Medical Conditions

Gestational Diabetes Risk

Content reviewed against published ACOG, NIH, Mayo Clinic guidelines

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If your baby has been diagnosed with or you suspect gestational diabetes risk, here is what the evidence says.

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.

Key takeaways

  • 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.
  • Usually normal when: You failed the one-hour glucose screen but passed the three-hour test (this is common and does not mean you have GDM)
  • Call your doctor if: You have very high blood sugar readings (above 200 mg/dL) that do not come down
  • Varies by age — see the age-by-age breakdown below
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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

Probably normal when...
  • 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
Mention at your next visit when...
  • 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
Act now when...
  • 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

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Gestational Diabetes Risk.

Things to mention

  • 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

Observations to share

  • 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

Urgent signs to report immediately

  • 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

My notes

From ismybabyalright.com — free, evidence-based baby health guides

Milestone

Month-by-Month Development

Detailed monthly development guides from birth through 24 months.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is gestational diabetes risk normal?
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.
When should I call the doctor about gestational diabetes risk?
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
When is gestational diabetes risk normal?
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
What causes gestational diabetes risk?
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. Common explanations include: 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.
What should I mention to my pediatrician about gestational diabetes risk?
You should mention gestational diabetes risk at your next visit if: 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.
Is gestational diabetes risk normal at 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.
Is gestational diabetes risk normal at 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.
Should I go to the ER for gestational diabetes risk?
Seek emergency care if you have very high blood sugar readings (above 200 mg/dL) that do not come down, or if you develop signs of diabetic ketoacidosis: nausea, vomiting, fruity-smelling breath, confusion, or rapid breathing. When in doubt, call your pediatrician's after-hours line for guidance.
Does gestational diabetes risk go away on its own?
In many cases, gestational diabetes risk resolves on its own, especially when you failed the one-hour glucose screen but passed the three-hour test (this is common and does not mean you have GDM). By 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.
ACOGNIHMAYO CLINIC

References

  1. [1]American College of Obstetricians and Gynecologists. Gestational Diabetes. ACOG Practice Bulletin No. 190, 2018. ACOG
  2. [2]National Institute of Diabetes and Digestive and Kidney Diseases. Gestational Diabetes. NIDDK, 2023. NIH
  3. [3]Mayo Clinic. Gestational diabetes - Symptoms and causes. Mayo Clinic, 2023. Mayo Clinic

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Resources

Well-Baby Visit PrepPregnancy TrackerBaby Tracker

Bottom line

Most cases of gestational diabetes risk are normal. Talk to your pediatrician if you have very high blood sugar readings (above 200 mg/dl) that do not come down.

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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