Conditions we treat
Gestational diabetes is high blood glucose that develops during pregnancy in someone who did not have diabetes before. Hormones from the placenta make the body more resistant to insulin, and when the pancreas can’t keep up, glucose rises. It usually appears in the second half of pregnancy and rarely causes noticeable symptoms, which is why routine screening matters. With careful monitoring and treatment, risks for both parent and baby can be reduced, and most people with well-controlled gestational diabetes carry their pregnancy to full term.
5–9%
of U.S. pregnancies are affected by gestational diabetes each year
About half
of women with gestational diabetes go on to develop type 2 diabetes
4–12 weeks
after birth is when a follow-up blood glucose test is recommended
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As pregnancy progresses, the placenta releases hormones that interfere with insulin’s action. Most people make enough extra insulin to compensate. When the body can’t, glucose builds up in the blood and gestational diabetes develops, typically around the 24th week of pregnancy.
Gestational diabetes is not caused by anything you did. Some people diagnosed during pregnancy actually had mild, undetected diabetes beforehand, which is one reason follow-up testing after birth is so important.
Anyone can develop gestational diabetes, including people with no risk factors. Your risk is higher if you:
If you have risk factors, your care team may check your glucose early in pregnancy. When early results meet the standard diabetes thresholds, the condition is usually treated as diabetes that existed before pregnancy. Everyone else is typically tested between 24 and 28 weeks, using one of two approaches:
A fasting 75-gram oral glucose tolerance test. Gestational diabetes is diagnosed if any value meets or exceeds 92 mg/dL fasting, 180 mg/dL at 1 hour, or 153 mg/dL at 2 hours.
A non-fasting 50-gram glucose drink with a blood test 1 hour later, followed by a longer 100-gram, 3-hour test if the first result is elevated.
When glucose runs high, extra sugar reaches the baby, who can grow larger than expected. A large baby (9 pounds or more) raises the chance of a difficult delivery, shoulder injury, and cesarean birth. High blood pressure and preeclampsia are also more common with gestational diabetes.
After birth, babies may have low blood sugar or breathing problems and need extra monitoring. Children born after a gestational diabetes pregnancy also have a higher risk of overweight and diabetes later in life, so let your baby’s pediatrician know about your diagnosis.
Treatment centers on checking your glucose, typically when you wake up and after meals, and keeping it within the targets your care team sets. Commonly used targets are below 95 mg/dL fasting, and either below 140 mg/dL one hour or below 120 mg/dL two hours after a meal.
Many people reach their targets with nutrition changes and activity alone, such as three meals and two to three snacks a day and a 10- to 15-minute walk after meals. If glucose stays high, insulin is the recommended medication because it does not cross the placenta; oral medicines are sometimes used after discussing risks and benefits. The ACOG patient guide to gestational diabetes offers practical day-to-day tips.
Gestational diabetes can change quickly, so timely adjustments matter. Your endocrinologist reviews your glucose log or CGM data, often between regular visits, and starts or adjusts insulin when needed. We teach injection technique, how to prevent and treat low blood sugar, and how to adapt doses as insulin needs rise later in pregnancy.
We share every plan with your obstetrician or maternal-fetal medicine specialist so everyone works from the same information, and we plan ahead for insulin changes around delivery. Virtual visits make appointments easier to fit into a busy pregnancy; contact us to arrange a consultation.
Gestational diabetes usually resolves after birth, and insulin is typically stopped. But it signals a higher lifelong risk: according to the CDC, about half of women who had gestational diabetes go on to develop type 2 diabetes.
Plan for a glucose test 4 to 12 weeks after delivery, then diabetes testing every 1 to 3 years if results are normal. Staying active, working toward a healthy weight, and planning future pregnancies with your care team can help lower your risk. Gestational diabetes can return in a later pregnancy, so early screening next time is wise.
No. Gestational diabetes is caused mainly by pregnancy hormones that make insulin work less effectively, combined with factors such as genetics that you can’t control. It can occur in people with no risk factors at all. What matters now is working with your care team to keep your glucose in range for the rest of your pregnancy.
Babies are not born with diabetes because of gestational diabetes. However, they may have low blood sugar right after birth and need extra monitoring. Children born after a pregnancy with gestational diabetes have a higher risk of becoming overweight and developing type 2 diabetes later in life, so let your pediatrician know about your diagnosis.
It usually does, and most people can stop insulin after delivery. You should still have a glucose test 4 to 12 weeks after birth to make sure your levels have returned to normal, followed by diabetes testing every 1 to 3 years. Having had gestational diabetes raises your lifelong risk of type 2 diabetes, so ongoing checkups matter.
Yes. Insulin is the recommended medication for gestational diabetes when diet and activity aren’t enough, because it does not cross the placenta to the baby. Your care team will teach you how to inject it, how to recognize and treat low blood sugar, and how to adjust doses as your needs change during pregnancy.
Yes. Virtual visits work well for gestational diabetes because much of the care involves reviewing glucose readings and adjusting treatment quickly. A TopInspired endocrinologist can review your log or CGM data, adjust insulin, and share updates with your obstetric team, which can save you extra trips during an already busy pregnancy.
Last reviewed September 19, 2026. This page is educational and is not a substitute for personal medical advice — see our medical disclaimer.
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