Gestational Diabetes: Causes, Treatment, and Management
Gestational diabetes mellitus (GDM) is a type of diabetes that develops during pregnancy. It usually shows up in the second trimester and can affect women with no previous history of diabetes. While it can be concerning, gestational diabetes is manageable with the right care and awareness.
What Is Gestational Diabetes?
Gestational diabetes occurs when your body can’t make enough insulin during pregnancy. Insulin is the hormone that helps control your blood sugar levels. During pregnancy, the placenta produces hormones that increase insulin resistance. This means your body needs to produce more insulin to keep blood sugar levels stable. If it can’t keep up, your blood sugar rises.
Most women with gestational diabetes can manage their blood sugar through diet, exercise, and close monitoring. But in some cases, medication or insulin injections may be necessary to maintain safe levels.
Causes and Risk Factors
The exact cause of GDM isn’t always clear, but it usually results from hormonal changes that make it harder for insulin to work. Several factors increase your risk:
• Being overweight or obese before pregnancy
• Previous GDM in a past pregnancy
• Family history of type 2 diabetes
• Age over 35
• Polycystic ovary syndrome (PCOS)
• Having delivered a baby over 4kg in a previous pregnancy
• Belonging to certain ethnic groups with higher risk (e.g., South Asian, Hispanic, Indigenous)
Even women with no risk factors can develop GDM, which is why universal screening is often done.
Symptoms and Diagnosis
Most women with gestational diabetes don’t have noticeable symptoms, which makes testing essential. That’s why screening is done between 24 and 28 weeks of pregnancy.
Diagnosis is made using a glucose tolerance test (GTT):
• You’ll fast overnight, then drink a sugary liquid at the clinic
• Your blood sugar levels will be tested before and after drinking the liquid
• If your levels are higher than normal, GDM may be diagnosed
In some cases, especially if you’re at high risk, the test might be done earlier in pregnancy.
Rarely, symptoms such as increased thirst, frequent urination, fatigue, or blurred vision may occur, but they are often subtle.
Treatment Options and Lifestyle Changes
The main goal of treatment is to keep blood sugar levels within a healthy range and reduce the risk of complications.
Healthy Eating
• Choose whole grains, lean protein, vegetables, and fruits with low glycemic index (GI)
• Avoid sugary drinks, processed snacks, and refined carbs
• Eat smaller, balanced meals throughout the day to keep sugar stable
Regular Exercise
• Aim for 30 minutes of moderate activity most days (e.g., walking, swimming, prenatal yoga)
• Exercise helps your body use insulin more effectively
Monitoring Blood Sugar
• You’ll need to check your blood sugar levels several times a day
• Your doctor will provide target levels and show you how to use a glucose meter
If lifestyle changes aren’t enough, your doctor may prescribe:
• Insulin injections (safe during pregnancy)
• Oral medications in some cases
Monitoring and Delivery Planning
Once diagnosed, your care team will closely monitor your pregnancy to ensure the best outcomes for both you and your baby.
This includes:
• Regular prenatal visits
• Ultrasounds to monitor baby’s growth and amniotic fluid levels
• Non-stress tests to check baby’s heart rate and movements
• Frequent review of blood sugar logs
Your delivery plan may include:
• Induction of labour if baby is growing too large
• Possible C-section if complications arise or baby is too big for vaginal delivery
• Blood sugar monitoring during labour
Most women with well-managed GDM have healthy, full-term deliveries.
Gestational diabetes is common and manageable. Schedule a pregnancy check-up if you’re due for gestational diabetes screening or would like personalised advice on managing your blood sugar during pregnancy.
FAQs
Can gestational diabetes return in my next pregnancy?
Yes. Women who have had gestational diabetes are more likely to develop it again in future pregnancies. Your doctor may recommend earlier screening and closer monitoring in subsequent pregnancies.
Does gestational diabetes mean I will have diabetes for life?
Not usually. Blood sugar levels often return to normal after delivery. However, women who have had gestational diabetes have a higher risk of developing type 2 diabetes later in life and should have regular follow-up screening.