Most women with gestational diabetes have no symptoms at all, which is why every pregnancy is screened with a glucose test between 24 and 28 weeks. When symptoms do appear, the most common are increased thirst, frequent urination, fatigue, blurred vision, and recurring yeast infections. Gestational diabetes affects an estimated 2-10% of pregnant individuals in the United States, and because it is usually silent, the glucose screening test, not symptoms, is how it is found.

Key Takeaways

Gestational diabetes usually has no symptoms. The only reliable way to detect it is a blood sugar test, which is why routine screening at 24-28 weeks matters even if you feel fine.
When symptoms occur, they are increased thirst, frequent urination, fatigue, blurred vision, and yeast infections or itching, all of which are easy to mistake for normal pregnancy discomforts.
The cause is insulin resistance driven by pregnancy hormones such as estrogen, cortisol, and human placental lactogen, not a lack of insulin.
Risk factors include being overweight, a family history of diabetes, being over 25, and belonging to certain ethnic groups.
Treatment is diet changes and regular exercise first, with insulin or medication added if blood sugar stays high.
After delivery, women who had gestational diabetes have a higher lifetime risk of type 2 diabetes and should be screened at least every three years.

Gestational diabetes symptoms: a pregnant woman reviewing blood sugar results with her doctor

What are the symptoms of gestational diabetes?

The symptoms of gestational diabetes, when they occur, are increased thirst, frequent urination, blurred vision, fatigue, and yeast infections. A majority of pregnant women with this condition do not demonstrate any symptoms. However, in some cases, women may experience increased thirst, frequent urination, and blurred vision.

A pregnant woman checking her blood sugar levels with a glucose meter

While gestational diabetes is often symptomless, there are some common signs that can point towards its presence. These include:

Increased thirst
Frequent urination
Occasionally blurred vision
Fatigue
Yeast infections
General itching or thrush

Weight gain during pregnancy can also be a factor in gestational diabetes, making it vital to monitor weight and maintain a healthy diet. Recognizing these symptoms early can help ensure that both the mother and baby's health is preserved, and a potentially complicated delivery is averted. Many of these signs overlap with the general signs of diabetes in women, which is one reason they are so easy to overlook during pregnancy.

Does gestational diabetes always cause symptoms?

No. Gestational diabetes often flies under the radar, presenting no visible symptoms that could raise a red flag. If any symptoms do manifest, they may be subtle, such as increased thirst or more frequent urination.

Thus, it is essential to be vigilant and have regular check-ups during pregnancy to keep an eye on blood sugar levels, even if no obvious symptoms are present. The seemingly ordinary nature of these symptoms can make it easy to dismiss them as typical pregnancy discomforts, which is why the glucose screening test is built into standard prenatal care rather than left to symptom reporting.

What causes gestational diabetes?

Gestational diabetes is caused by insulin resistance that develops during pregnancy. During pregnancy, hormonal changes can disrupt the normal functioning of insulin, leading to gestational diabetes. The body's inability to use insulin effectively during pregnancy, known as insulin resistance, is the primary cause of gestational diabetes. Unlike type 1 diabetes, it is not caused by a lack of insulin.

Hormonal changes in pregnancy

Pregnancy hormones block insulin. As pregnancy progresses, the body undergoes significant hormonal changes. Hormones such as estrogen, cortisol, and human placental lactogen can block insulin, leading to insulin resistance, a key factor in the development of gestational diabetes. These hormonal fluctuations can disrupt the insulin's regular functioning, causing an increase in blood sugar levels and potentially leading to gestational diabetes.

Insulin resistance

Insulin resistance is a condition where the body cannot use insulin effectively, leading to high blood sugar levels. This can be attributed to a range of factors such as genetics, obesity, and lack of physical activity. If left unmanaged, insulin resistance can lead to gestational diabetes, making it crucial to maintain a healthy lifestyle during pregnancy. For a fuller explanation of how this works, read our guide to insulin resistance and improving sensitivity.

Who is most at risk of gestational diabetes?

Women who are overweight, have a family history of diabetes, are over 25, or belong to certain ethnic groups are at higher risk of gestational diabetes. Certain risk factors increase the likelihood of developing gestational diabetes. These include:

Being overweight or obese
Having a family history of diabetes
Being over 25 years old
Belonging to certain ethnicities

Individuals with these risk factors are at a higher risk of developing gestational diabetes. It is essential to be aware of these risk factors, as they can help in early detection and management of gestational diabetes, thereby minimizing potential complications. Many of the same diabetes causes and risk factors apply outside of pregnancy too.

How is gestational diabetes diagnosed?

Gestational diabetes is diagnosed with a glucose tolerance test, usually between 24 and 28 weeks of pregnancy. Diagnosing gestational diabetes involves a series of tests to measure blood sugar levels. These tests include initial screening, glucose tolerance tests, and postpartum screening. Early diagnosis can help manage blood sugar levels effectively, reducing the risk of complications for both the mother and the baby.

Test	When it happens	What it involves
Initial screening	24-28 weeks of pregnancy (earlier if you have risk factors)	A glucose drink followed by a blood draw to see how your body processes sugar
Glucose tolerance test (OGTT)	After an abnormal screening result	A sweetened solution with blood glucose checked at regular intervals; elevated results in two of the three draws confirm the diagnosis
Postpartum screening	After the baby is born, then at least every three years for life	A blood sugar test to check for persistent diabetes or prediabetes

Initial screening

Initial screening for gestational diabetes typically occurs between 24-28 weeks of gestation and involves an oral glucose tolerance test (OGTT). This test measures how the body processes sugar and can help detect gestational diabetes at an early stage, ensuring timely intervention and treatment. If you want to understand the different blood tests used, see our overview of diabetes tests and diagnosis.

Glucose tolerance test

The glucose tolerance test is a crucial diagnostic tool for gestational diabetes. This test involves consuming a sweetened solution and having blood glucose levels monitored at regular intervals. If the blood sugar levels are elevated in two of the three blood draws, a diagnosis of gestational diabetes is given.

Postpartum screening

Postpartum screening is conducted after the baby is born to check for persistent diabetes. This is crucial as some women may continue to have diabetes after delivery, or they may have type 2 diabetes that was not diagnosed before pregnancy. Regular screening helps in early detection and management of diabetes, ensuring the health of the mother post-delivery.

How is gestational diabetes treated?

Gestational diabetes is treated with diet changes and regular exercise first, with medication or insulin added if blood sugar stays above target. Once diagnosed, gestational diabetes can be effectively managed through a combination of diet modifications, regular exercise, and medication or insulin injections if necessary. These strategies can help maintain normal blood sugar levels, ensuring a healthy pregnancy and reducing the risk of complications. It is important to work closely with your healthcare provider to develop an individualized plan that meets your needs.

Diet changes

Diet plays a critical role in managing gestational diabetes. A balanced diet rich in whole fruits, vegetables, lean proteins, and healthy fats can help maintain normal blood sugar levels. Avoiding simple carbohydrates and sugary drinks is also crucial. Remember, moderation is key: even when eating healthy foods, they should be consumed in appropriate portions. Our gestational diabetes diet guide covers meal planning in detail, and the list of foods to avoid with diabetes applies during pregnancy as well.

Exercise

Regular physical activity is another cornerstone of gestational diabetes management. Exercise helps lower blood sugar levels and improves overall health. Engaging in both aerobic and resistance exercises, such as walking, swimming, and prenatal exercise classes, can be beneficial. The crucial part is to make it a regular part of your routine and do it at a moderate intensity, with your provider's approval.

Medication and insulin

In some cases, diet and exercise may not be enough to manage blood sugar levels. Medication or insulin injections may be prescribed as part of the treatment plan. While insulin and metformin are commonly employed, other drugs like glyburide may also be used. However, it's important to note that these treatments are used in conjunction with lifestyle modifications, not as a substitute. Regular home monitoring is part of the plan; here is why checking your blood sugar matters.

What are the complications of untreated gestational diabetes?

Untreated gestational diabetes raises the risk of high blood pressure and preeclampsia for the mother, and of a large baby (macrosomia) and low blood sugar after birth for the baby. If left unmanaged, gestational diabetes can have serious complications for both the mother and baby.

Complications for the mother

For the mother, complications can include high blood pressure, preeclampsia, and a higher likelihood of needing a C-section. These complications can affect the mother's health and the delivery process, making it crucial to manage gestational diabetes effectively.

Complications for the baby

For the baby, complications can include macrosomia, or being significantly larger than average, and hypoglycemia, or low blood sugar levels. These can lead to a difficult delivery and potential health issues for the baby after birth, emphasizing the importance of managing the mother's blood sugar levels during pregnancy to maintain the baby's blood sugar. Macrosomia can also cause damage to the baby's shoulders during birth, and newborns may experience respiratory distress syndrome.

How can you lower your risk of gestational diabetes?

You can lower your risk of gestational diabetes by eating a balanced diet, exercising regularly, and reaching a healthy weight before and during pregnancy. While gestational diabetes can be a daunting diagnosis, there are steps that can be taken to reduce the risk of developing this condition. Leading a healthy lifestyle before and during pregnancy can significantly lower the risk of developing gestational diabetes.

Healthy eating

Maintaining a balanced, nutritious diet is key in preventing gestational diabetes. Here are some tips to help you achieve a healthy pregnancy and lower the risk of gestational diabetes:

Consume a variety of foods
Eat meals slowly and mindfully
Abstain from processed foods
Ensure adequate hydration

By following these guidelines provided by the American Diabetes Association, you can support your overall health and reduce the likelihood of developing gestational diabetes.

Regular physical activity

Engaging in regular physical activity can also be beneficial in preventing gestational diabetes. Regular exercise not only helps maintain a healthy weight, but also improves overall health, both of which can reduce the risk of developing gestational diabetes.

Does gestational diabetes go away after pregnancy?

Gestational diabetes usually goes away after delivery, but it leaves a higher lifetime risk of type 2 diabetes for the mother and a higher risk of obesity and type 2 diabetes for the child. While the focus is frequently on managing gestational diabetes during pregnancy, it is essential to remember that the condition can have long-term implications for both the mother and child.

The mother's long-term health

For the mother, gestational diabetes presents a serious health risk. It increases her chances of developing type 2 diabetes and cardiovascular disease later in life. Regular monitoring of blood sugar levels after pregnancy is crucial, and women with a history of gestational diabetes should be screened for diabetes or prediabetes on a lifelong basis, at least every three years. Learn the prediabetes symptoms to watch for, and read our expert strategies for preventing type 2 diabetes after gestational diabetes.

The child's long-term health

For the child, being born to a mother with gestational diabetes can increase the risk of obesity, type 2 diabetes, and other metabolic disorders later in life. This highlights the need for early intervention and ongoing monitoring of children born to mothers with gestational diabetes. Early intervention can include lifestyle changes such as diet and exercise, as well as medication if necessary.

When should you see a doctor about gestational diabetes symptoms?

See your doctor or midwife promptly if you notice increased thirst, frequent urination, blurred vision, unusual fatigue, or recurring yeast infections during pregnancy, even though these can seem like ordinary pregnancy discomforts. If you have risk factors such as being overweight, a family history of diabetes, or a previous pregnancy with gestational diabetes, ask about earlier screening rather than waiting until 24-28 weeks. Early diagnosis and treatment can help overcome insulin resistance and manage the condition effectively, ensuring a healthy pregnancy and delivery. Do not skip the routine glucose screening test, because for most women it is the only sign.

Frequently asked questions about gestational diabetes symptoms

What are the warning signs of gestational diabetes during pregnancy?

Excessive thirst, frequent urination, fatigue and blurred vision are all warning signs of gestational diabetes during pregnancy and should not be ignored. Yeast infections and general itching can also occur. Prompt medical attention is necessary to ensure the health and safety of both mother and baby.

When do gestational diabetes symptoms start?

Gestational diabetes usually does not present any signs or symptoms, and the only way to detect it is through a blood sugar test. Insulin resistance from pregnancy hormones builds through the second trimester, which is why screening is timed for 24-28 weeks. Some women may experience slight symptoms such as increased thirst before that point.

Are there signs of gestational diabetes before the glucose test?

Usually not. Most women feel normal before the glucose test, and symptoms such as thirst, frequent urination, and fatigue overlap with ordinary pregnancy. If you notice them, or you have strong risk factors, tell your provider; they may screen you earlier in pregnancy.

How does gestational diabetes make you feel?

Gestational diabetes can lead to increased thirst, frequent urination, dry mouth, and fatigue, leaving you feeling thirsty, drained, and uncomfortable. Many women feel nothing unusual at all. These symptoms can be managed with lifestyle changes, such as eating a balanced diet and exercising regularly, and your doctor may prescribe medication to help control your blood sugar levels.

Is increased hunger a symptom of gestational diabetes?

Increased hunger can occur with high blood sugar in any form of diabetes, but it is a weak signal in pregnancy because appetite naturally rises. Thirst, frequent urination, and fatigue are more typical, and none of them are reliable enough to replace the glucose test.

How harmful is gestational diabetes to the baby?

Gestational diabetes can be harmful to the baby, leading to potential complications such as larger babies delivered by cesarean section, respiratory distress syndrome, and low blood glucose levels in the newborn. With blood sugar kept in range through diet, exercise, and medication where needed, most women with gestational diabetes deliver a healthy baby.

References, studies and sources

Centers for Disease Control and Prevention (CDC). Gestational Diabetes. https://www.cdc.gov/diabetes/about/gestational-diabetes.html
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Gestational Diabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/gestational
American Diabetes Association. Gestational Diabetes. https://diabetes.org/about-diabetes/gestational-diabetes
UCSF Health. Dietary Recommendations for Gestational Diabetes. https://www.ucsfhealth.org/education/dietary-recommendations-for-gestational-diabetes

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