Gestational Diabetes

University of Iowa Health Care specialists help you manage gestational diabetes for a healthy pregnancy and a healthy baby.

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Gestational diabetes is a type of diabetes that you can get only while you're pregnant. About six out of every 100 pregnant people develop the condition.

It's important to be tested for gestational diabetes. If untreated, it can be harmful to you and your baby.

The risks include:

Polyhydramnios (too much amniotic fluid around the baby)
Preeclampsia (high blood pressure)
Macrosomia (large baby)
Need for a cesarean section delivery if the baby is too large and labor is too long
Hypoglycemia (low blood sugars) for the baby after delivery
Respiratory distress syndrome (breathing problems for the baby after delivery)
Fetal death. This is rare, but a baby may die before delivery for reasons that are not always known.

It can be upsetting to get this diagnosis, but gestational diabetes is manageable with the right help.

UI Health Care’s dedicated team has years of experience and specialized training in managing gestational diabetes.

We use high-tech tools that make it easy for you to monitor your blood sugar. And your team is just a phone call or video visit away if you have a question.

Our team of experts has helped hundreds of people with gestational diabetes have healthy pregnancies and healthy babies.

Gestational diabetes symptoms and diagnosis

Gestational diabetes means that your blood sugar, or blood glucose, is too high. This happens because of changes in your body during pregnancy.

An increase in hormones from the placenta elevates your blood glucose, which provides energy for your baby to grow. But in some people, blood glucose increases too much, and they develop gestational diabetes.

Anyone can develop gestational diabetes. Most people who have it don’t have symptoms, so everyone is screened.

Your pregnancy care provider will order a screening test in your third trimester, when gestational diabetes usually develops.

Risk factors for gestational diabetes

If you have risk factors for gestational diabetes, your provider may test you before your second trimester. You could be at risk if you:

Have prediabetes
Have obesity
Have a parent or sibling with Type 2 diabetes
Had gestational diabetes during a previous pregnancy
Have given birth to a baby who weighed more than nine pounds
Are of African-American, Hispanic/Latino, American Indian/Alaska Native, South Asian, or East Asian descent

Glucose tolerance testing

Gestational diabetes screening starts with a one-hour glucose tolerance test.

When you arrive for your screening appointment, you'll drink a sugary glucose solution.

After an hour, a technician will take a blood sample from your arm. This goes to the lab to measure your blood glucose level.

The clinic will call you with the results the next business day.

If you need further testing

If your blood glucose is high after the one-hour test, you'll come back for a definitive glucose tolerance test.

This test requires you to fast for eight hours. You’ll have a fasting lab drawn, and then the lab will give you the glucose drink. Your blood will be tested at one, two, and three hours after you drink the solution.

If two or more results are higher than normal, you’ll be diagnosed with gestational diabetes.

Gestational diabetes treatment from UI Health Care

Your care team includes:

Our dietician
Your obstetrician, midwife, or a specialized high-risk obstetrics physician
Our team of nurses dedicated to caring for people with gestational diabetes

They'll work with you on a plan for having a healthy pregnancy and a healthy baby.

Diet, exercise, and blood sugar monitoring will be part of your plan. You may also have more frequent prenatal visits to check your baby's growth and talk about how you're doing.

We’ll stay in close communication with you. And you can always reach a member of your care team quickly if you have questions.

Lifestyle changes

Most people can control gestational diabetes with diet and exercise.

Meal planning: Choosing the right foods will help keep your blood sugar within a safe range. Our dietician will teach you how to follow a healthy eating plan.
Exercise: Exercise can lower your blood sugar by making your body use glucose for energy. Your team will encourage you to be active and to walk after meals and before bed.

Checking your blood sugar

Having gestational diabetes used to mean tracking your blood sugar and calling us with weekly reports.

Today, we use technology to make the process much simpler for you.

Your nurse will give you a wireless glucose meter and show you how to use it.

You'll check your blood sugar four times a day. The meter will automatically send the reading to your care team. They’ll monitor the results and contact you if needed.

If you need insulin

If diet and exercise don't work to regulate your blood sugar, you may need to go on insulin.

You'll take insulin as an injection with a syringe or an insulin pen.

These are safe to use during pregnancy. Insulin doesn't cross the placenta, so it doesn't affect your baby.

Some providers prescribe oral medications. But because studies aren't clear about these medications' effects during pregnancy, our team doesn't prescribe them.

Ultrasound monitoring

Gestational diabetes can cause babies to grow larger than normal.

Risks of high birth weight include injury to you or the baby during birth, and health problems for the baby.

Babies born at a higher weight than average are at risk for:

Breathing problems
Childhood obesity
Low blood sugar (hypoglycemia)
You'll have extra ultrasound appointments during your pregnancy so your team can keep a close eye on your baby's growth.

The frequency of your ultrasounds will depend on how well your blood sugar is controlled.

Diabetes after delivery

For most people, gestational diabetes goes away soon after delivery.

However, having gestational diabetes gives you a 50% chance of developing Type 2 diabetes in the next five to 10 years.

At your six-week postpartum visit, you'll have a two-hour glucose tolerance test. This will show whether your gestational diabetes has resolved on its own.

Even if that test shows the diabetes has resolved, you should get tested for diabetes every one to three years.

Specialized care for people with diabetes who become pregnant

If you've already been diagnosed with diabetes, we can help you manage your condition during pregnancy.

If you have Type 1 diabetes, you'll likely need to use more insulin during pregnancy.
If you have Type 2 diabetes that you treat with oral medication, your provider may have you stop taking the medication and use insulin instead.