The risk of gestational diabetes rises with an increase in body mass index BMI across racial and ethnic groups. But people with both high and low BMIs can get gestational diabetes.

Still, in studies, it has been found that even in cases of low BMI among people who are Asian and Hispanic , there is an increased risk of gestational diabetes. Additionally, though People of Color are disproportionately affected by type 2 diabetes, non-Hispanic Black women have the highest risk of developing type 2 diabetes after gestational diabetes than all racial and ethnic groups, according to the CDC.

A study compared the rate of gestational diabetes in Asian women to women of other ethnic backgrounds in a group of 5, women who had participated in a previous study in Los Angeles. Researchers also looked at whether cultural assimilation acculturation had any impact on the outcome.

None of the participants had type 1 or type 2 diabetes before pregnancy. Researchers adjusted for the known risk factors of the condition. No evidence suggested other factors, including acculturation, affected the rates of gestational diabetes.

However, studies that discuss gestational diabetes and use race and ethnic differences for clarity can be limited. Additional research is still needed to consider environmental, behavioral, genetic, and socioeconomic factors as well as access to healthcare.

The American Diabetes Association ADA encourages doctors to routinely screen pregnant people for signs of gestational diabetes. If your blood sugar level is high, a healthcare professional may perform a 3-hour oral glucose tolerance test.

This is considered two-step testing. Some doctors skip the glucose challenge test altogether and only perform a 2-hour glucose tolerance test. This is considered one-step testing. A doctor will likely diagnose gestational diabetes if you have any of the following blood sugar values :.

A doctor will not perform any more tests. The cut-off for this range may depend on your risk factors. A doctor will likely diagnose gestational diabetes if you have at least two of the following values :.

Many people who experience gestational diabetes will develop type 2 diabetes outside of pregnancy. There are two other types of diabetes:. The ADA also encourages doctors to screen for type 2 diabetes at the beginning of pregnancy. If you have risk factors for type 2 diabetes, a doctor will likely test you for the condition at your first prenatal visit.

These risks factors include :. According to the CDC , being an African American, Hispanic or Latino, American Indian, or Alaska Native person may also increase your risk of developing type 2 diabetes.

The CDC also notes that some Pacific Islanders and Asian American people may also have a higher risk. Gestational diabetes is divided into two classes :.

If you receive a diagnosis of gestational diabetes, your treatment plan will depend on your blood sugar levels throughout the day. In most cases, a doctor will advise you to test your blood sugar before and after meals. If a doctor encourages you to monitor your blood sugar levels , they may provide you with a glucose-monitoring device.

A doctor may also prescribe insulin injections for you until you give birth. Ask them about properly timing your insulin injections in relation to your meals and exercise to avoid low blood sugar. A doctor can also tell you what to do if your blood sugar levels fall too low or are consistently higher than they should be.

A balanced diet can help manage gestational diabetes. In particular, people with gestational diabetes can pay special attention to their carbohydrate, protein, and fat intake.

The CDC recommends working with a dietitian to develop a nutritious eating plan or following meal plans, such as the plate method. You may also need to avoid certain foods if you have gestational diabetes. According to a review of literature , the ADA, along with the American Academy of Nutrition and Dietetics, recommends all pregnant people eat a minimum of g of carbohydrates and 28 g of fiber per day.

For people with gestational diabetes, the American College of Obstetrics and Gynecologists ACOG recommends eating complex carbohydrates over simple ones. Complex carbs are digested more slowly, are less likely to produce high blood sugar, and may help reduce insulin resistance. The recommended dietary allowance RDA of protein during pregnancy varies by trimester and may vary based on your individual needs.

During the first trimester of pregnancy, the RDA is about 46 g of protein per day. However, ACOG lists certain types of fish that should be avoided due to their high mercury content, including tuna and swordfish.

Healthy sources of fat can provide nutrients, such as vitamins and minerals. Health-promoting fats to incorporate into your diet include:.

If gestational diabetes is not managed well or left untreated, blood sugar levels may remain higher than they should be throughout your pregnancy. This can lead to complications that affect the health of you and your baby before, during, and after birth.

To avoid these complications, you can take steps to manage your gestational diabetes. Your blood sugar should return to typical levels after you give birth. But developing gestational diabetes raises your risk of type 2 diabetes later in life. A doctor will test you for diabetes 6 to 12 weeks after your baby is born, and again every 1 to 3 years.

Taking steps to prevent type 2 diabetes can also help prevent associated complications. However, changing your lifestyle can help reduce your risk of developing it. Even light activity, such as walking, may be beneficial.

A doctor can help you create a plan to reach and maintain a moderate weight. Even losing a small amount of weight can help reduce the risk of gestational diabetes.

Gestational diabetes occurs when the body cannot produce the insulin needed during pregnancy, resulting in high blood sugar.

If you have gestational diabetes, a doctor may recommend changes to your diet along with blood sugar monitoring to help manage the condition. In some cases, you may need insulin injections. In many cases, if you have gestational diabetes during pregnancy, your blood sugar should return to your typical levels after you give birth.

However, you may have a higher risk of developing type 2 diabetes later in life. Read this article in Spanish. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

VIEW ALL HISTORY. If you did not previously exercise, ask your doctor or nurse if exercise is recommended. Most individuals who do not have medical or pregnancy-related complications are able to exercise, at least moderately, throughout their pregnancy.

Walking is a great form of exercise for those starting an exercise regimen. Insulin — Approximately 15 percent of patients with gestational diabetes will require insulin. Insulin is a medicine that helps to reduce blood sugar levels and can reduce the risk of gestational diabetes-related complications.

Insulin is the most common medicine for treating gestational diabetes. You must give insulin by injection because it does not work when it is taken by mouth. Most pregnant people start by giving one to two shots of insulin per day. If your blood sugar levels are high after eating, you may need to give yourself a shot three or four times per day.

Instructions for drawing up and giving insulin shots are available separately. See "Patient education: Type 2 diabetes: Insulin treatment Beyond the Basics ".

If you take insulin, you should check your blood sugar level at least four times per day. You also need to write down your results or store them in the meter and how much insulin you took and review these records at each prenatal visit or more frequently based on your doctor's recommendation figure 1.

Keeping accurate records helps to adjust insulin doses and can decrease the risk of complications. The bedtime snack is especially important to help keep your fasting first blood sugar of the day before eating in range.

Oral diabetes medicines, such as those taken by people with type 2 diabetes, are sometimes used during pregnancy in the United States. We prefer insulin therapy for pregnant patients with diabetes who cannot control blood glucose levels adequately by their diet nutritional therapy. Insulin is effective and safe and does not cross the placenta to the fetus.

Most oral diabetes medicines pass from the pregnant individual to their baby through the placenta; while they have not been shown to harm the fetus or newborn, it is not known if there are longer term effects on children. There are studies underway to help answer this question.

However, oral anti-hyperglycemic agents are a reasonable alternative for individuals who will not take, or are unable to comply with, insulin therapy, as long as they understand the lack of information on long-term risks or benefits.

Prenatal visits — Most pregnant individuals who develop gestational diabetes have more frequent prenatal visits eg, once every week or two , especially if insulin is used. The purpose of these visits is to monitor your and your baby's health, discuss your diet, review your blood sugars, and adjust your dose of insulin if you are taking it to keep your blood sugar levels near normal.

It is common to change the dose of insulin as the pregnancy progresses. You may also be asked to have one or two ultrasound examinations to check on the growth and size of the baby. See "Gestational diabetes mellitus: Obstetric issues and management".

Nonstress testing — You may need tests to monitor the health of the baby during the later stages of pregnancy, especially if your blood sugars have been high, you are using insulin, or if you have any pregnancy-related complications eg, high blood pressure.

The most commonly used test is the nonstress test. This test is discussed in a separate topic review. See "Patient education: Postterm pregnancy Beyond the Basics ". If your blood sugar levels are close to normal during pregnancy and you have no other complications, the ideal time to give birth is between 39 and 40 weeks of pregnancy, no later than your due date.

If you do not give birth by your due date, you may be offered induction of labor or additional testing to monitor your and your baby's health. In most individuals with gestational diabetes and a normal-size baby, there are no advantages to a cesarean over a vaginal birth, although cesarean may be needed in any pregnancy, especially with a first baby.

Those with a very large baby may be offered cesarean birth before labor starts. The risks and benefits of cesarean birth are discussed separately. See "Patient education: C-section cesarean delivery Beyond the Basics ". Your blood sugar levels will be monitored during labor.

Most individuals have normal blood sugar levels during labor and do not need any insulin. Insulin is given if your blood sugar level becomes high. High blood sugar levels during labor can cause problems in the baby, both before and after delivery.

See "Pregestational preexisting and gestational diabetes: Intrapartum and postpartum glucose management". AFTER-DELIVERY CARE. After giving birth, most individuals with gestational diabetes have normal blood sugar levels and do not require further treatment with insulin.

You can return to your prepregnancy diet, and you are encouraged to breastfeed. See "Patient education: Deciding to breastfeed Beyond the Basics ". However, your doctor may check your blood sugar level the day after delivery to be sure that it is normal or near normal.

Pregnancy itself does not increase the risk of developing type 2 diabetes. However, having gestational diabetes does increase your risk of developing type 2 diabetes later in life. After you deliver, you should have testing for type 2 diabetes. Typically, this is done between 4 and 12 weeks postpartum, ideally prior to your postpartum check-up.

But it may be done in the hospital before you are discharged. Testing usually includes a two-hour glucose tolerance test GTT so that you are tested for both pre-diabetes and diabetes. Risk of recurrent gestational diabetes — One-third to two-thirds of individuals who have gestational diabetes in one pregnancy will have it again in a later pregnancy.

If you are overweight or obese, weight reduction through diet and exercise can reduce this risk. Risk of developing type 2 diabetes — Individuals with gestational diabetes have an increased risk of developing type 2 diabetes later in life, especially if they have other risk factors eg, family history of type 2 diabetes.

The risk of developing type 2 diabetes is greatly affected by body weight. Individuals with obesity have a 50 to 75 percent risk of developing type 2 diabetes, while this risk is less-than percent in those who are a normal weight.

If you are overweight or obese, you can reduce your risk of type 2 diabetes by losing weight and exercising regularly. The American Diabetes Association ADA recommends that all persons with a history of gestational diabetes have testing for type 2 diabetes every one to three years after their initial post-pregnancy test for diabetes.

If you have elevations in your blood sugars in the pre-diabetes range at the time of your postpartum screening, the ADA recommends testing yearly testing. It is also recommended that you work with your primary care provider to eat a healthy diet, lose any excess weight, and exercise regularly to help decrease your risk of developing type 2 diabetes.

Cardiovascular disease — Individuals who have had gestational diabetes in the past are at increased risk of developing cardiovascular disease, including heart attack and stroke.

While this is mostly tied to the risk of type 2 diabetes see above , even those who do not develop type 2 diabetes appear to have a small increase in their risk of heart disease later in life. Continuing to make healthy lifestyle choices such as eating a balanced diet, exercising regularly, and avoiding smoking can help minimize this risk.

See "Patient education: Diet and health The Basics ". Birth control — Individuals with a history of gestational diabetes can use any type of birth control after pregnancy. A review of all of the birth control options is available separately.

See "Patient education: Birth control; which method is right for me? Beyond the Basics ". Your health care provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site www. Related topics for patients, as well as selected articles written for health care professionals, are also available.

Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.

These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: Gestational diabetes The Basics. Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed.

These articles are best for patients who want in-depth information and are comfortable with some medical jargon. Patient education: Preeclampsia Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics Patient education: Type 2 diabetes: Insulin treatment Beyond the Basics Patient education: Postterm pregnancy Beyond the Basics Patient education: C-section cesarean delivery Beyond the Basics Patient education: Deciding to breastfeed Beyond the Basics Patient education: Birth control; which method is right for me?

Beyond the Basics. Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based.

Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading. Clinical presentation, diagnosis, and initial evaluation of diabetes mellitus in adults Effects of advanced maternal age on pregnancy Infants of mothers with diabetes IMD Pregestational preexisting diabetes mellitus: Obstetric issues and management Gestational diabetes mellitus: Screening, diagnosis, and prevention Gestational diabetes mellitus: Glucose management and maternal prognosis Gestational diabetes mellitus: Obstetric issues and management Pregestational preexisting and gestational diabetes: Intrapartum and postpartum glucose management.

htm , available in Spanish. The editorial staff at UpToDate would like to acknowledge Donald R Coustan, MD, and Michael F Greene, MD, who contributed to earlier versions of this topic review.

Why UpToDate? Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you. Select the option that best describes you. View Topic. Font Size Small Normal Large. Patient education: Gestational diabetes Beyond the Basics.

Formulary drug information for this topic. No drug references linked in this topic. Find in topic Formulary Print Share. Author: Celeste Durnwald, MD Section Editors: David M Nathan, MD Erika F Werner, MD, MS Deputy Editor: Vanessa A Barss, MD, FACOG Contributor Disclosures.

You're also more likely to develop type 2 diabetes. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line in most provinces and territories if you are having problems.

It's also a good idea to know your test results and keep a list of the medicines you take. Call anytime you think you may need emergency care. For example, call if:. Call your doctor or nurse advice line now or seek immediate medical care if:.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:. Enter A in the search box to learn more about "Gestational Diabetes: Care Instructions".

Author: Healthwise Staff. Medical Review: E. Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional.

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Main Content Alberta Content Related to Conditions Gestational Diabetes More Alberta Content. Important Phone Numbers. Topic Contents Overview How can you care for yourself at home?

When should you call for help? Where can you learn more? Top of the page. Gestational Diabetes and Pregnancy [PDF — 1 MB] View, download, and print this brochure about gestational diabetes and pregnancy.

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Minus Related Pages. Last Reviewed: July 14, Source: Centers for Disease Control and Prevention. Facebook Twitter LinkedIn Syndicate. home Pregnancy Homepage. Links with this icon indicate that you are leaving the CDC website. The Centers for Disease Control and Prevention CDC cannot attest to the accuracy of a non-federal website.

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You will be subject to the destination website's privacy policy when you follow the link. Talk with your health care team about what activities are best for you during your pregnancy. Ask your doctor if you may continue some higher intensity activities, such as lifting weights or jogging.

Read tips on how to eat better and be more active while you are pregnant and after your baby is born. Your health care team may ask you to use a blood glucose meter to check your blood glucose levels. This device uses a small drop of blood from your finger to measure your blood glucose level.

Your health care team can show you how to use your meter. Recommended daily target blood glucose levels for most women with gestational diabetes are. You can keep track of your blood glucose levels using My Daily Blood Glucose Record PDF, 45 KB.

You can also use an electronic blood glucose tracking system on your computer or mobile device. Record the results every time you check your blood glucose.

Your blood glucose records can help you and your health care team decide whether your diabetes care plan is working. Take your tracker with you when you visit your health care team. If you need to use insulin, your health care team will show you how to give yourself insulin shots.