What to know about gestational diabetes and high risk pregnancy

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Doctors consider gestational diabetes a high risk pregnancy, so people with the condition will require close observation. With suitable blood sugar management, most people go on to have healthy pregnancies and infants.

However, people with gestational diabetes have an elevated risk for adverse childbirth and postnatal outcomes.

According to the Centers for Disease Control and Prevention (CDC), it may increase the risk of having a large baby and requiring a cesarean delivery to help minimize risks to the pregnant person and infant.

The CDC suggests that to reduce risks, it is important that a person has tests for gestational diabetes. It can be challenging as it does not always cause symptoms, but doctors can assess people’s medical history and possible risk factors.

Older research shows that people with gestational diabetes have an increased risk of developing:

• high blood pressure
• preeclampsia, a sudden, dangerous increase in blood pressure
• pregnancy loss
• early or preterm labor and delivery

According to the CDC, if a person has gestational diabetes, as well as a high birth weight, the infant has an increased risk of:

• premature birth, which can cause breathing difficulties and other issues
• low blood sugar levels
• type 2 diabetes later in life

Blood sugar usually returns to typical levels after the infant is born. However, about 50% of people with gestational diabetes go on to develop type 2 diabetes.

Doctors will test a person’s blood sugar levels 6–12 weeks after giving birth and every 1–3 years to ensure levels remain stable. They may also recommend people reach a moderate weight, if applicable, to help prevent any further complications.

Learn more about blood sugar goals with gestational diabetes.

According to the American College of Obstetricians and Gynecologists (ACOG), people with well-managed gestational diabetes can have full-term pregnancies from 37 weeks. Learn more about pregnancy trimesters.

Most people with gestational diabetes have no pregnancy complications if they are able to follow their treatment plans to manage their blood sugar levels. If blood sugar is within typical levels, they can wait for labor to start naturally.

However, doctors may induce labor if there are concerns about the pregnant person or the infant’s health. If they suspect any of the complications described above, there is a higher risk of doctors having to perform an emergency cesarean.

The National Institute of Child Health and Human Development suggests earlier delivery may be from 34 weeks if a person has not been able to manage their blood sugar levels.

Learn more about the average week of delivery with gestational diabetes.

To help diagnose and manage gestational diabetes, doctors will screen for the condition using an oral glucose challenge test to assess a person’s blood sugar levels.

If they are high, they will order an oral glucose tolerance test to provide an accurate diagnosis. Both test results require high blood sugar readings to classify as gestational diabetes.

Testing usually takes place between 24 and 28 weeks. However, if a person is at higher risk for gestational diabetes, doctors may test earlier. This helps individuals better manage their condition and improve pregnancy outcomes.

Find out more about screening for gestational diabetes.

Treating gestational diabetes

There are several ways a pregnant person can treat gestational diabetes. A healthcare professional will provide them with support on how to manage their condition.

According to the United Kingdom’s National Health Service (NHS), a treatment plan usually includes:

Nutritional guidance

Certain dietary changes will aim to manage blood sugar levels. People can seek support from a doctor or dietitian. They may recommend:

• having three meals a day
• choosing foods with a low glycemic index, such as:
  • whole wheat foods
  • brown rice
  • pulses and beans
• eating fruits and vegetables
• eating sources of protein
• limiting sugary foods and drinks

Learn more about the best diet for gestational diabetes.

Exercise

Regular physical activity helps lower blood sugar levels. The NHS recommends people aim for at least 150 minutes of moderate-intensity exercise a week.

Read more about the benefits of exercise for gestational diabetes.

Medication

If diet and exercise are not effective, some people may require medication, such as metformin, to help stabilize blood sugar levels. Others may require insulin injections.

Monitoring

A medical professional will closely monitor blood sugar levels and also request a person check them at home.

Doctors recommend attending all prenatal appointments to monitor the growth and development of the fetus and the pregnant person’s health.

Possible questions to ask a doctor include:

• Am I at risk for gestational diabetes?
• What can I do to lower my risk?
• How could gestational diabetes affect my baby’s health?
• How could gestational diabetes affect my health?
• If I have gestational diabetes, what happens next?

Additional questions may also include:

• How do I test myself for gestational diabetes?
• Will I have diabetes after pregnancy?
• Will my baby have diabetes?
• What symptoms will I experience with gestational diabetes?
• Does insulin have any side effects?

Doctors may classify some people with gestational diabetes as high risk pregnancies. This is because they have a higher risk of high blood pressure or premature labor if their blood sugar levels do not remain stable during pregnancy.

Gestational diabetes may also affect the health of the fetus, as they may have a large birth weight or have low blood sugar levels when they are born.

However, most people have full-term pregnancies if they manage their condition and follow medical advice.

To help reduce risks and improve pregnancy outcomes, people can regularly monitor their blood sugar levels, follow a specific eating plan, and take moderate-intensity exercise. Some individuals may also require insulin to help manage blood sugar levels.