If you’re expecting or planning to become pregnant, you may have questions about gestational diabetes and the related health risks.

Gestational diabetes occurs in as many as 10 percent of pregnancies, but can be controlled by eating healthy foods, exercising and, if necessary, medication. Women who develop gestational diabetes did not have diabetes before becoming pregnant.

Some women have more than one pregnancy affected by gestational diabetes.

Dr. Richard Thompson

“We typically see gestational diabetes when we do a glucose tolerance test around 24 to 28 weeks,” said Dr. Richard Thompson of Novant Health OB/GYN Bolivia, near the coast of North Carolina. During the glucose tolerance test, patients consume a drink that has a high sugar load that most women’s bodies should be able to handle. If the patient’s blood sugar levels spike, further glucose tests are performed.

Thompson, who has Type 1 diabetes, said his personal history helps him connect to gestational diabetes patients.

“I understand how much of an effect diabetes can have on a lifestyle,” Thompson said. “Constantly monitoring your blood sugar levels and maintaining a healthy diet really changes your everyday life.”

“I try to relate things from my past to how they’re feeling about their diagnosis. But I emphasize that gestational diabetes is something we can get under control,” he said.

Key risk factors

There are several risk factors that can increase one’s chances of having gestational diabetes, including:

  • Over age 25. A 2016 study shows that the average age of first-time mothers continues to increase. With older maternal age, women have a higher chance of developing gestational diabetes.
  • Prediabetic or have a family history of diabetes. A woman’s risk increases if she has prediabetes or if a close family member, such as a parent or sibling, has Type 2 diabetes. Women are also more likely to develop gestational diabetes if they had it during a previous pregnancy, if they delivered a baby who weighed more than 9 pounds or if they had an unexplained stillbirth.
  • Overweight. Women are more likely to develop gestational diabetes if they are significantly overweight with a body mass index (BMI) of 30 or higher.
  • Nonwhite race. For unexplained reasons, women who are black, Latino, American Indian or Asian are more likely to develop gestational diabetes.

Even if a woman is at risk for gestational diabetes, there are some lifestyle changes she can make to minimize her chances of developing it.

Dr. Alyssa Mills

One of biggest steps women can take is to lose weight before pregnancy either through diet and exercise, or if recommended, weight loss surgery, said Dr. Alyssa Mills of Novant Health Maternal-Fetal Medicine. She also said following the recommended weight gain guidelines could help prevent the development of gestational diabetes.

“The phrase, ‘eating for two,’ shouldn’t be a free pass for nine months,” Mills said. “In actuality, the recommended guidelines for caloric intake in pregnancy are more like eating for 1.2 people instead of two.”

Staying fit is important for women who are expecting. “It’s OK to work out while pregnant,” said Thompson, who added that patients can consult their doctor about possible modifications. “Even if women didn’t work out before pregnancy, it’s still good for them to ease into an exercise routine to help with weight management.”

Learning to control gestational diabetes

Obstetricians at Novant Health sometimes may refer patients who are diagnosed with gestational diabetes to the diabetes center. There, patients receive education about dietary modifications they can make to help control their sugar levels.

If a woman is unable to control her sugar with diet alone, she is then prescribed medication by her obstetrician or may be referred to a maternal-fetal medicine specialist.

Complications can be serious

If gestational diabetes is not well-controlled, both the mother and her baby can be at risk for complications:

  • Excessive birth weight. If gestational diabetes is not controlled, the baby’s blood sugar can be too high. The baby is “overfed” and grows extra-large, causing discomfort and problems during delivery. Very large babies are more likely to become wedged in the birth canal, sustain injuries at birth or require a cesarean section birth.
  • Early birth and respiratory distress syndrome. Because of a mother’s high blood sugar, she is at greater risk of going into labor early. Babies born early may experience respiratory distress syndrome, a condition that makes breathing difficult. They may need help breathing until their lungs mature. Even if the baby isn’t born early, he or she could still be at risk for respiratory distress syndrome.
  • Low blood sugar. Gestational diabetes in the mother can lead to low blood sugar in the baby shortly after birth because the mother’s own insulin production is high. Severe episodes may cause seizures in the baby.
  • Preeclampsia. Gestational diabetes can increase a woman’s risk of developing high blood pressure during pregnancy. It can also raise her risk of preeclampsia and eclampsia – two serious complications of pregnancy that can cause high blood pressure and other symptoms that can threaten the lives of both mother and baby.
  • Future diabetes. If the mother has gestational diabetes, both she and the baby can be at risk to develop Type 2 diabetes later in life.

Recovering from gestational diabetes

Most women experience a rapid return to normal blood sugar levels after delivery. However, women who have gestational diabetes are at a greater risk of developing Type 2 diabetes later in life. Because of this risk, women who have had gestational diabetes should be screened once a year to ensure it doesn’t progress to Type 2 diabetes.

Childbirth is unpredictable — but thinking through your preferences ahead of time can make you feel more confident on the day of. Download our birth preparation guide.