People who have gestational diabetes in their first pregnancy are more likely to have it in other pregnancies. This is recurrent gestational diabetes. Some people may also have more severe outcomes during subsequent pregnancies.

Gestational diabetes is a type of diabetes that some people develop during pregnancy. It usually disappears after a person gives birth. Doctors typically diagnose gestational diabetes in weeks 24–28 of pregnancy.

This condition happens when the body cannot make enough insulin to meet the extra needs of pregnancy. Insulin is a hormone that helps manage a person’s blood sugar, or blood glucose, levels. When insulin does not regulate blood sugar and blood sugar becomes too high, it can cause many complications for a person and their baby.

This article discusses gestational diabetes and why it may be worse in a person’s second pregnancy. It examines how gestational diabetes in the second pregnancy differs from the condition in the first pregnancy, the potential symptoms and causes, and how to treat and prevent it.

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In most people who develop gestational diabetes, the condition goes away soon after they give birth. However, if it does not go away, doctors call it type 2 diabetes. Half of people who experience gestational diabetes may develop type 2 diabetes.

When people have had gestational diabetes in their first pregnancy, they have an increased risk of developing it in subsequent pregnancies. The likelihood that gestational diabetes will recur is high, with around 50% of women experiencing it in their first and second pregnancies.

The symptoms of gestational diabetes and recurrent gestational diabetes are similar. However, a 2022 study found that women who had gestational diabetes more than once had an increased risk of negative outcomes.

For example, the study found that, compared with women with gestational diabetes, those with recurrent gestational diabetes had:

Experts suggest that the increased chance of developing gestational diabetes and the resulting negative outcomes may arise from increased weight gain between pregnancies and patterns of weight gain and loss across pregnancies.

Learn more about gestational diabetes.

Researchers have compared gestational diabetes in people who are experiencing it for the first time and in those who have developed it across multiple pregnancies. Although it is essentially the same condition, a few differences exist among people who experience it more than once.

Some factors increase a person’s risk of developing gestational diabetes. These risk factors may include:

According to studies from 2021 and 2022, additional risk factors for recurrent gestational diabetes may include:

  • gestational diabetes during a previous pregnancy
  • previous delivery of a baby weighing more than 9 pounds
  • a higher fasting blood sugar level
  • high maternal birthweight
  • weight gain between pregnancies

A 2016 study also suggests that the time between pregnancies, known as interpregnancy interval, may play a role in recurrent gestational diabetes. The researchers found that women with less time between pregnancies had a higher risk of a subsequent gestational diabetes diagnosis.

Gestational diabetes does not typically cause symptoms. Some people may experience mild symptoms such as increased thirst or more frequent urination.

Doctors usually conduct a blood test to check for gestational diabetes during weeks 24–28 of pregnancy.

Learn more about symptoms of gestational diabetes.

Gestational diabetes happens when a person’s body cannot make enough insulin during pregnancy. Insulin is a hormone that the pancreas produces. It allows sugar to enter the cells in the body for energy and helps regulate blood sugar levels.

The changes people experience during pregnancy, such as increases in hormone production, cause their cells to use insulin less effectively. This is called insulin resistance.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, all people have some level of insulin resistance during late pregnancy. Most people can produce the insulin they need to overcome insulin resistance. However, when they cannot, they develop gestational diabetes.

Some people may have insulin resistance before pregnancy, and this increases their chances of gestational diabetes during pregnancy.

Many people with gestational diabetes manage their blood sugar levels by making changes to their diet and lifestyle. Some people may also need diabetes medication.

Doctors may advise the following strategies for managing gestational diabetes:

  • Check blood sugar levels regularly to ensure they are within a healthy range.
  • Follow a healthy diet and eat the right foods at the most suitable times.
  • Participate in regular physical activity to help reach target blood sugar levels.
  • Go to all follow-up appointments to monitor the baby’s growth and development.

A doctor may prescribe insulin, metformin, or other medications if dietary and lifestyle strategies do not help manage blood sugar levels.

There is no sure way to prevent gestational diabetes. However, some risk factors for gestational diabetes are modifiable, such as those concerning weight and physical activity.

Exercising regularly and taking other steps to maintain a moderate weight can help lower a person’s risk of developing gestational diabetes during their first, second, and subsequent pregnancies.

A person who is already pregnant should not try to lose weight unless a doctor advises it. In that case, a doctor will work with the person to create a plan that best suits their needs.

Learn more about preventing gestational diabetes.

People who have previously had gestational diabetes during pregnancy are more likely to develop it during second or subsequent pregnancies. They are also more likely to develop type 2 diabetes in the future.

Many people do not know they have gestational diabetes because the condition has few symptoms. While these symptoms do not differ between pregnancies, people who have gestational diabetes multiple times tend to have worse outcomes than those who have it once.

There are several risk factors for gestational diabetes and some additional ones for recurrent gestational diabetes. People can aim to lower their risk of developing gestational diabetes a second time by getting regular physical activity and taking other steps to manage their weight.

Most people can manage gestational diabetes with dietary and lifestyle strategies. However, some people may need to take diabetes medication to help regulate their blood sugar levels.