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.

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. 

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.

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. 

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  the 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. 

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) 
• 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. 

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. 

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. 

• 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 

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. 

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. 

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. 

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. 

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 

Dietitians. 
To find a dietitian near you, call the American Dietetic Association's National Center for Nutrition and Dietetics. 

Health Information. 
To learn more about pregnancy, contact the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health. Call NICHD toll-free. 

Notes: Dr. Nelson Crumfield

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EditText of this page (last edited June 17, 2010)