Gestational Diabetes Risk
The short answer
Gestational diabetes develops when your body cannot produce enough insulin during pregnancy to handle the increased blood sugar levels. It affects about 6-9% of pregnancies and is very manageable with diet, exercise, and sometimes medication. Most women with gestational diabetes deliver healthy babies with proper monitoring and care.
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By Age
What to expect by age
First trimester
Gestational diabetes is typically not diagnosed in the first trimester, but early screening may be offered if you have risk factors such as obesity, a history of GDM in a prior pregnancy, PCOS, or a strong family history of type 2 diabetes. If you are flagged early, your provider may order an early glucose tolerance test between weeks 8-12.
Second trimester
Most women are screened for gestational diabetes between 24-28 weeks with a glucose challenge test. If you fail the one-hour screen, a three-hour glucose tolerance test confirms the diagnosis. Being diagnosed at this stage is very common and gives you plenty of time to manage blood sugar levels through diet and lifestyle changes.
Third trimester
During the third trimester, managing gestational diabetes becomes increasingly important as the baby grows rapidly. Your provider will likely monitor your blood sugar closely, and the baby may be monitored via non-stress tests and ultrasounds to track growth. Uncontrolled GDM can lead to a larger baby (macrosomia), but controlled GDM typically results in normal delivery outcomes.
Postpartum
Gestational diabetes usually resolves after delivery. However, your blood sugar will be checked after birth and again at 6-12 weeks postpartum. Women who had gestational diabetes have a higher lifetime risk of developing type 2 diabetes, so ongoing screening every 1-3 years is recommended along with maintaining a healthy diet and exercise habits.
What Should You Do?
When to take action
- You failed the one-hour glucose screen but passed the three-hour test (this is common and does not mean you have GDM)
- Your blood sugar is well-controlled with diet and exercise modifications alone
- Your baby is growing within the normal range on ultrasound despite your GDM diagnosis
- You have occasional slightly elevated readings but your average blood sugar is within target
- You are consistently getting blood sugar readings above your target range despite dietary changes
- You are experiencing excessive thirst, frequent urination, or blurry vision during pregnancy
- Your baby is measuring large for gestational age on ultrasound
- You have very high blood sugar readings (above 200 mg/dL) that do not come down
- You develop signs of diabetic ketoacidosis: nausea, vomiting, fruity-smelling breath, confusion, or rapid breathing
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
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How to Advocate for Your Child's Needs
You know your child better than anyone, and your observations matter. If you feel something is not right with your child's development or health, you have every right to ask questions, request evaluations, and seek second opinions. Advocating for your child is not being difficult - it is being a good parent.
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Research has found statistical associations between atopic conditions (eczema, food allergies, asthma) and certain neurodevelopmental differences such as ADHD and autism spectrum disorder. However, having allergies does not mean your child will be neurodivergent, and most children with allergies develop typically. These conditions may share some underlying immune and genetic pathways, but one does not cause the other.