Pregnancy

• Gestational diabetes (diabetes in pregnancy developing for the first time) affects both mother and baby if not managed, but with good care many women have healthy pregnancies. 
• Recognise symptoms of pregnancy diabetes, but remember many women have no symptoms, screening is key. 
• In the US, testing is usually done around 24–28 weeks; if you’re at high risk your provider may test earlier or more often. 
• Management follows US guidance: lifestyle changes, monitoring, and medication/insulin if needed. 
• Preventive and long‑term health efforts matter, healthy diet, activity, weight management before, during and after pregnancy help reduce future risk of type 2 diabetes. 
• Work with your healthcare team to achieve the best outcome for you and your baby. 

Pregnancy is a special time, but it can also bring unexpected health challenges, including a form of diabetes known as gestational diabetes. This condition develops when your body has difficulty regulating blood sugar during pregnancy. While usually treatable, it’s important to spot symptoms early, get screened, and take steps to protect your health and your baby’s. 

In this article, we’ll cover what pregnancy diabetes is, the common symptoms during pregnancy, causes, US‑style testing, prevention strategies, and treatment options. 

What is pregnancy diabetes? 

In US practice, when we talk about pregnancy diabetes we usually mean gestational diabetes mellitus (GDM), that is, diabetes that first appears during pregnancy (rather than someone who already had type 1 or type 2 diabetes before pregnancy). 

Having gestational diabetes means you’ll receive closer monitoring of both you and your baby because there are increased risks (for example larger baby size, delivery complications, or future risk of type 2 diabetes). 

Common symptoms of gestational diabetes during pregnancy 

Recognising early symptoms of pregnancy diabetes can help, but keep in mind that many women have mild or no obvious symptoms. Some of the diabetes pregnancy signs to be aware of include: 

• Increased thirst and more frequent urination 
• Unusual fatigue or feeling extra tired 
• Blurred vision 
• Frequent infections (for example urinary tract infections) 

These signs can also occur in a normal pregnancy, so even if you feel they might just be “part of being pregnant,” it’s worth discussing with your provider, especially if you have risk factors. Many women with GDM don’t notice symptoms at all, which is why screening is so important. 

What causes diabetes during pregnancy? 

Understanding what causes diabetes during pregnancy can help you feel more in control. Here’s how it works: 

• During pregnancy the placenta produces hormones that increase insulin resistance (i.e., your body uses insulin less effectively). 
• Your pancreas must work harder to produce more insulin; if it cannot keep up, your blood sugar rises. 
• Additional risk factors: being overweight or obese before pregnancy, previous GDM, family history of type 2 diabetes, certain ethnic backgrounds, older maternal age.  

Testing for gestational diabetes during pregnancy 

In the US, the usual recommendation is to test for GDM around 24–28 weeks of pregnancy.  

Here are the key points: 

• The USPSTF recommends screening for gestational diabetes in asymptomatic pregnant persons at 24 weeks or later.  
• Common methods: a “glucose challenge test” (non‑fasting, drink a sugary drink, check blood sugar after 1 hour) followed by an “oral glucose tolerance test” (OGTT) if needed.  
• If you have high risk (for example history of GDM, obesity, strong family history), your provider may test earlier or more closely. 
• After birth, if you had GDM, your provider will encourage follow‑up testing (because of higher risk of type 2 diabetes later).  

How to treat diabetes during pregnancy 

Treatment of diabetes during pregnancy focuses on keeping your blood glucose levels within target ranges, so you and your baby stay healthy. In the US, guidelines emphasise: 

• Lifestyle changes: healthy meal planning, regular moderate physical activity, appropriate pregnancy weight gain. 
• Monitoring blood sugar: your provider may ask you to check fasting and after‑meal glucose levels.  
• Medication or insulin: if lifestyle changes alone aren’t enough, insulin (and sometimes other medications) may be prescribed. The ADA notes oral medications may be used in some cases. 
• Work closely with your healthcare team (OB/GYN, endocrinologist or diabetes educator, dietitian) to tailor your care plan. 

Managing gestational diabetes for a healthy pregnancy 

If you are diagnosed with GDM, here are additional pointers for managing for a healthier outcome: 

• Keep a log of your blood sugar readings, meals, and physical activity, this helps your care team adjust your plan. 
• Attend all prenatal appointments; your baby’s growth and your health (including blood pressure) will be monitored more closely if you have GDM. 
• Plan for labour and postnatal care: after delivery your baby may need monitoring for low blood sugar, and you may need postpartum glucose testing. 
• After pregnancy, continue healthy habits (breastfeeding, healthy diet, staying active) to reduce your chance of developing type 2 diabetes later. 

Sources  

• Recommendation: Gestational Diabetes: Screening | United States Preventive Services Taskforce 
• Dietary Recommendations for Gestational Diabetes | UCSF Health 
• Gestational Diabetes-Causes & Treatment | ADA