What is Gestational Diabetes and Why Does It Matter?
When we talk about pregnancy and nutrition, one of the most common topics that keeps coming up is gestational diabetes mellitus (GDM). It affects about 6–10% of pregnancies in the United States and is more than just a “temporary blood sugar issue.” It’s a clear sign from your body that indicates you should pay attention to your glucose metabolism for the health of both you and your baby.
Let’s unpack what gestational diabetes is, how it develops, how it’s diagnosed, and what it means for your long-term health.
What Is Gestational Diabetes?
Gestational diabetes is a type of diabetes first diagnosed during pregnancy. It usually develops in the second or third trimester and typically goes away after delivery, but the implications don’t stop there.
During pregnancy, hormones such as human placental lactogen, estrogen, cortisol, and progesterone increase insulin resistance. That’s normal. What’s not normal is when your pancreas can’t keep up with the rising demand for insulin. This leads to elevated blood glucose levels, also known as hyperglycemia.
Why Does It Happen?
Think of it this way: pregnancy is a state of physiological insulin resistance. Your body naturally wants to keep more glucose circulating to nourish your growing baby. But if your pancreas can’t compensate by producing enough insulin, blood sugar stays high.
Risk factors include:
Family history of type 2 diabetes
Overweight or obesity (BMI ≥ 25)
Polycystic ovarian syndrome (PCOS)
Advanced maternal age (over 35)
Previous baby >9 lbs or previous GDM
Ethnic backgrounds with higher diabetes risk: African American, Hispanic, Native American, South or East Asian, Pacific Islander
How Is It Diagnosed?
Most U.S. practitioners screen between 24–28 weeks using one of two approaches:
1. The Two-Step Approach (most common in the U.S.):
Step 1: 50-gram oral glucose challenge test (non-fasting). If plasma glucose ≥ 130–140 mg/dL at 1 hour, you move to step 2.
Step 2: 100-gram oral glucose tolerance test (fasting). You “fail” if 2 or more of these thresholds are exceeded:
2. The One-Step Approach (WHO and some U.S. providers):
75-gram oral glucose tolerance test (fasting). GDM is diagnosed if any of these values are exceeded:
Does Gestational Diabetes Go Away?
Often, yes—blood sugars typically normalize after delivery. But here’s the kicker:
Up to 60% of women with gestational diabetes develop type 2 diabetes within 10 years if no lifestyle changes are made.
That’s why postpartum follow-up is so important. Women should continue to monitor their blood glucose for several months after the baby is born and receive a 75-gram 2-hour OGTT 4–12 weeks postpartum, and at least every 1–3 years thereafter.
What Are the Risks?
For baby:
High birth weight (macrosomia)
Low blood sugar at birth
Increased risk of childhood obesity and type 2 diabetes
For mom:
Increased cesarean risk
Hypertension/preeclampsia
Future diabetes and cardiovascular disease
Final Thoughts
Gestational diabetes doesn’t mean you’ve failed. It means your body is calling for support. Nutrition, movement, and stress management are powerful tools that can dramatically improve outcomes. And the beautiful truth? What helps manage blood sugar during pregnancy also protects your heart, brain, and future self.
Look for 7 Practical Tips to Keep Glucose Numbers in Check — Naturally.
References:
ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol. 2018 Feb;131(2):e49-e64. doi: 10.1097/AOG.0000000000002501.
Lende M, Rijhsinghani A. Gestational Diabetes: Overview with Emphasis on Medical Management. Int J Environ Res Public Health. 2020 Dec 21;17(24):9573. doi: 10.3390/ijerph17249573.
Alejandro EU, Mamerto TP, Chung G, Villavieja A, Gaus NL, Morgan E, Pineda-Cortel MRB. Gestational Diabetes Mellitus: A Harbinger of the Vicious Cycle of Diabetes. Int J Mol Sci. 2020 Jul 15;21(14):5003. doi: 10.3390/ijms21145003
Wei X, Zou H, Zhang T, Huo Y, Yang J, Wang Z, Li Y, Zhao J. Gestational Diabetes Mellitus: What Can Medical Nutrition Therapy Do? Nutrients. 2024 Apr 19;16(8):1217. doi: 10.3390/nu16081217.