Understanding gestational diabetes

by Kaiser Permanente |
Young pregnant woman suffering from backache.

When you’re pregnant, there’s a small chance that you’ll develop gestational diabetes, which can cause your blood sugar levels to become too high. While it’s serious and must be monitored and treated, it is possible to lower your chances of getting gestational diabetes by focusing on healthy eating and regular physical activity.

What is gestational diabetes?

Changes in hormones while you’re pregnant can lead to high blood sugar, causing gestational diabetes. Normally, your body uses the hormone insulin to move sugar from your bloodstream into the cells that need it. During pregnancy, the placenta produces hormones that, along with pregnancy weight gain, make it harder for insulin to do its job. This can lead to higher levels of sugar in your bloodstream.

It’s unclear why this happens in some pregnancies and not others, but there are some known risk factors. You are more likely to develop gestational diabetes if:

  • You had high blood sugar during a previous pregnancy.
  • You’ve had babies with a birth weight of more than nine pounds in the past.
  • You are carrying extra body weight.
  • You have a close relative who has diabetes.
  • Your racial or ethnic group is at higher risk (African American, Asian American, Arab American, Hispanic/Latin, Native American, Pacific Islander).
  • Belonging to any of these groups doesn’t mean you’ll get gestational diabetes. It just means your chances are a little higher.

Lower your chances of gestational diabetes

Here are several actions you can take to lower your risk.

Eat healthy

Keep in mind that the types of foods you eat affect your blood sugar. Your goal is to keep your blood sugar from routinely being high. Paying attention to your eating choices will help keep your blood sugar within a healthy range.

Foods that are rich in refined carbohydrates can make your blood sugar rise. Some examples of these foods are white bread, pasta, rice and tortillas, and starchy vegetables such as corn, peas, and potatoes. While dairy and fruit are both part of a healthy pregnancy diet, eating too many sweetened dairy products, like sweetened yogurts or ice cream, can add extra carbohydrates.

Foods that don’t raise your blood sugar too high include proteins such as cooked meat, cheese, beans or lentils, and tofu. Also look for non-starchy vegetables like salad greens, spinach, broccoli, bell peppers, eggplant.

Keep in mind that when you eat can be as important as what you eat. Eating smaller, more frequent meals every two to three helps keep your blood sugar stable. Try not to skip meals or snacks, even if you aren’t feeling hungry.


Being physically active is always important for good health, but especially if you’re at risk for gestational diabetes. Exercise helps control your blood sugar levels, and to maintain a healthy body weight.

Even simple physical activities like taking a brisk evening walk after dinner can help regulate blood sugar. Discuss your exercise plan with your physician or nurse-midwife to be sure you are getting enough exercise while staying safe for your stage of pregnancy.

Control your weight

If you have been diagnosed as overweight or obese, losing even a few pounds can make a difference. You should always talk to your physician or nurse-midwife before trying to lose weight while you are pregnant.

Getting screened for gestational diabetes

Your care team will recommend you get screened for gestational diabetes between 24 and 28 weeks. Many of the symptoms of gestational diabetes, like frequent urination, are part of any pregnancy, so it’s important to get screened even if you’re not feeling any symptoms.

Fortunately, the screening process is simple. You’ll be asked to take at least one and possibly two tests. It depends on which type of test your care team offers, and most don’t require any preparation.

For some exams, you’ll need to fast for a few hours before taking the test. Your care team will notify you if you need to prepare. Here’s a brief snapshot of what to expect: you’ll arrive at a lab, drink a bottle of very sweet juice, sit calmly for an hour, and then have your blood drawn to test for the blood sugar level. If it’s normal, you’re all set. If not, you’ll take a second test a few days later.

If you need a second test, the process is a little different. You must fast for eight hours beforehand — no eating, drinking, smoking, or vigorous exercise. This time, your blood will be drawn when you arrive. Then, you drink the juice and have more blood drawn once an hour for three hours. If your blood sugar levels are too high, you might have gestational diabetes.

Managing pregnancy with gestational diabetes

Most women with gestational diabetes have perfectly healthy pregnancies and babies, but you do need to monitor and manage your condition closely. The goal is to keep your blood sugar levels within the target range. This always involves making healthy food choices and exercising, and it might also include monitoring your blood sugar and taking medications.

By working on what you can control, like diet and physical activity, you can reduce your risk. And sometimes, even if you do all the "right things," you may still end up with gestational diabetes. In that case, your care team will be there to support you throughout your pregnancy and after.

It’s important to know that gestational diabetes raises the risk for you and your baby for developing diabetes later in life. As always, be sure to continue eating healthy after pregnancy and stay in touch with your doctors every step of the way. If you introduce these habits into your routine, you’ll have a head start on managing your overall health for the long run.

This article has been created by a national group of Kaiser Permanente ob-gyns, certified nurse-midwives, pediatricians, lactation consultants and other specialists who came together to provide you with the best pregnancy, birth, postpartum, and newborn information.

Some of the content is used and adapted with permission of The Permanente Medical Group.