Gestational Diabetes: Screening, Prevention, and Management

Gestational diabetes (GDM) is a common condition that affects how your cells use sugar during pregnancy. This guide explains the screening process, how to manage your blood sugar, and what it means for you and your baby.

second-trimester 10 min read
Pregnant woman checking blood sugar levels as part of gestational diabetes care

TL;DR

Gestational diabetes (GDM) is a type of diabetes that develops during pregnancy, typically diagnosed through a glucose screening test between 24 and 28 weeks. Most women can manage the condition through a balanced diet and regular exercise, ensuring a healthy pregnancy and delivery. While it usually resolves after birth, it requires careful monitoring to protect both mother and baby.

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Important

Contact your doctor immediately if you experience extreme thirst, frequent urination beyond the usual pregnancy norm, blurred vision, or unusual fatigue, as these can be signs of high blood sugar.

In This Article

What Exactly is Gestational Diabetes?

Gestational diabetes (GDM) is high blood sugar (glucose) that develops during pregnancy in women who did not have diabetes before they were pregnant.

During pregnancy, your placenta produces hormones that help your baby grow. These hormones can also make your body's cells more resistant to insulin—the hormone that regulates blood sugar. Usually, your pancreas makes extra insulin to compensate, but if it can't keep up, your blood sugar levels rise, leading to gestational diabetes. Viva Eve's providers want you to know that a GDM diagnosis is not your fault. It is a biological response to the hormonal shifts of pregnancy. It affects approximately 6% to 9% of pregnant women. The good news is that with proper screening and management, the vast majority of women with GDM have healthy pregnancies and give birth to healthy babies. Our team, including our in-house Registered Dietitian, Tamsin Jordan, works closely with you to create a manageable plan that fits your life.

How Does the Glucose Screening Test Work?

The glucose screening test is a standard prenatal test performed between 24 and 28 weeks that involves drinking a sugary solution and having your blood drawn one hour later.

The screening process usually happens in two steps. First is the Glucose Challenge Test. You'll drink a sweet liquid (Glucola) and wait one hour before we draw your blood. If your results are higher than the standard threshold, it doesn't necessarily mean you have GDM—it just means you need the follow-up 'three-hour' test. The Glucose Tolerance Test (GTT) is the diagnostic step. For this one, you'll need to fast overnight. We draw your blood, then you drink a more concentrated sugary solution, and we draw your blood again at one, two, and three hours. If two or more of those readings are high, a diagnosis of gestational diabetes is confirmed. While drinking the solution isn't everyone's favorite part of pregnancy, it is a vital tool for ensuring we can provide the right care for you and your baby.
Gestational diabetes can happen in any pregnancy, and having certain risk factors doesn’t mean you will develop it. Some factors—such as age, family history, or conditions like PCOS—may simply prompt us to take a closer look. If any of these apply to you, we may recommend earlier screening so we can monitor things proactively and support a healthy pregnancy from the start.

How Do I Manage Gestational Diabetes with Diet?

Managing GDM primarily involves balancing your intake of carbohydrates, proteins, and healthy fats to prevent spikes in your blood sugar levels.

The goal isn't to cut out carbohydrates entirely—your baby needs them for energy. Instead, we focus on 'complex' carbohydrates that digest slowly, such as whole grains, legumes, and non-starchy vegetables. This is often called a low-glycemic index diet. Pairing your carbs with protein (like eggs, chicken, or tofu) and healthy fats (like avocado or nuts) further stabilizes your blood sugar. Consistency is key. Instead of three large meals, we often recommend three moderate meals and two to three snacks spaced throughout the day. This prevents your blood sugar from dropping too low or spiking too high. Our dietitian can help you translate these clinical guidelines into a meal plan that includes foods you actually enjoy, making the management process feel less like a 'diet' and more like a sustainable health shift.

What are the Risks if GDM is Not Managed?

Unmanaged gestational diabetes can lead to excessive fetal growth (macrosomia), which increases the risk of birth injuries and C-section delivery, as well as low blood sugar for the baby after birth.

When your blood sugar is high, that extra glucose passes through the placenta to your baby. The baby's pancreas then produces extra insulin to handle the sugar, and that extra energy is stored as fat. This can lead to a baby that is much larger than average, which can make a vaginal delivery more difficult and increase the likelihood of needing a C-section. After birth, because the baby is no longer receiving your high sugar levels but still has high insulin levels, their blood sugar can drop dangerously low (hypoglycemia). Monitoring and managing your sugar levels during the second and third trimesters significantly reduces these risks. At Viva Eve, we use regular ultrasounds to monitor your baby's growth and ensure we are making the best decisions for your delivery plan.

When is Medication or Insulin Necessary?

If diet and exercise are not enough to keep your blood sugar levels within the target range, your doctor may prescribe oral medication or insulin injections to protect your pregnancy.

About 10% to 20% of women with GDM will need medication. If this happens to you, please don't feel like you have 'failed.' Some women's bodies simply require more help to overcome the insulin resistance caused by the placenta. Insulin is considered the 'gold standard' for treatment because it does not cross the placenta, meaning it effectively manages your sugar without affecting the baby directly. You will likely be asked to monitor your blood sugar at home using a small device called a glucose meter. You'll prick your finger four times a day—once in the morning (fasting) and one or two hours after each main meal. Tracking these numbers allows us to adjust your plan in real-time and provides peace of mind that your management strategy is working.

Navigating the Emotional Impact of a GDM Diagnosis

Receiving a gestational diabetes diagnosis can cause feelings of guilt, anxiety, or overwhelm. It is important to remember that this is a manageable medical condition, not a personal failure.

We often see patients who feel like they've done something 'wrong' to cause their diabetes. We want to be clear: you did not eat your way into GDM. This is a condition driven by placental hormones. The stress of tracking every meal and pricking your finger can be exhausting, and it's okay to feel frustrated by the extra steps added to your pregnancy journey. We understand that managing GDM involves more than numbers alone. We’re here to support you throughout the process, offering clear guidance and practical tools to help management feel more manageable over time. We recognize the effort you’re putting in and celebrate progress along the way. It’s also important to remember that GDM is temporary—blood sugar levels often return to normal after delivery. We’ll continue to support you postpartum with follow‑up testing and care to help protect your long‑term health.
Common Questions

Frequently Asked Questions

For most women, GDM goes away after the baby is born. However, having GDM does increase your risk of developing type 2 diabetes later in life. We recommend a follow-up glucose test six to 12 weeks after delivery and regular screenings every few years to monitor your long-term health.

Yes, many women with well-managed GDM have successful vaginal deliveries. If your blood sugar is controlled and the baby is a healthy size, we support your birth preferences. If the baby is very large or if there are other complications, we may discuss an induction or a C-section for safety.

Target ranges typically include a fasting blood sugar of 95 mg/dL or less, and a one-hour post-meal reading of 140 mg/dL or less (or 120 mg/dL or less after two hours). Your Viva Eve provider will give you a specific log and target numbers tailored to your needs.

Exercise is actually one of the best ways to manage GDM! Physical activity helps your cells use insulin more effectively. We recommend a 10-15 minute walk after meals to help lower your post-meal blood sugar spikes. Just check with us before starting any new, intense routine.

No, your baby will not be born with diabetes. However, they may be at a higher risk for obesity and type 2 diabetes later in their own life. Feeding your baby breast milk and encouraging a healthy lifestyle as they grow can help mitigate these risks.

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