Gestational diabetes is a type of diabetes that can develop during pregnancy. We discuss what it is and what this means for you and your baby.
If you or your partner is diagnosed with gestational diabetes, it’s good to keep in mind that:
- Gestational diabetes can cause problems during pregnancy and after birth but the risks can be reduced if the condition is detected early and is managed. One study showed that pregnant people who can control gestational diabetes through their diet and whose babies are growing normally may be considered at low risk.
- It’s fairly common for pregnant women to develop diabetes during their pregnancy, it affects around one in 20 pregnancies.
- Gestational diabetes is temporary and normally goes away after birth.
(NHS, 2019; Jabak and Hameed, 2020; NICE, 2020; International Diabetes Federation, 2021)
What is gestational diabetes?
Gestational diabetes is a temporary form of diabetes that develops during pregnancy. It is high amounts of sugar in the blood but this usually returns to normal after giving birth.
- Gestational diabetes develops when the body doesn’t produce enough insulin for the extra needs of pregnancy. Insulin is a hormone that helps control blood sugar levels.
- It can occur at any stage of pregnancy but is more common in the second half.
- Most cases are discovered when blood sugar levels are tested during antenatal screening but some people can experience symptoms.
- You will be offered extra care and support to manage the diabetes and reduce any risks for your baby.
(NHS, 2019; NICE, 2020)
Being diagnosed with gestational diabetes can bring extra feelings of responsibility, financial constraint or conflict with cultural practices, as diet and lifestyle may need to be adjusted. It could also be seen as an opportunity to make positive lifestyle changes and healthy eating choices (Craig et al, 2020).
Some parents might find a diagnosis confusing or stressful, so it can be helpful to get some support from family, friends and health professionals. Many families find that once they have made changes to their diet and routine, they feel more positive and in control, particularly as they learn more (Craig et al, 2020).
What are the symptoms?
Often gestational diabetes has no obvious symptoms. Most cases are picked up when blood sugar levels are tested during antenatal checks.
Some pregnant women may develop symptoms if their blood sugar level gets too high, like:
- being more thirsty than usual
- a dry mouth
- weeing more often than usual
Some of these can be common symptoms during pregnancy, so aren't necessarily a sign of gestational diabetes. Do speak to a midwife or GP if you're worried.
Can gestational diabetes be prevented?
Some research has found that diet and exercise might reduce the risk of a person developing gestational diabetes. Vitamin D or Myo-inositol supplements also showed a possible benefit (Griffith et al, 2020).
Who is at risk of gestational diabetes?
Some women are more likely than others to get gestational diabetes in pregnancy. A person has a higher risk if:
- their body mass index (BMI) was higher than 30 before the pregnancy.
- they have previously given birth to a large baby weighing 4.5kg (10lb) or more.
- they had gestational diabetes in a previous pregnancy.
- they have a family history of diabetes; for example, a parent or a brother or sister has diabetes.
- their family’s ethnicity is south Asian, Black, African-Caribbean or Middle Eastern.
(NHS, 2019; NICE, 2020)
A midwife or GP will ask about these risk factors at the first antenatal appointment – at around eight to 12 weeks of pregnancy. Individuals will be offered a test for gestational diabetes if any of these risk factors apply. (NHS, 2019; NICE, 2020).
"If you have had gestational diabetes before, chat with your GP about how you can reduce your risks of getting it or type 2 diabetes later." (NHS, 2021)
How will gestational diabetes affect pregnancy and the baby?
Most women who develop diabetes in pregnancy have healthy pregnancies and healthy babies.
Occasionally, gestational diabetes can cause problems like:
- The baby being bigger than usual, which may lead to complications during birth and so increase the likelihood of an induced labour or caesarean.
- Too much amniotic fluid around the baby (polyhydramnios).
- It may cause the baby to be born prematurely.
- It could cause pre-eclampsia – a condition that causes high blood pressure during pregnancy and can cause pregnancy complications if not treated.
- The baby could develop low blood sugar after birth, or yellowing of the skin and eyes (jaundice) after they are born, which may require treatment in hospital.
- Stillbirth – although this is extremely rare.
(NHS, 2019; NICE, 2020)
"Good blood glucose control through diet and exercise and/or medicines reduces these risks." (NHS, 2019; NICE, 2020)
What is the treatment for gestational diabetes?
Controlling blood sugar levels during pregnancy reduces the risk of complications. This can be done through healthy eating and regular exercise. Some people may also need medication (NHS, 2019; NICE, 2020).
Find out more in our article about treating gestational diabetes.
How will my care be different if I have gestational diabetes?
It can be reassuring to know that the healthcare team will monitor people with gestational diabetes more closely during pregnancy and birth to check for any issues (NHS, 2019; NICE, 2020).
Gestational diabetes and giving birth
Your midwife or GP will discuss with you the timing for giving birth and where to have your baby.
- It will be recommended that birth takes place before 41 weeks in a hospital, or earlier if there are concerns about the pregnant person or baby’s health, or if blood sugar levels are not well controlled.
- If your baby has not been born by this time, they will offer induction of labour or a caesarean birth.
- Caesarean birth may be advised if your baby is estimated to be very large (macrosomia) using ultrasound measurements. These measurements are accurate 90% of the time at spotting larger babies but they can overestimate a baby’s actual weight.
- Blood sugar levels will be monitored during and after labour.
(Milner and Arezina, 2018; NHS, 2019; NICE, 2020)
What will happen after I give birth?
Gestational diabetes usually goes away after your baby is born – when your hormones return to their normal levels.
- Blood glucose levels will be tested after giving birth, before leaving hospital and once again at the six to 13 week postnatal check.
After birth, any medicine that was being taken to control blood sugar levels will be stopped and blood sugar levels will be checked the next day.
It is important to feed your baby as soon as possible after birth: within 30 minutes and at frequent intervals (at least every two to three hours) after to help to stabilise their blood sugar levels.
Your baby’s blood sugar level will be tested between two to four hours after birth and, if it is low, your doctors may recommend that your baby is fed through a tube or drip temporarily.
If a baby needs more specialised care, they may be looked after in a specialist neonatal unit.
If all the checks go well, the parent and baby will be discharged to go home after 24 hours.
(NHS, 2019; NICE, 2020)
What about breastfeeding?
Breastfeeding a baby quickly after birth can help their blood glucose stay at a safe level (NHS, 2019).
Some parents choose to express and safely store colostrum from week 36 of pregnancy. This colostrum can then be used to supplement feeding a baby after birth. This practice is safe, it may speed up the production of breastmilk after birth, and it is associated with babies breastfeeding for longer. It might also build a parent’s confidence with breastfeeding and make parents feel prepared for their baby’s arrival (Foudil-Bey et al, 2021).
Breastfeeding for three months or more might reduce the risk of developing type 2 diabetes later in life for the parent (Much et al, 2014).
Will gestational diabetes recur or lead to diabetes?
People who have had gestational diabetes are more likely to develop the condition in a future pregnancy. So it’s important to talk to a GP when planning future pregnancies.
It is also more likely that someone may develop type 2 diabetes later in life if they have had gestational diabetes. The risk is higher in the four to five years after having gestational diabetes. It’s important to talk to your GP about what can reduce this risk, and seek medical advice if any symptoms of diabetes develop.
An annual blood glucose test may be offered to anyone who has had gestational diabetes (NHS, 2019; NICE, 2020).
If you have any concerns, contact your midwife or GP.
This page was last reviewed in November 2021
Further information and support
Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.
You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.
Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.
Our support line offers practical and emotional support in all areas of pregnancy and early parenthood: 0300 330 0700.
Read our article about gestational diabetes treatment.
Find out more about gestational diabetes and how to manage it from the NHS Choices website. https://www.nhs.uk/conditions/gestational-diabetes/
Read Diabetes UK’s new guide to understanding gestational diabetes, with practical tips for having a healthy pregnancy. https://www.diabetes.org.uk/Documents/gestational-diabetes/0302A-gestational-diabetes-guide-0915.pdf
Contact the Diabetes UK careline on 0345 123 2399, Monday to Friday, 9am–6pm.
Craig L, Sims R, Glaziou P, Thomas R. (2020) Women’s experiences of a diagnosis of gestational diabetes mellitus: a systematic review. BMC Pregnancy Childbirth. 20(1):76. Available at: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s1288… [Accessed 17th November 2021].
Foudil-Bey I, Murphy M, Dunn S, Kelly E, Chaar D. (2021) Evaluating antenatal breastmilk expression outcomes: a scoping review. Int Breastfeed J. 16(1):25. Available at: https://internationalbreastfeedingjournal.biomedcentral.com/articles/10… [Accessed 17th November 2021].
Griffith R, Alsweiler J, Moore A, Brown S, Middleton P, Shepherd E, et al. (2020) Interventions to prevent women from developing diabetes during pregnancy: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 6:CD012394. Available at: https://www.cochrane.org/CD012394/PREG_interventions-prevent-women-deve… [Accessed 17th November 2021].
International Diabetes Federation. (2021) IDF Diabetes Atlas. Available at: https://diabetesatlas.org/data/en/country/209/gb.html [Accessed 17th November 2021].
Jabak S, Hameed A. (2020) Continuous intrapartum fetal monitoring in gestational diabetes, where is the evidence? J Matern Fetal Neonatal Med. 13;1-4. Available at: https://pubmed.ncbi.nlm.nih.gov/33307915/ [Accessed 17th November 2021].
NHS. (2019) Gestational diabetes. Available from: https://www.nhs.uk/conditions/gestational-diabetes/ [Accessed 17th November 2021].
NHS. (2021) Diabetes in pregnancy. Available at: https://www.nhs.uk/pregnancy/related-conditions/existing-health-conditi… [Accessed 29th November 2021]
NICE. (2020) Diabetes in pregnancy: management from preconception to the postnatal period. Available from: https://www.nice.org.uk/guidance/ng3 [Accessed 17th November 2021].
Milner J, Arezina J. (2018) The accuracy of ultrasound estimation of fetal weight in comparison to birth weight: A systematic review. Ultrasound. 26(1):32-41. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810856/ [Accessed 29th Novemebr 2021]
Much D, Beyerlein A, Roßbauer M, Hummel S, Ziegler A. (2014) Beneficial effects of breastfeeding in women with gestational diabetes mellitus. Mol Metab. 3(3):284-292. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986583/ [Accessed 17th November 2021].