2 diabetes later in life. That’s one reason why it’s important to follow up with your midwife or doctor after your baby is born to check for diabetes, and to get regular check-ups in the years after you’ve had your baby.  

The good news is a healthy diet, regular exercise, and weight loss can help reduce the chances of developing diabetes later in life. Sometimes people are able to make lifestyle changes when they learn they have gestational diabetes during pregnancy which can help them stay healthy later in life. 

Babies of women with gestational diabetes are at risk for being larger than normal, greater than nine pounds, which can make birth more difficult or increase the chances a Cesarean section is needed. They’re also at increased risk of preterm delivery and can experience low blood sugar after they’re born. These babies have a higher chance of developing Type 2 diabetes themselves later in life. 

Uncontrolled diabetes can even increase the chance of stillbirth, so it’s really important to know about it so we can manage it and prevent these things from happening.  

If you’re considering becoming pregnant, you can help start the pregnancy out as healthy as possible by eating healthy and exercising to help reduce the chances of developing gestational diabetes. For women who have a body mass index in the obese or overweight category, they may reduce their risk of diabetes by losing weight prior to pregnancy. 

If you have diabetes or gestational diabetes, it’s important to go to your prenatal visits so your provider can help you know how to best manage this condition and improve your and your baby’s outcome. 

Intermountain Healthcare Fact Sheet on Gestational Diabetes (PDF)

Intermountain Healthcare Face Sheet on Gestational Diabetes Meal Planning (PDF)