What is Gestational Diabetes?

This series of articles will answer all your questions about the symptoms and treatments for gestational diabetes.

What is diabetes mellitus (DM)?

Regular diabetes is caused by either:

  1. The pancreas not producing enough insulin (Type 1 diabetes)
  2. The body not responding to the insulin (Type 2 diabetes)

Without enough good, working insulin in your body, you end up with too much glucose in the blood and not enough in your cells. Insulin helps the cells take in glucose produced from the foods you eat, which, in turn, supplies the energy for your body.

What is gestational diabetes (GDM)?

Gestational diabetes happens only during pregnancy, usually around the 24th week. It somewhat is like Type 2 diabetes when your pancreas makes insulin, but the insulin doesn’t work as it should.

This is because during this time in your pregnancy, your placenta begins making large amounts of hormones. Some of these hormones may stop the insulin from helping the cells absorb glucose from the blood.

At the same time, your pancreas can’t keep up with the extra demand for insulin. Without enough good, working insulin in your body, you end up with too much glucose in the blood and not enough in your cells. If your cells can’t get enough glucose, your body won’t have enough energy to work and play. Also, the extra glucose in your blood can be dangerous. This condition, called hyperglycemia, is how diabetes is diagnosed.

Warning Signs & Symptoms of Gestational Diabetes

  • Glycosuria (sugar spills into urine)
  • Ketonuria (ketones spill into urine)
  • Hyperglycemia (Severe cases called: Diabetic Ketoacidosis or DKA)
  • Hypoglycemia (Severe cases called: Diabetic Shock)

Definition: Hyperglycemia

Hyperglycemia is when the levels of sugar in your blood are too high. The normal range for blood sugar is between 71-100. A fasting blood sugar of 100-125 is considered pre-diabetes.

Signs and symptoms of high blood sugar
  • Fruity odor in breath
  • Unquenchable thirst, dry mouth
  • Frequent urination
  • Nausea
  • Vomiting
  • Stomach pain
  • Shortness of breath
How to prevent high blood sugar
  • Eat small frequent, healthy meals
  • Monitor your blood sugar regularly
  • Keep track of carbohydrate intake and follow physicians recommendations
  • Take required medications (and/or insulin) as directed

Definition: Hypoglycemia

Hypoglycemia is when the levels of sugar in your blood are too low. Blood sugar level of 70 or less is very low and should be treated, a blood sugar level of 54 or less is extremely low and needs immediate attention. Hypoglycemia is not uncommon in women with gestational diabetes because they are trying to lower their blood sugar level and may let it slip too low. See the “Staying In Balance” section for symptoms of hypoglycemia and how to treat it.

Signs and symptoms of low blood sugar
  • Sweating
  • Shakiness, nervousness, panicky, anxiety
  • Dizziness, confusion
  • Hunger
  • Fatigue and weakness
  • Difficulty speaking
How to prevent low blood sugar
  • Eat small frequent meals
  • Monitor your blood sugar regularly
  • Keep snacks and drinks with you–especially if you plan to do a lot of walking or other activities

Definition: Glycosuria

As more and more sugar builds up in your blood, it spills over into your urine–this is called glycosuria. Sugar in your urine is another sign of diabetes. Too much sugar in your urine pulls water from your body, causing you to feel thirsty. Even though you drink plenty of water, you still feel thirsty. Drinking a lot of water also causes you to go to the bathroom often. Feeling thirsty all of the time and going to the bathroom a lot are both signs of diabetes. Other signs include blurry vision and feeling tired.

Definition: Ketosis or Ketonuria

Ketosis is a dangerous side effect of diabetes–When your body doesn’t have enough glucose for energy, it uses fat instead. Using fat for energy produces ketones, which are acids. Ketones can also build up in your body and spill into your urine, this is called ketonuria. Ketones can act like a poison in your body and make you very sick. They can make you throw up, feel very sleepy, or feel like you can’t breathe. Part of managing your diabetes will be to check your urine for ketones.

Frequently Asked Questions: Gestational Diabetes & Pregnancy

If diabetes is managed well, most problems can be prevented. Gestational diabetes usually lasts only until the end of your pregnancy. During this short time, you can reduce your risks of having any of the problems listed below by carefully following the advice of your doctor and diabetes specialists.

What are the risks to me and my baby of having gestational diabetes?

For Mothers

  • Risk of developing Type 2 Diabetes after pregnancy is increased.
  • Risk of hypoglycemic or hyperglycemic incidence.
  • Risk of unhealthy weight gain or weight loss.
  • Risk of cesarean section delivery.
  • Risk of preeclampsia.
  • Risk of hypertension (high blood pressure) during pregnancy.

For Baby

  • Risk of high birth weight.
  • Risk of difficulty controlling blood sugars in the first few days after birth (low blood sugar levels).
  • Risk of premature birth.
  • Risk of respiratory distress syndrome.
  • Risk of developing Type 2 Diabetes later in life.

Does GDM make me more at risk of developing preeclampsia?

  • Yes, according to research done in Diabetologia women have a 70% increased risk of developing preeclampsia/eclampsia when they have gestational diabetes.

Who is at risk for developing gestational diabetes?

  • Women who have had gestational diabetes in a prior pregnancy are more likely to have it again in another pregnancy.
  • Women who struggle with high blood pressure may have an increased risk of gestational diabetes.
  • Women who have had pre-diabetes before pregnancy may have an increased risk of developing gestational diabetes.

How is GDM diagnosed?

  • During your prenatal visits your physician or midwife will screen you for gestational diabetes using the glucose tolerance test and/or glucose challenge test. They may routinely check your blood sugar levels and your urine (for the presence of ketones and glucose). Depending on the results of these tests you may be diagnosed with Gestational Diabetes Mellitus, or GDM.

How is GDM treated or managed?

  • Most often GDM can be controlled by diet modifications alone. Watching carbohydrate (carb) intake and monitoring blood sugar is the most effective way to begin controlling and modifying your diet.
  • In some cases medications or insulin may be prescribed by your care provider. Speak to your doctor, midwife or diabetes specialist to understand your plan as these are individualized plans.
  • Gestational Diabetes usually goes away on its own within a few weeks after delivery of the infant.

Diet tips for mothers with Gestational Diabetes:

  • Eat small frequent meals
  • Eat meals that are low in carbohydrates but higher in fiber or healthy fats
  • Try to learn your body’s response to different foods early on and make a dietary plan for yourself to follow
  • Keep a food log together with a blood sugar log
  • Drink lots of water and get some exercise throughout the day
  • Educate yourself on healthy nutrition and implement changes

How many carbs can someone with GDM consumer per day?

  • The amount of carbs you can consume if you have Gestational Diabetes will depend on your body’s ability to control blood sugar levels after eating.
  • Generally 15-20 grams of carbohydrates per snack and 45-60 grams of carbohydrates per meal would be a good target to aim for, but it is important to monitor your blood sugar according to your care provider’s recommendations and adjust your diet as needed.


Mom with newborn covered with vernix
Mom with newborn covered with vernix

Three-quarters of women with gestational diabetes can manage it through diet alone.

More about Gestational Diabetes

What is Gestational Diabetes?
How Do I Know If I Have Gestational Diabetes?
Will My Baby Be Alright?
Managing Your Diabetes
Tests To Check Your Baby’s Health
Labor and Delivery
Can I Get Diabetes Again?

Side view of pregnant woman
Hormones during pregnancy block insulin from absorbing glucose (sugar) in your cells. This results in too much sugar in your blood.

Pregnancy and Childbirth