U.S. Department 

of Health and 

Human Services 

What I need to know about
 

Gestational Diabetes Gestational Diabetes

NATIONAL INSTITUTES OF HEALTH 

National Diabetes Information Clearinghouse 

What I need to know about 

Gestational Diabetes 

NATIONAL INSTITUTES OF HEALTH 

National Diabetes Information Clearinghouse 
Contents
 

What is gestational diabetes?.................................. 1 

What causes gestational diabetes?.......................... 2 

What is my risk of gestational diabetes? ................ 2 

When will I be checked for gestational 

diabetes?.................................................................... 3
 

How is gestational diabetes diagnosed?................. 4
 

How will gestational diabetes affect my baby? ...... 7
 

How will gestational diabetes affect me?............... 8
 

How is gestational diabetes treated?...................... 9
 

How will I know whether my blood glucose 


levels are on target? ............................................... 12
 

Will I need to do other tests on my own?............. 14
 

After I have my baby, how can I find out 


whether my diabetes is gone?................................ 15
 

How can I prevent or delay getting type 2 


diabetes later in life?.............................................. 16
 

Where can I get more information? ..................... 17
 

Acknowledgments .................................................. 18
 
What is gestational diabetes? 

Gestational (jes-TAY-shun-ul) diabetes is diabetes 

that is found for the first time when a woman is 

pregnant. Out of every 100 pregnant women in 

the United States, three to eight get gestational 

diabetes. Diabetes means that your blood glucose 

(also called blood sugar) is too high. Your body 

uses glucose for energy. But too much glucose 

in your blood can be harmful. When you are 

pregnant, too much glucose is not good for 

your baby. 

This booklet is for women with gestational diabetes. 

If you have type 1 or type 2 diabetes and are 

considering pregnancy, call the National Diabetes 

Information Clearinghouse at 1–800–860–8747 

for more information and consult your health 

care team before you get pregnant. 

Gestational diabetes is diabetes that is found 

for the first time when a woman is pregnant. 

1 
What causes gestational diabetes? 

Changing hormones and weight gain are part of 

a healthy pregnancy. But both changes make it 

hard for your body to keep up with its need for a 

hormone called insulin. When that happens, your 

body doesn’t get the energy it needs from the food 

you eat. 

What is my risk of gestational
 

diabetes?
 

To learn your risk for gestational diabetes, check
 

each item that applies to you. Talk with your doctor
 

about your risk at your first prenatal visit.
 

❑ I have a parent, brother, or sister with diabetes.
 

❑	 I am African American, American Indian, Asian 

American, Hispanic/Latino, or Pacific Islander. 

❑	 I am 25 years old or older. 

❑	 I am overweight. 

❑	 I have had gestational diabetes before, or I have 

given birth to at least one baby weighing more 

than 9 pounds. 

❑	 I have been told that I have “pre-diabetes,” 

a condition in which blood glucose levels are 

higher than normal, but not yet high enough 

for a diagnosis of diabetes. Other names for it 

are “impaired glucose tolerance” and “impaired 

fasting glucose.” 

2 
If you checked any of these risk factors, ask your 

health care team about testing for gestational 

diabetes. 

●	 You are at high risk if you are very overweight, 

have had gestational diabetes before, have a 

strong family history of diabetes, or have glucose 

in your urine. 

●	 You are at average risk if you checked one or 

more of the risk factors. 

●	 You are at low risk if you did not check any of 

the risk factors. 

When will I be checked for gestational 

diabetes? 

Your doctor will decide when you need to be 

checked for diabetes depending on your risk factors. 

●	 If you are at high risk, your blood glucose level 

may be checked at your first prenatal visit. If 

your test results are normal, you will be checked 

again sometime between weeks 24 and 28 of 

your pregnancy. 

●	 If you have an average risk for gestational 

diabetes, you will be tested sometime between 

weeks 24 and 28 of pregnancy. 

●	 If you are at low risk, your doctor may decide 

that you do not need to be checked. 

3 
How is gestational diabetes
 

diagnosed?
 

Your health care team will check your blood 

glucose level. Depending on your risk and your 

test results, you may have one or more of the 

following tests. 

Fasting blood glucose or random blood 

glucose test 

Your doctor may check your blood glucose level 

using a test called a fasting blood glucose test. 

Before this test, your doctor will ask you to fast, 

which means having nothing to eat or drink except 

water for at least 8 hours. Or your doctor may 

check your blood glucose at any time during the 

day. This is called a random blood glucose test. 

These tests can find gestational diabetes in some 

women, but other tests are needed to be sure 

diabetes is not missed. 

4 
Your health care provider will check your blood glucose 

level to see if you have gestational diabetes. 

Screening glucose challenge test 

For this test, you will drink a sugary beverage and 

have your blood glucose level checked an hour 

later. This test can be done at any time of the day. 

If the results are above normal, you may need 

further tests. 

5 
Oral glucose tolerance test 

If you have this test, your health care provider will 

give you special instructions to follow. For at least 

3 days before the test, you should eat normally. 

Then you will fast for at least 8 hours before the 

test. 

The health care team will check your blood glucose 

level before the test. Then you will drink a sugary 

beverage. The staff will check your blood glucose 

levels 1 hour, 2 hours, and 3 hours later. If your 

levels are above normal at least twice during the 

test, you have gestational diabetes. 

Above-normal results for the oral glucose 

tolerance test* 

Fasting 95 or higher 

At 1 hour 180 or higher 

At 2 hours 155 or higher 

At 3 hours 140 or higher 

Note: Some labs use other numbers for this test. 

* These numbers are for a test using a drink with 100 

grams of glucose. 

6 
How will gestational diabetes 

affect my baby? 

Untreated or uncontrolled gestational diabetes can 

mean problems for your baby, such as 

●	 being born very large and with extra fat; this can 

make delivery difficult and more dangerous for 

your baby 

●	 low blood glucose right after birth 

●	 breathing problems 

If you have gestational diabetes, your health care 

team may recommend some extra tests to check on 

your baby, such as 

●	 an ultrasound exam, to see how your baby is 

growing 

●	 “kick counts” to check your baby’s activity (the 

time between the baby’s movements) or special 

“stress” tests 

Working closely with your health care team will 

help you give birth to a healthy baby. 

Both you and your baby are at increased risk for 

type 2 diabetes for the rest of your lives. (See page 

16 for information on how to lower your child’s 

chances of getting type 2 diabetes.) 

7 
How will gestational diabetes
 

affect me?
 

Often, women with gestational diabetes have no 

symptoms. However, gestational diabetes may 

●	 increase your risk of high blood pressure during 

pregnancy 

●	 increase your risk of a large baby and the need 

for cesarean section at delivery 

The good news is your gestational diabetes 

will probably go away after your baby is born. 

However, you will be more likely to get type 2 

diabetes later in your life. (See page 16 for 

information on how to lower your chances of 

getting type 2 diabetes.) You may also get 

gestational diabetes again if you get pregnant 

again. 

Some women wonder whether breastfeeding 

is OK after they have had gestational diabetes. 

Breastfeeding is recommended for most babies, 

including those whose mothers had gestational 

diabetes. 

Gestational diabetes is serious, even if you have no 

symptoms. Taking care of yourself helps keep your 

baby healthy. 

8 
How is gestational diabetes treated? 

Treating gestational diabetes means taking steps to 

keep your blood glucose levels in a target range. 

You will learn how to control your blood glucose 

using 

● a meal plan 

● physical activity 

● insulin (if needed) 

Using a meal plan will help keep your blood glucose in 

your target range. 

9 
Meal Plan
 

You will talk with a dietitian or a diabetes educator 

who will design a meal plan to help you choose 

foods that are healthy for you and your baby. 

Using a meal plan will help keep your blood 

glucose in your target range. The plan will provide 

guidelines on which foods to eat, how much to eat, 

and when to eat. Choices, amounts, and timing are 

all important in keeping your blood glucose levels 

in your target range. 

You may be advised to 

●	 limit sweets 

●	 eat three small meals and one to three snacks 

every day 

●	 be careful about when and how much 

carbohydrate-rich food you eat; your meal 

plan will tell you when to eat carbohydrates 

and how much to eat at each meal and snack 

●	 include fiber in your meals in the form of fruits, 

vegetables, and whole-grain crackers, cereals, 

and bread 

For more about meal planning, call the National 

Diabetes Information Clearinghouse for a copy of 

What I need to know about Eating and Diabetes or 

you can read it online at www.diabetes.niddk.nih. 

gov/dm/pubs/eating_ez/index.htm. 

10 
Physical Activity 

Physical activity, such as walking and swimming, 

can help you reach your blood glucose targets. 

Talk with your health care team about the type of 

activity that is best for you. If you are already 

active, tell your health care team what you do. 

Physical activity can help you reach your blood glucose 

targets. 

11 
Insulin 

Some women with gestational diabetes need 

insulin, in addition to a meal plan and physical 

activity, to reach their blood glucose targets. If 

necessary, your health care team will show you 

how to give yourself insulin. Insulin is not harmful 

for your baby. It cannot move from your 

bloodstream to the baby’s. 

How will I know whether my blood 

glucose levels are on target? 

Your health care team may ask you to use a small 

device called a blood glucose meter to check your 

levels on your own. You will learn 

●	 how to use the meter 

●	 how to prick your finger to obtain a drop 

of blood 

●	 what your target range is 

●	 when to check your blood glucose 

You may be asked to check your blood glucose 

●	 when you wake up 

●	 just before meals 

●	 1 or 2 hours after breakfast 

●	 1 or 2 hours after lunch 

●	 1 or 2 hours after dinner 

12
 
The following chart shows blood glucose targets for 

most women with gestational diabetes. Talk with 

your health care team about whether these targets 

are right for you. 

Blood glucose targets for most women with
 

gestational diabetes 

On awakening not above 95 

1 hour after a meal not above 140 

2 hours after a meal not above 120 

Each time you check your blood glucose, write 

down the results in a record book. Take the book 

with you when you 

visit your health care 

team. If your results 

are often out of 

range, your health 

care team will 

suggest ways you 

can reach your 

targets. 

Each time you check your blood 

glucose, write down the results. 

13 
Will I need to do other tests on
 

my own?
 

Your health care team may teach you how to test 

for ketones (KEE-tones) in your morning urine 

or in your blood. High levels of ketones are a sign 

that your body is using your body fat for energy 

instead of the food you eat. Using fat for energy 

is not recommended during pregnancy. Ketones 

may be harmful for your baby. 

If your ketone levels are high, your health care 

providers may suggest that you change the type 

or amount of food you eat. Or you may need to 

change your meal times or snack times. 

14
 
After I have my baby, how can I find 

out whether my diabetes is gone? 

You will probably have a blood glucose test 6 to 12 

weeks after your baby is born to see whether you 

still have diabetes. For most women, gestational 

diabetes goes away after pregnancy. You are, 

however, at risk of having gestational diabetes 

during future pregnancies or getting type 2 

diabetes later. 

After you have your baby, you can do a lot 

to prevent or delay type 2 diabetes. 

15 
How can I prevent or delay getting
 

type 2 diabetes later in life?
 

You can do a lot to prevent or delay type 2 diabetes. 

●	 Reach and maintain a reasonable weight. Even 

if you stay above your ideal weight, losing 5 to 7 

percent of your body weight is enough to make 

a big difference. For example, if you weigh 200 

pounds, losing 10 to 14 pounds can greatly 

reduce your chance of getting diabetes. 

●	 Be physically active for 30 minutes most days. 

Walk, swim, exercise, or go dancing. 

●	 Follow a healthy eating plan. Eat more grains, 

fruits, and vegetables. Cut down on fat and 

calories. A dietitian can help you design a 

meal plan. 

Remind your health care team to check your 

blood glucose levels regularly. Women who have 

had gestational diabetes should continue to be 

tested for diabetes or pre-diabetes every 1 to 2 

years. Diagnosing diabetes or pre-diabetes early 

can help prevent complications such as heart 

disease later. 

Your child’s risk for type 2 diabetes may be lower 

if you breastfeed your baby and if your child 

maintains a healthy weight. 

16
 
Where can I get more information? 

Diabetes Teachers (nurses, dietitians, and other 

health professionals) 

To find a diabetes teacher near you, call 

the American Association of Diabetes 

Educators toll-free at 1–800–TEAMUP4 

(1–800–832–6874). Or go to 

www.diabeteseducator.org and click on 

“Find a Diabetes Educator.” 

Dietitians 

To find a dietitian near 

you, call the American 

Dietetic Association’s 

National Center for 

Nutrition and Dietetics 

at 1–800–366–1655. Or 

go to www.eatright.org 

and click on “Find a 

Nutrition Professional.” 

Health Information 

To learn more about pregnancy, contact the 

National Institute of Child Health and Human 

Development (NICHD), part of the National 

Institutes of Health. Call NICHD toll-free at 

1–800–370–2943. Or go to www.nichd.nih.gov. 

17 
For more information about diabetes, contact the 

National Diabetes Information Clearinghouse 

(NDIC) (see the next page) for free copies of these 

publications: 

Managing Diabetes 

What I need to know about Diabetes Medicines 

What I need to know about Eating and Diabetes 

What I need to know about Physical Activity and Diabetes 

Your Guide to Diabetes: Type 1 and Type 2 

Preventing Type 2 Diabetes 

Am I at Risk for Type 2 Diabetes?
 

Small Steps. Big Rewards. Your GAME PLAN
 

for Preventing Type 2 Diabetes
 

Or you can read them online at 

www.diabetes.niddk.nih.gov/dm/a-z.asp. 

Acknowledgments 

The NDIC would like to thank the following
 

individuals who provided editorial guidance or
 

facilitated field-testing of this publication.
 

Boyd E. Metzger, M.D.
 

Northwestern University
 

Evanston, IL
 

Susan A. Biastre, R.D., L.D.N., C.D.E.
 

Women & Infants’ Hospital
 

Providence, RI
 

Beverly Gardner, R.D., L.D.N., C.D.E. 

Outpatient Nutrition & Diabetes Education Center 

Durham Regional Hospital 

Durham, NC 

18 
National Diabetes 

Information Clearinghouse 

1 Information Way
 

Bethesda, MD 20892–3560
 

Phone: 1–800–860–8747
 

Fax: 703–738–4929 

Email: ndic@info.niddk.nih.gov 

Internet: www.diabetes.niddk.nih.gov 

The National Diabetes Information Clearinghouse (NDIC) 

is a service of the National Institute of Diabetes and 

Digestive and Kidney Diseases (NIDDK). The NIDDK is 

part of the National Institutes of Health under the U.S. 

Department of Health and Human Services. Established 

in 1978, the Clearinghouse provides information about 

diabetes to people with diabetes and to their families, health 

care professionals, and the public. The NDIC answers 

inquiries, develops and distributes publications, and works 

closely with professional and patient organizations and 

Government agencies to coordinate resources about 

diabetes. 

Publications produced by the Clearinghouse are carefully 

reviewed by both NIDDK scientists and outside experts. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this booklet to duplicate and 

distribute as many copies as desired. 

This booklet is also available at www.diabetes.niddk.nih.gov. 
U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

National Institute of Diabetes and 

Digestive and Kidney Diseases 

NIH Publication No. 06–5129 

April 2006