Pregnancy

• Gestational diabetes (diabetes in pregnancy developing for the first time) occurs due to increased insulin resistance in pregnancy and can impact both mother and baby if not managed. 
• Recognise symptoms of pregnancy diabetes, but remember many women don’t show obvious signs, so risk assessment and screening are important. 
• Testing is typically based on risk factors. In the UK, screening is not universal.  
• Management follows NHS guidance, including a healthy diet, regular physical activity, blood glucose monitoring, and, if needed, medication. 
• Prevention and long‑term health: Healthy lifestyle before, during and after pregnancy helps reduce risk of future type 2 diabetes and promotes better outcomes. 
• Working with your healthcare team (midwife, obstetrician, diabetes specialist) is key for a healthy pregnancy outcome when dealing with diabetes in pregnancy. 

Pregnancy is an exciting time, but it can also bring unexpected health challenges. One condition that can arise during pregnancy is pregnancy diabetes, more precisely known as gestational diabetes mellitus (GDM).  

This condition develops when your body struggles to regulate blood sugar during pregnancy, typically due to increased insulin resistance caused by pregnancy hormones.  

While in many cases it resolves after birth, it’s important to recognise symptoms early, manage the condition, and take steps to protect both your health and your baby’s. 

In this article, we’ll cover symptoms of gestational diabetes during pregnancy, what causes it, how it is tested, how to prevent it, how it is treated, and what it means for you and your baby. 

What is pregnancy diabetes? 

Pregnancy diabetes in the context of this article refers mainly to gestational diabetes, diabetes that develops during pregnancy for the first time (rather than pre‑existing type 1 or type 2 diabetes). The NHS states that gestational diabetes “develops during pregnancy and usually goes away after your baby is born.” 

It’s important to note that women with pre‑existing diabetes (type 1 or type 2) also need specialist care for “diabetes in pregnancy”, but that is a different category.  

Being diagnosed with gestational diabetes in pregnancy means you will usually receive closer monitoring of you and your baby.  

Common symptoms of gestational diabetes during pregnancy 

Recognising early symptoms of pregnancy diabetes is helpful, but many women don’t experience obvious signs, meaning screening and monitoring are key. 

Some of the common diabetes pregnancy signs to watch for include: 

• Increased thirst and frequent urination 
• Feeling unusually tired or fatigued 
• Blurred vision 
• Recurring infections (for example urinary tract infections) 

These symptoms can occur in a “normal” pregnancy too, which is why it’s important to follow up with your midwife or doctor if you’re at higher risk. 

It’s also worth noting that many women with gestational diabetes don’t notice any symptoms at all, which is why screening or risk‑factor assessment is part of antenatal care.  

How to treat diabetes during pregnancy 

Treatment of gestational diabetes (or diabetes in pregnancy more broadly) is about keeping blood glucose levels under control so that both you and your baby remain healthy.  

Diet and lifestyle: 

• Eat regularly (for example three meals a day) and avoid skipping meals.  
• Choose starchy and low glycaemic index (GI) carbohydrates (wholegrain pasta, brown rice, pulses, wholemeal bread).  
• Eat plenty of fruit and vegetables (aim for at least 5 portions a day).  
• Avoid or minimise sugary foods and drinks. For example, replacing sugary soft drinks with water or diet/zero versions. 

Physical activity: A common recommendation is to aim for at least 150 minutes (2½ hours) of moderate‑intensity activity per week, plus strength exercises on two or more days a week (if you are able and it’s safe) during pregnancy.  

Blood glucose monitoring: Once diagnosed, you’ll be supported to monitor your blood glucose levels regularly (before meals and/or after meals) so your care team can adjust your plan.  

Medication: If diet and lifestyle changes alone don’t achieve target glucose levels, medication may be prescribed. Typically this may involve tablets (e.g., Metformin) and/or insulin. NHS guidance emphasises these are safe in pregnancy when necessary. 

It’s critical that you work closely with your healthcare team (midwives, obstetricians, diabetes specialist nurses) for the optimal outcome. 

How to prevent pregnancy diabetes 

Many women ask: how to prevent pregnancy diabetes or how to prevent gestational diabetes during pregnancy. While you cannot eliminate all risk (for example genetic or ethnic risk factors), there are lifestyle steps that align with NHS/UK guidance and can reduce your risk: 

• Maintain a healthy weight before becoming pregnant, or aim to keep to weight gain recommendations during pregnancy.  
• Eat a balanced, healthy diet with a focus on lower‑GI carbohydrates, wholegrains, pulses, vegetables, lean proteins, and lower sugar.  
• Stay physically active; regular exercise helps improve insulin sensitivity. 
• Attend pre‑pregnancy check‑ups if you have risk factors (such as previous gestational diabetes, high BMI, family history of diabetes) and seek advice about managing these risks.  
• After having gestational diabetes, you should engage in follow‑up and long‑term healthy habits because there is increased risk of type 2 diabetes. 

Managing gestational diabetes for a healthy pregnancy 

Once diagnosed with gestational diabetes, your care will become more closely monitored. Some additional management pointers: 

• Keep a blood sugar log and review with your diabetes/maternity team. 
• Follow your personalised meal plan as advised by your dietitian or maternity team. 
• Attend regular prenatal appointments to monitor your baby’s growth, your health (including blood pressure) and wellbeing. Higher glucose can influence baby’s growth (for example a larger baby) and may require growth scans or closer monitoring.  
• Plan for labour and the postnatal period: After birth your healthcare team will check that your blood sugar is back to normal and that your baby is safe, for example the baby may be monitored for low blood sugar (hypoglycaemia) in the first hours after birth.  
• Maintain healthy habits after birth. Breastfeeding, healthy diet and activity help reduce your future risk of type 2 diabetes.  

With proper management and monitoring, most women with gestational diabetes go on to have healthy pregnancies and healthy babies. 

Sources  

• Gestational diabetes - NHS  
• Gestational diabetes diet | What can I eat | Diabetes UK 
• Gestational diabetes - UK National Screening Committee (UK NSC) - GOV.UK