Gestational Diabetes: Everything you need to know

February 2, 2022
7 minute read

During pregnancy, a woman’s blood sugar can become high, leading to diabetes. This type of diabetes is called gestational diabetes. It affects around 5% of pregnant women and even those who haven’t been affected by diabetes before.

Certain factors can increase your chances of developing gestational diabetes and there are treatment options that can help to manage it. In most cases, gestational diabetes disappears after birth and in this blog, we discuss how it can affect pregnancy and the different management options.

Symptoms and risks of gestational diabetes

There are no obvious symptoms of gestational diabetes and women generally find out they have it when they get tested for it during their second trimester. Some women may experience the following symptoms if their blood sugar gets too high:

  • increased thirst
  • needing to urinate more often
  • a dry mouth
  • tiredness

However, it is worth noting that some of the above symptoms are common in pregnancy and are not associated with being a sign of gestational diabetes. It is recommended you speak to your GP or midwife if you are concerned about any symptoms you may experience.

Some women may be screened for the condition earlier if they are greater risk of developing it, for example, if they have a family history of diabetes.

A woman may be at increased risk if:

  • your body mass index is greater than 30. See the NHS BMI calculator here.
  • you previously had a baby that weighed 10lb or more at birth
  • you previously had gestational diabetes during another pregnancy
  • one of your parents or siblings has diabetes
  • you are of Black, south Asian, African-Caribbean or Middle Eastern origin (even if you were born in the UK)

Testing for gestational diabetes

At around 8 to 12 weeks of your pregnancy and during your first round of antenatal care, your midwife or doctor will ask you some questions to determine your risk of developing gestational diabetes. If you are at greater risk - usually if you have one or more of the risk factors above - you will be offered an earlier screening test.

If you are not at increased risk, you will be given a test between 24 and 28 weeks. The test is called an oral glucose tolerance test (OGTT). It involves having a blood test in the morning, before you have anything to eat or drink, then you are given a glucose drink to have. After 2 hours, you will have another blood test to see how your body has processed the glucose. Your midwife or GP will discuss your result and provide you with treatment options if necessary.

Gestational diabetes and pregnancy

Gestational diabetes is more common in the second or third trimester, but it can develop at any stage of pregnancy. Most women with gestational diabetes have normal pregnancies with healthy babies however there are some exceptions as follows:

  • the baby growing larger than usual which may lead to difficulties during delivery. It also increases the chance of needing induced labour or a caesarean section
  • too much fluid that surrounds the baby (amniotic fluid) can cause premature labour or other problems at delivery
  • premature birth (before the 37th week of pregnancy)
  • pre-eclampsia - a condition that causes high blood pressure during pregnancy
  • jaundice in the baby or low blood sugar of the baby, which may require hospital treatment after they are born
  • stillbirth – although this is rare

Treatment for gestational diabetes

The problems linked with having gestational diabetes (see above) can be reduced by managing blood sugar levels. This can be controlled by making changes to your diet and exercise regime to effectively treat gestational diabetes. If this doesn’t work for you, you may be offered medication such as tablets or injections to control blood sugar levels.  

If you have gestational diabetes, you will be given a blood sugar monitor kit to help you manage the condition at home. Testing your blood glucose levels at home is straightforward with a small finger prick to place a drop of blood on a testing strip. You can find out more about how to test your blood sugar here. You will also be closely monitored throughout your pregnancy and at birth to keep an eye on any potential problems.

Diet tips

Simple changes to your diet can help to manage gestational diabetes. You will be referred to a dietician who can advise you further, but you may be advised to:

  • have three regular meals a day and do not skip any meals
  • eat plenty of fruit and vegetables, always aiming for 5 a day
  • eat wholewheat foods such as brown bread, rice and pasta
  • swap snacks high in sugar such as cakes and biscuits for fruit, nuts and seeds. Note you do not need to go on a no sugar diet
  • eat lean sources of protein with less fat such as chicken, turkey, and fish

Exercise tips

By doing physical exercise you lower your blood sugar levels and therefore exercise is a great way to help manage gestational diabetes. It is recommended pregnant women exercise for about 30 minutes every day to help reduce developing gestational diabetes or at least 2 hours and 30 minutes a week plus two days of strength exercises. You will be advised about safe pregnancy exercises by your midwife or GP.

Medication for gestational diabetes

If changes to your diet and exercise regime do not work for you in controlling your blood sugar levels, you may be offered medication such as metformin tablets or insulin injections which also help to reduce your blood sugar levels. In most cases, you can stop taking the medication once you have given birth, as usually gestational diabetes subsides.

Metformin is the most commonly prescribed medication for gestational diabetes. Occasionally, you may be given glibenclamide as an alternative. Metformin is a tablet taken up to three times a day with food and has the following side effects:

  • feeling or being sick
  • stomach cramps
  • diarrhoea
  • loss of appetite

To read more about metformin, click here.

Insulin injections may be administered for the following reasons:

  • if you cannot take metformin
  • it doesn’t work for you in controlling blood sugar levels
  • it causes adverse side effects
  • if you have very high blood sugar levels
  • if your baby is too large and you have too much fluid in your womb

You will be shown how to administer insulin yourself and counselled on the quantity and dosage required each day. Blood sugar levels can increase over pregnancy so your dose may be increased over time, or if you are not on medication to begin with you may need to take it at a later stage in your pregnancy.

You will be given lots more information on managing your gestational diabetes from your healthcare provider. Below are some other resources you can trust.

NHS Gestational Diabetes Treatment

Tommy’s Treatment for Gestational Diabetes

If you would like to speak to one of our friendly pharmacists about gestational diabetes, get in touch for advice and guidance.

Content last reviewed on:
February 2, 2022
Next review date:
February 2, 2024
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