Gestational Diabetes: What Is It and How Is It Managed?

Gestational diabetes is one of the most common pregnancy complications in the UK, affecting around 1 in 20 pregnancies. Despite how common it is, a diagnosis can still come as a shock. The good news is that with the right management, most women with gestational diabetes go on to have a healthy pregnancy and a healthy baby. Here is everything you need to know.

What Is Gestational Diabetes?

Gestational diabetes is a type of diabetes that develops during pregnancy in women who did not have diabetes before. It occurs when the body cannot produce enough insulin to meet the extra demands of pregnancy, causing blood glucose levels to rise higher than normal. It typically develops in the second or third trimester and usually resolves after the baby is born.

What Causes Gestational Diabetes?

During pregnancy, the placenta produces hormones that can make the body’s cells less responsive to insulin — a process known as insulin resistance. Most women’s bodies compensate by producing extra insulin, but in some women the pancreas cannot keep up with the increased demand. The result is raised blood glucose levels, which is gestational diabetes.

Who Is at Higher Risk?

While gestational diabetes can affect any pregnant woman, certain factors increase the risk:

• A BMI of 30 or above

• A previous baby weighing 4.5kg (10lb) or more at birth

• Gestational diabetes in a previous pregnancy

• A parent, brother, or sister with diabetes

• Family origins in South Asia, East Asia, Middle East, or Africa

What Are the Symptoms?

Gestational diabetes often has no obvious symptoms, which is why screening is so important. Some women may notice increased thirst, needing to urinate more frequently than usual, a dry mouth, or tiredness — but these can all be normal pregnancy symptoms too. This is why the glucose tolerance test is the only reliable way to diagnose it.

How Is Gestational Diabetes Diagnosed?

In the UK, women at higher risk are offered an oral glucose tolerance test (OGTT) between 24 and 28 weeks of pregnancy. The test involves fasting overnight, having a blood test, drinking a glucose drink, and then having another blood test two hours later. If your blood glucose levels are above the threshold at either point, gestational diabetes is diagnosed.

How Is Gestational Diabetes Managed?

The aim of treatment is to keep blood glucose levels within a safe range throughout the remainder of your pregnancy. Management typically involves:

• Diet changes — reducing sugary and refined carbohydrate foods, eating regular balanced meals, and spreading carbohydrates throughout the day. A specialist dietitian will provide personalised guidance

• Regular blood glucose monitoring — testing your blood sugar levels at home several times a day using a finger-prick test and glucose monitor

• Physical activity — gentle, regular exercise such as walking helps the body use insulin more effectively and can significantly improve blood glucose control

• Medication — if diet and exercise alone are not sufficient, metformin tablets or insulin injections may be prescribed by your diabetes care team

What Does Gestational Diabetes Mean for My Baby?

When gestational diabetes is well controlled, most babies are born healthy. However, uncontrolled high blood glucose can cause the baby to grow larger than usual (a condition called macrosomia), which can increase the risk of complications during labour and delivery. Babies born to mothers with gestational diabetes may also have low blood glucose levels at birth and are monitored closely after delivery. Well-managed gestational diabetes significantly reduces these risks.

Does Gestational Diabetes Go Away After Birth?

In most cases, yes. Blood glucose levels usually return to normal shortly after delivery. However, women who have had gestational diabetes have a higher risk of developing type 2 diabetes later in life — around a 50% lifetime risk according to Diabetes UK. You will be offered a follow-up blood test at your six-week postnatal check and advised on lifestyle measures to reduce your long-term risk.

Extra Monitoring During Pregnancy

Women with gestational diabetes are offered additional NHS growth scans to monitor their baby’s size and wellbeing. Many also choose to supplement this with private wellbeing scans for extra reassurance between appointments. At MyBaby Ultrasound in Camberley, our wellbeing scans check your baby’s growth, movements, amniotic fluid levels, and heartbeat — giving you detailed, personalised reassurance whenever you need it. Wellbeing scans start from just £70, with no referral required.